A.N. Semyachkina (to the 80th birthday).

The article briefly describes the general ideas on the body’s biorhythms determining the essence of its homeostasis. The article pays special attention to the importance of alternative interaction of the body's reactions in the formation of biorhythms. It is emphasized that the violation of biorhythms (desynchronosis) is the most profound and most sensitive marker of functional disorders. In this regard, the practicing doctors should use methods of chronodiagnosis and chronotherapy more widely. The article presents the authors’ data and the data of other authors on the high efficiency of chronotherapy. This method, focused on the individual approach to the treatment of a child, makes it possible to increase the effectiveness of treatment while decreasing usage of drugs. The future of medicine is impossible without a chronobiological understanding of its problems.

Conflict of interest: The author of this article confirmed the lack of conflict of interest and financial support, which should be reported.

Atopic dermatitis is a disease of early childhood. Most children are infected with the herpes simplex virus at this age. The changes in  the congenital and adaptive immunity in  children with atopic dermatitis create precondition for the development of infectious complications, including those caused by herpes viruses. The authors of the article discuss details of various clinical manifestations of herpes infection in children with atopic dermatitis and they carry out differential diagnostics. Particular attention is paid to herpes eczema – the severe complication of atopic dermatitis in the course of disseminated herpes infection.

Conflict of interest: The authors of this article confirmed the lack of conflict of interest and financial support, which should be reported.

With every coming year more and more children suffer from speech problems, making their parents visit various specialists (pediatrician, neurologist, speech therapist, defectologist), who use their diagnostic techniques to detect speech disorders. The absence of a unified classification system and diagnostics leads to the late correction of speech disorders. The article considers main reasons for disturbances in normal speech development, risk factors of speech pathology, clinical manifestations of some types of speech disorders, various approaches to diagnosis and systematization of speech disorders.

Conflict of interest: The authors of this article confirmed the lack of conflict of interest and financial support, which should be reported.

Goat’s milk-based formulas are becoming more and more widespread in Europe and Russia. The article discusses the latest data on the composition and properties of goat’s milk. The article presents data on the content of functional components in goat’s milk, including lactoferrin and other bioactive peptides, oligosaccharides, nucleotides, polyamines and taurine. The authors assess adapted goat’s milk-based formulas and compare with cow’s milk-based formulas. The research described in  the article demonstrates the positive effect of goat’s milk-based formulas on the physical development of young children. The article presents the study demonstrating the effectiveness of Kabrita® Gold formula in young children with functional gastrointestinal disorders.

The fetal growth retardation takes one of  the leading places in  the structure of perinatal morbidity and mortality. The frequency of this pregnancy complication in Russia is high – from 3% to 24% among full-term infants and from 18% to 46% among premature newborns. The article analyzes the capabilities of various diagnostic methods for predicting fetal growth retardation. The more indicators are included in the review the more effective isitsreliability in the formation of risk groupsforthis pathology and more effective measures to prevent fetal growth retardation can be taken.

Conflict of interest: The authors of this article confirmed the lack of conflict of interest and financial support, which should be reported.

Primary immunodeficiency is a rare disease with a high medico-social significance. Objective: to characterize principal clinical syndromes in 35 patients from 12 to 37 years old with primary immunodeficiency associated with an abnormal antibody production. The infectious syndrome is the most significant syndrome, it was revealed in all the patients, in some cases it was combined with autoimmune, atopic and lymphoproliferative syndrome. Thus, there isthe need to inform physicians of variousspecialties about this pathology. 

Conflict of interest: The authors of this article confirmed the lack of conflict of interest and financial support, which should be reported.

