The paper touches upon various problems of disabled children, which occur in all spheres of the life of a disabled child and his family. The factors that aggravate the already extremely difficult path of a child with disabilities to adequate rehabilitation support, education, acquisition of profession are identified.

The paper presents data on free radical oxidation as a universal physiological process in the cell. In health, at the low concentrations of reactive oxygen species under the control of the antioxidant system, these are involved in the regulation of vascular tone and immune defense and act as second messengers to transmit signals across the cell membrane. Urinary system diseases develop oxidative stress. The reactive oxygen species are shown to be involved in the regulation of extracellular matrix metabolism, apoptosis, by contributing to the development of nephrosclerosis and the progression of chronic kidney disease. Many aspects of free radical reactions in urinary system diseases in children require that they should be investigated using current direct control methods. There is a need for further development of new approaches to combination treatment using antioxidant agents in children with for urinary system diseases.

The paper reviews the data available in the literature on the health status and development of children born after in vitro fertilization (IVF). It analyzes the data of Russian and foreign publications in the period 1995 to 2013 with a predominant focus on large-scale multicenter studies. Results. Suboptimal perinatal outcomes (miscarriage, low birth weight, and their complications) are mainly caused by parental factors, such as infertility, advanced maternal age, and concurrent metabolic, genetic and epigenetic alterations, which affects the quality of gametes and the course of pregnancy and is likely to determine the increased (1,3—2) risk of congenital malformations and the need for their surgical correction in the children born after IVF as compared to those from spontaneous pregnancies. The only proven IVF-associated factor for suboptimal perinatal outcomes is multiple pregnancy. The data on the higher rate of somatic and other diseases in children born after IVF are controversial and unconfirmed by large-scale studies; it is difficult to compare the magnitude of genetic and epigenetic changes due to their rarity. The prediction of the reproductive status and delayed diseases (cancer, metabolic disturbances) in this group of children remains open.

The paper gives the results of reviewing the data available in the literature published in the past 10 years on the neuroinfections, including meningitides. It demonstrates the necessity of searching for new markers for the early diagnosis of purulent meningitides to make a differential diagnosis, to monitor the efficiency of antibiotic therapy, to make an early prediction of a disease outcome.

The status of 239 newborn infants born to mothers with hypertensive syndrome (a study group) and that of 51 neonates from healthy mothers (a control group) were analyzed. Neonatal mortality and morbidity rates were studied in relation to gestational age and the type and severity of hypertensive disorders. Hypertensive disorders in pregnancy were found to lead to still birth in 2,1% of cases, late miscarriage in 12,1%, prematurity in 47,7%, and intrauterine growth retardation in 27,6%. The incidence of diseases in the infants born to hypertensive mothers was 6,6 times higher than that in those from healthy mothers. The most common nosological entities among the newborn infants were intracranial hemorrhage (29,3%), respiratory distress syndrome (20,1%), hypoxic-ischemic brain damage (22,6%), polycythemia (8,4%), and hyperbihrubinemia (8,8%). Reproductive losses in hypertensive disorders accounted for 17,2% and occurred in 70,7% of cases in the early postnatal period. Severe pathology and prematurity are responsible for high neonatal morbidity and mortality rates.

Objective: to determine a relationship of individual risk factors in pregnant women to the occurrence of fetal congenital heart disease. A case-control study was performed in 764 pregnant women. An odds ratio (OR) and 95% confidence intervals (95% CI) were calculated to assess the role of risk factors. The presence of at least one risk factor for fetal heart disease was confirmed in 309 (40,4%) pregnant women. One hundred and fifty-six cases of fetal heart disease was diagnosed in the presence of a risk factor in 61 (8%) cases and in its absence in 95 (12,4%). Hereditary heart disease in her previous child and a pregnant woman herself was not a statistically significant risk factor: OR 1,43; 95% CI, 0,45—3,85; OR 2,67; 95 CI, 0,65—9,74, respectively. Analysis of the ultrasonographic markers of chromosomal abnormalities and threatened miscarriage in the first trimester also showed their low significance. There was no significant relationship between a pregnant woman's age over 35 years and the risk of fetal heart disease. In vitro fertilization as a risk factor for fetal heart disease was found to have no significant impact. A 2,2-fold increase in the risk of fetal heart disease (OR 2,23; 95 CI, 1,04—4,56) was associated with a pregnant woman's diseases (acute respiratory viral infection in the first trimester, urogenital or intrauterine infection, etc.). Thus, the investigation of the role of individual risk factors for fetal heart disease has not shown their statistical significance and calls for their further investigation to subsequently elaborate preventive measures.

