The results of historical and medical research reflecting the state of children's healthcare system during the most difficult period of our country history — World War II, 1941-1945 yy. — are presented in the article. The aim of this research is to show how the most tough challenges of children's healthcare were solved according to the archive and literature sources. The relevance of the study is determined by the fact that most of the works on this topic were carried out in the Soviet era, so because it was ideology-driven, these works could not show the real picture. Rare studies of the post-Soviet era about situation with children's health during the war are fragmented or have been performed only in some regions. The analysis of the performed study has shown that (despite the extraordinary circumstances of wartime) all the actions performed by central and local health authorities for children health maintenance could be considered as successful. The following tasks were solved: control of infection as the primary cause of children mortality, sensible food security during shortage or even lack of necessary products, implementation of medical help for evacuated children, restoring of paediatric services on the territories that were rid of occupation.

Fungal infections in these days have the major risk for patients who receive immunosuppressive therapy and suffer from immunodeficiency conditions during their long stay in a hospital. The literature review is dedicated to Candida auris that was firstly isolated in 2009. Later it was reported that this fungus is the cause of nosocomial infections which mortality rate reaches 72%. C. auris has multi-drug resistance and it can survive for a long time in the environment. The lack of sensitivity of diagnostic tests for this fungus detection is the main problem in clinical practice. This leads to inappropriate management and increases the risk of mortality due to infection. C. auris was included in the group of infectious agents that has the highest danger to public health according to the recent report of the Centre for Disease Control (USA).

Background. Dermatological complications of insulin therapy in children with type 1 diabetes (T1D) cause low patient retention to treatment, reduce insulin therapy (with injection pens and pumps) efficiency, limit the use of modern high-tech methods of glycemia monitoring. Objective. Our aim was to study the structure and risk factors of dermatological complications of insulin therapy in children with T1D. Methods. Children aged from 1 to 17 with T1D and their parents were interviewed using the questionnaire containing 28 questions about skin changes associated with insulin therapy or glycemia monitoring in the past and about injection techniques. Skin (local allergic and/or inflammation reactions) and subcutaneous fat (hypotrophy and hypertrophy) changes at injection, infusion set, catheter and sensor sites were estimated via patient examination. The structure of dermatological complications of insulin therapy and their correlation with injection technique, infusion pump sets installation and glycemia monitoring were analyzed. Results. The study has included 50 patients with median age of 12 years (10; 14), T1D duration of 4 years (3; 7). 32 patients have performed insulin injections via injection pens, others have used insulin pump therapy. Continuous glycemia monitoring via sensor-augmented pump was performed in 5 patients, flash glycemia monitoring — in 17 patients. Allergic reactions (urticarial-type) to insulin were reported in 4 (8%) cases. Signs of allergic contact dermatitis at the catheter/sensor site were revealed in 5/18 (28%) patients on insulin pump therapy (no rotation of infusion systems installation sites) and 10/22 (45%) patients on glycemia monitoring (3 with continuous glycemia monitoring, 7 with flash glycemia monitoring). Lipoatrophy was revealed in 1 patient (on insulin pump therapy), lipohypertrophy was revealed in 22 patients: 20/32 (63%) were using injection pens and 2/18 (11%) — insulin pump therapy. Lipohypertrophy was revealed more often on self-administration via injection pens (in all cases patients did not change the insulin injection site, the needle was replaced less than 1 time per day). Conclusion. Risk of dermatological complications in children with T1D is higher when the injection technique or infusion set installation is inappropriate.

Background. Hemolytic disease of the newborn due to AB0 incompatibility typically develops when mother has 0 (I) blood group and prenatal child has А (II) or B (III). Mother’s antibodies аand рhave immune interaction with the child’s antigens A or B in such situation. It became possible for woman with 0 (I) group to carry of the child with AB (IV) group due to the use of donor ovum for in vitro fertilization. Naturally it is impossible. Clinical Case Description. Hemolytic disease of the newborn development in the child with АВ(IV) Blood Group from the Mother with 0 (I) Blood Group is demonstrated. It was the child of the second pregnancy resulting from in vitro fertilization of donor ovum with intracytoplasmic sperm injection and further tubal embryo transfer. The disease was manifested with icteric and anemia syndromes. Hyperbilirubinemia presented from birth, maximum level was on the 5th day of life. The treatment included phototherapy and immunoglobulin intravenous injections. The child's condition was stabilized by the 6th day. Conclusion. The hemolytic disease of the newborn development is possible when the woman with 0 (I) blood group is carrying the fetus with AB (IV) group especially when we are using donor ovum for in vitro fertilization without taking into account the blood group of the donor. It must be considered during preimplantation genetic testing, selection and tubal embryo transfer.

Background. Acrodermatitis enteropathica is the rare form of inherited dermatoses. The disease onset in children is associated with the ablactation and the beginning of cow milk products use, that makes differential diagnosis of acrodermatitis and allergic dermatoses pretty difficult. The caution of specialists to hypozincemia at periorificial dermatitis combined with alopecia and diarrhea in infants will allow to establish correct diagnosis and choose management timely. Clinical Case Description. The clinical case of erosive- desquamative dermatitis combined with alopecia and hypozincemia is presented in this article. Positive dynamics of skin lesion due to administration with zinc sulfate medication is shown. Conclusion. The presence of periorificial dermatitis in the child of any age requires to perform the differential diagnosis for zinc deficiency conditions.

The system of palliative medical care for children in Russia has been actively developing in recent years. It is important to discuss the principles of outpatient palliative care organization in different regions of the country. The experience of creation and operating of outpatient liaison pediatric service based on non-profit charitable foundation is described.