The resuscitation aids using inspiratory support for a long time lead to changes of the nasal cavity and nasopharynx in premature infants, which can later lead to long-term persistent violations of nasal breathing. Objective: to identify possible pathological changes in the nasal cavity and nasopharynx in premature infants of different gestational age in the first six months of life. The authors carried out a cross-sectionalstudy of 178 premature infants of 3 months old (gestational age from 25 to 36 weeks). There were examined upper respiratory tract, the nasal cavity and nasopharynx by endoscopic method. Results: a high percentage of curvature of the nasal septum (84.9%), tubular mucus reflux (44.6%) and their combinations in premature infants. In our opinion, these defects are connected both with the peculiarity of the structure of the nasal septum in newborns, and long-term mechanical impact of the nasogastric tube and / or nasotracheal intubation tube. Conclusion: the frequency and nature of pathological processes in the nasal cavity and nasopharynx depend on the gestational age of children, and therefore all premature infants, in addition to examination by ENT doctor, need to undergo diagnostic endoscopy of the nasal cavity and nasopharynx during the first six months of life.

Conflict of interest: The authors of this article confirmed the absence conflict of interests, financial or any other support which should be reported.

For the purpose of comparative analysis of clinical and immunological parameters in children with juvenile idiopathic arthritis (n=56) and reactive arthritis (n=22) we determined the concentration of individual Th1- (IL-1β, IL-6, INF-γ), Th2- (IL-4) and Th17- associated interleukins (IL-17) in the blood serum. We conducted clinical examination of the patients, taking into account the duration of the disease, the amount of drug therapy and indicators of functional status. The concentration of interleukins in the serum was determined by enzyme immunoassay using ready-made commercial kits. We found that the course of juvenile idiopathic arthritis and reactive arthritis is characterized by a certain unidirectionality of disorders in the system of Th1-and Th2-associated cytokines. There were indentified key correlations between the studied interleukins for the diseases concerned. We proposed an interrelated analysis of immunological activity indicators, which allowed simplifying the differential diagnostics of articular form of juvenile idiopathic arthritis and reactive arthritis.

Conflict of interest: The authors of this article confirmed the lack of conflict of interest and financial support, which should be reported.

The article contains the analysis of Rosstat data for 2012–2016 on early neonatal death due to congenital developmental anomalies. From 2012 to 2016 there was an annual progressive decrease in the number of early neonatal deaths (from 6969 to 4113) in the Russian Federation. The total number of newborns died in the first 168 hours of life due congenital anomalies decreased from 1126 (2012) to 759 (2016), while the values of early neonatal mortality decreased from 366.4 to 217.8. However, the proportion of such infants increased from 16.2% (2012) to 18.5% (2016) from the total number of deaths in the early neonatal period. The type of defects and the frequency of their registration as the initial cause of early neonatal death differ in the federal districts of the Russian Federation and there are certain gender differences.

Conflict of interest: The authors of this article confirmed the lack of conflict of interest and financial support, which should be reported.

The article presents the organizational experience of medical care for children born with very low and extremely low body weight in the Ivanovo region. Medical care is carried out on the basis of the perinatal center, starting from the antenatal period until the age of 3 years. It includes the following steps: the first stage is the intensive care unit, the second stage is the pathology department for newborns and premature infants, and the third stage is catamnestic observation. The article describes organizational technologies of the regional model of medical care for children born with very low and extremely low body weight. There are data on the state of health and disability of the deeply premature infants.

Conflict of interest: The authors of this article confirmed the lack of conflict of interest and financial support, which should be reported.

Relevance. Statistical indicators are the basis for planning of the organization of medical care for children with cancer, as well as analysis of the effectiveness of medical care. Materials and methods. The authors have analyzed operational reports for 2017 of the executive authorities in the field of health care of 18 objects of the Russian Federation being part of the Central Federal District. Results. There 9 pediatric oncology departments, there are 464 children’s oncological beds, the bed occupancy per yearis 319.3. There are 91 doctors providing medical care to children with cancer, 64 (70.3%) of the doctors have a certificate of pediatric oncologist. In 11 subjects there are no Departments for Pediatric Oncology. There are 821 primary patients with malignant neoplasms. There are 156 deceased patients, 66 of them were diagnosed in 2017. 52 (6.3%) patients are revealed actively. There were 12 (per 100 thousand for the age group of 0–17 years) cases of incidence of malignant neoplasms, mortality is 2.3 (per 100 thousand for the age group of 0–17 years), one-year mortality is 8%. The average time taken to diagnose and to verify the diagnosis before the beginning of treatment remains unknown. Conclusion. Operational reports contain non-matching indicators, thus, the information is not completely reliable. Incidence rates are significantly lower than those in countries with high reliability of statistical data. The percentage of patients identified actively remains extremely low. In order to eliminate the noted defects, it is necessary to introduce a single database of children with cancer in the Russian Federation.