Objective: to study the specific structural and functional features of erythrocyte membranes in the neonatal infants (и=181) from mothers with gestosis in relation to the clinical course of an early postnatal adaptation process. A control group consisted of 42 neo-nates rom mothers with physiological pregnancy. The biophysical state of erythrocyte membranes was investigated by fluorescence spectroscopy at birth and on day 4 of life. The indicators of fluidity in the deep and paraprotein layers of phospholipids were determined in relation to the pyrene eximer-to-monomer fluorescence ratio. By day 4 of life, the neonatal infants of healthy mothers were found to have increased viscosity (decreased fluidity) of membranes, which may be considered as an adaptive compensation mechanism upon transition to new living conditions. In the neonates of mothers with gestosis, these membrane changes were less pronounced and those of mothers with severe gestosis had no significant increase in membrane viscosity by day 4 of life, which was associated with the more severe course of an early postnatal adaptation period.

According to the data of Russian and international statistical offices, the rate of congenital malformations is on the rise This rate differs in the regions of one country; for instance, in Russia it ranges from 11,99 per 1,000 children in the Kursk Region and 12,27 in Ryazan to 40,03 in Chuvashia and 43,17 in North Ossetia. The paper gives the results of studying the rate of congenital malformations in the Republic of Sakha (Yakutia), which have indicated an increase in its morbidity in the Promyshnennyi and Vilyui group of areas versus other areas where the population is mainly employed in agriculture. It also shows the pattern of congenital anomalies in the Republic. The prevalence of congenital malformations affects infant mortality rates and it is one of the major factors of disability in the pediatric population.

Objective: to study the spectrum and frequency of dysplasia-dependent and connective tissue dysplasia-associated disorders in adolescents. One hundred and ten 10-to-14-year-old pupils of one of the Leninsk-Kuznetsky schools were examined. The presence and degree of undifferentiated connective tissue dysplasia (UCTD) were established according to the phenotypic characters; joint mobility was rated using the standard Beighton methods. The adolescents showed a high prevalence of the signs of UCTD whose degree corresponded to that of joint hypermobility. The latter was accompanied by joint pain in 89 (33,3%) adolescents in the study group or concurrent with scoliosis in 77,8% and platypodia in 22,2%. In a control group (я=29), scoliosis and platypodia were 2 and 3,3 times rarer, respectively; complaints of arthralgia were absent. After 3 years, the number of adolescents with platypodia increased up to 33,3% in the study group and up to 10,3% in the control group; that of teenagers with scoliosis did up to 81,5and 41,4%, respectively. A larger number of adolescents with CTD were noted to have vegetovascular disorders, more commonly with parasympathotonia with insufficient autonomic performance support. A great difference was retained in the frequency of myopia and biliary dyskinesia and in the incidence of respiratory infections. Thus, the high prevalence of dysplasia-dependent disorders in adolescents suggests that there is a need for the early detection of the signs of CTD in children to timely implement a package of prevention and health-improvement measures.

The diagnosis of neonatal skin diseases is often a complicated interdisciplinary problem. The authors present the data available in the literature data and their clinical observation of a newborn baby with Bloch—Sulzberger syndrome, a rare genetic dermatosis. The specific feature of the observation is the development of the disease immediately after birth and its complex differential diagnosis. Central nervous system involvement as epilepsy syndrome determines the severity of the patient's condition and seriously affects the prognosis of the disease. The issues of in-depth studies using molecular genetic technologies that enhance the value of medical genetic counseling to the family are discussed.

The specific features of epilepsy are analyzed in three siblings with biotinidase deficiency. The first sibling aged 10 months died in status epilepticus. The second baby was diagnosed with the disease at the age of 5 months. In the third sibling, pathogenetic treatment was started at birth. Emphasis is laid on the importance of early diagnosis and prompt therapy with biotin.

Objective: to reveal the specific features of somatic, reproductive, and mental health in adolescent girls with elevated dehydroepiandrosterone (DHEA) sulfate levels. One hundred and fifty-nine adolescent girls aged 15 to 18 years from Novosibirsk were examined. A set of studies encompassed clinical examination and examinations by a pediatrician and a gynecologist, abdominal and small pelvic ultrasounds, evaluation of the autonomic nervous system, determination of hormonal profiles, and psychological questionnaire survey. Every two girls had elevated DHEA sulfate levels. The girls with hyperandrogenism had most commonly somatic diseases, as well as psychological features, which require early diagnosis and differential clinical observation to reduce the risk of further reproductive dysfunction.

Congenital heart defects in children are the most important problem in neonatology and pediatrics, by making a significant contribution to the structure of neonatal/infantile mortality and childhood morbidity. Irrespective of the type of a defect, its presence affects hemodynamics and impairs normal vital activity. Children with hemodynamic heart defects belong to a risk group for severe respiratory syncytial (RS) virus infection. Contagion of such patients increases the length of their hospital stay, changes time periods for surgical intervention, complicates a postoperative period, and raises the risk of a fatal outcome. The possibilities of treatment for the infection are limited. Therefore its prevention is put in the forefront; for this purpose, palivizumab, the world's only drug, is used for the passive immunoprevention of RS virus infection in children at risk for its severe form. The drug can reduce in-hospital morbidity and the duration and severity of the disease. The current worldwide protocols for RS virus infection prevention are unified in terms of classifying the patients with congenital heart defects as a category requiring protection. The international and Russian experience with palivizumab could elaborate and propose the guidelines for the prevention of RS viral infection in patients with hemodynamic congenital heart defects, which are given in this paper and have been approved at the congress on Pediatric Cardiology 2014.

The efficacy of the probiotic "Linex for children" containing bifidobacteria to maintain the intestinal microflora and local intestinal immunity was studied in infants with acute respiratory viral infection (ARVI). All children received antibiotic therapy for evolving bacterial complications; 20 children from a study group were given the probiotic "Linex for children" along with antibiotics; 20 comparison group children with the same disease did not take the probiotic. Treatment with the probiotic did not deteriorate the intestinal microflora. Two thirds of the examined children showed improvement in the microflora composition, including normal biocenosis achievement. In the comparison group, the intestinal microflora was deteriorated in most children (и=15) and unchanged only in three. During the treatment of ARVI, the fecal slgA concentration increased in both groups, but after a probiotic cycle, it was significantly higher than in the comparison group (145,1+5,49 and 107,1+4,5 mg/g feces, respectively; /КО,05). The use of the probiotics also caused a six-fold increase in lysozyme concentrations in the coprofiltrate up to 33,8+2,30 ug/ml and no change in this indicator in the comparison group. It is expedient to use the probiotic "Linex for children" in infants with ARVI to prevent impairments in the intestinal microflora and local intestinal immunity during antibacterial therapy.

The objective of the investigation was to study the efficiency of dietary therapy incorporating New Zealand goat's milk-based buckwheat Bibikasha in the diets of 55 breast-fed babies with mild and moderate atopic dermatitis. The babies' age was 5 to 6 months. Of them, 30 babies who were given buckwheat Bibikasha as the first additional food formed a study group. A comparison group consisted of 25 babies who had milk-free instant buckwheat porridge as the first additional food. Low-allergen diet was prescribed for breast-feeding mothers. Incorporation of 150-ml New Zealand goat's milk-based buckwheat Bibikasha as the first cereal food in the diet of babies with atopic dermatitis showed its good tolerability and favorable effect on the course of the disease. Thus, multimodality therapy for atopic dermatitis in combination with dietary incorporation of the Bibikasha results in not only short-term positive results (remission on day 12 after therapy initiation and 3,4-fold reduction in SCORAD scores), but also a long-term positive effect (3,3-fold prolongation of remission and 3-fold reduction in the number of recurrences), and decreased levels of total serum IgE and allergen-specific IgE against casein with a good rate of weight gain. The dietary substitution of milk-free instant porridges for the new class of goat's milk-based formulas (Bibikasha) for babies with atopic dermatitis can optimize their dietary therapy.

The paper gives an update on the problems of nutrition in infants older than 1 year of age, as well as the list and amount of permissible foods. It is intended for pediatricians.

Thirty-nine infants aged 1,5 to 12 months with allergic enteropathy caused by cow's milk protein intolerance were comprehensively examined to evaluate the morphomnctional state of the intestinal mucosa in infants with food allergy in the first year of life and to analyze the efficiency of performed dietary therapy. Along with multiple coprological tests, fecal calprotectm levels were determined in the babies in the course of the disease. The maintained high levels with an unclear tendency towards a reduction in this indicator (/>=(),06) were registered on days 5—7 of hospital stay; calprotectm production was reduced on days 14—17 day during stabilization and relief of clinical symptoms. Ineffective dietary correction was accompanied by preserved clinical symptoms and elevated fecal calprotectm levels. The analysis of the efficiency of treatment has shown that dietary therapy using the infant formula based on the complete hydrolysis of protein with anti-inflammatory lipids causes a reduction in dermal and gastrointestinal manifestations. It has been concluded that fecal calprotectm determination is a non-invasive criterion for the diagnosis of the morphomnctional state of the intestine in infants with gastrointestinal food allergy and allows the evaluation of the efficiency of dietary therapy.

After the Chernobyl accident, exposure to penetrating radiation and inhalation of inspired air radionuclides has led to the changed function of respiratory organs and promoted the altered development and course of chronic allergic bronchopulmonary diseases. The purpose of the study was to evaluate the clinical state of respiratory organs and to assess the results of immunological examination in children living in the regions with different levels of radionuclide pollutants after the Chernobyl accident. Eighty-nine children aged 3 to 17 years with asthma and allergic bronchitis: 53 children living in the radionuchde-polluted regions of the Bryansk Region (a study group) and 36 matched case-control children residing in the radiation-free regions of the Bryansk and Moscow Regions (a comparison group) were examined. Respiratory pattern parameters (an acoustic component of respiratory performance in different frequency ranges) were estimated; the levels of immunoglobulins (IgA, IgE, IgM, and IgG) and circulating immune complexes (CIC), the dose of radioactive radiation exposure, and the surface activity of radionuclides were determined in the areas where the patients lived. The investigators established the staging of chronic allergic bronchopulmonary diseases, which was characterized by a decrease in their prevalence within the first 6—8 years after the Chernobyl accident, followed by an increase and simultaneous discordance in the prevalence of infectious diseases associated with a change in the immune system (T-and B-cell components, CIC, and local immune system). Asthma progression suggests that the pattern of respiratory system function is arduous in the children from radionuclide-polluted regions. The altered correlations between the respiratory pattern and immunological parameters status suggest that the radiation factor is implicated in the development of asthma. Of the most informative value are the indicators characterizing the acoustic components of high- and moderate-frequency bronchophonography.

Studies conducted in 28 frequently ill children and 71 children with tuberous sclerosis, by applying the energy-intensive technique (a process of ligand-dependent redistribution of immunoglobulin receptors in В lymphocytes), have shown that the body's bioenergy deficiency is detected in different conditions; it may be transient and also a sequel of inherited mutations. Its degree and qualitative differences depend on many causes, in particular on disease pathogenesis, patient age, etc.

The urinary levels of mlcroalbumin and P2-mlcroglobulin were determined in 71 patients aged 1 to 14 years with vesicoureteral reflux. According to the degree of reflux nephropathy as evidenced by dimercaptosuccinic acid (DMSA) scintigraphy, the patients were divided into 3 groups: 9 patients without reflux nephropathy (Group 2); 41 with mild reflux nephropathy (Group 3); and 21 with severe reflux nephropathy (Group 4). A control group (Group 1) consisted of 29 healthy children without a history of kidney disease. Mi-croalbumin and P2-microglobulin from the morning urine portions were determined by enzyme-linked immunosorbent assay (ELISA) and recalculated with reference to urinary creatinine. A relationship was found between the urinary levels of proteins and the severity of reflux nephropathy. There was a significant rise in urinary microalbumin and P2-microglobulin excretion levels in severe reflux nephropathy. This permits the use of this study in patients with reflux nephropathy as a diagnostic marker of its severity.