Conflict of interest: The author of this article confirmed the lack of conflict of interest and financial support, which should be reported.

Primary ciliary dyskinesia is a rare genetically determined pathology leading to the development of chronic inflammatory lesions of the respiratory system in children, impaired fertile function in older patients. The disease is characterized by an autosomal recessive mode of inheritance with marked genetic heterogeneity. The article describes clinical observation of a patient – carrier of a rare mutation and describes the features of this case.

Conflict of interest: The authors of this article confirmed the lack of conflict of interest and financial support, which should be reported.

Neonatal lupus is a complex of symptoms diagnosed in newborns whose mothers suffer from autoimmune rheumatic diseases; it is manifested by two main signs: diseases of the skin and heart. A newborn may have classic ring-shaped erythema, telangiectasia, skin atrophy, follicular plugs and scales. This skin lesion is usually combined with a partial or complete heart block due to fibrosis of its pathways. There is a Clinical case of a child with neonatal lupus from own practice.

Conflict of interest: The authors of this article confirmed the lack of conflict of interest and financial support, which should be reported.

Objective: comparative analysis of the antibacterial efficacy of local treatment of chronic tonsillitis in children. Material and methods. The  study included 116 children from 5 to 12 years old divided into two groups: Group 1 (main group) and Group 2 (control group), 59 and 57 patients respectively. All patients were subjected to examination of ENT organs, bacterial and viral antibodies check-up, and microbiological research of the tonsil’s lacunae. Group 1 was subjected to rinsing lacunas with a solution of furasol (potassium furazidin), Group 2 was subjected to rinsing lacunas with a solution of furatsilin (nitrofural). With similar input data, clinical examination and microbiological research in one month after the end of treatment showed higher efficacy of furazidine potassium in relation to the main pathogenic agents of the tonsil’s lacunae as compared to furatsilin. Conclusion: 1. The lacunae of the tonsils contain several microorganisms of different groups, which requires a more careful selection of the treatment in relation to bacteria with a high pathogenic potential. 2. Furasol is a highly effective antimicrobial drug for the local treatment of chronic tonsillitis, which helps to restore the biocenosis of the tonsils by affecting the pathogenic flora without adversely affecting saprophytic bacteria.

Conflict of interest: The authors of this article confirmed the lack of conflict of interest and financial support, which should be reported.

Summary. Objective: to characterize the dental health of adolescents with arterial hypertension and to increase its level with a complex of therapeutic and prophylactic measures based on the results obtained. The study included 130 adolescents (65 – with arterial hypertension and 65 – control group) of 14.3 ± 2 years old. The level of systolic blood pressure in the main group was higher than that of the adolescents in the control group (126.6 ± 12.6 mm Hg vs 113.2 ± 7.4 mm Hg, p=0.00009), while the level of diastolic blood pressure was comparable. The data obtained suggest that adolescents with arterial hypertension are characterized by unsatisfactory oral hygiene indicators and a significantly higher incidence of major dental diseases: dental caries and periodontitis. It justifies the selection of adolescents with arterial hypertension in a group that is vulnerable both to the development of new and to the progression of existing diseases of the dental-maxillary system, which can significantly worsen cardiovascular health. Therefore, there is a need to develop a system of preventive actions built on the basis of an interdisciplinary approach with the active participation of somatic and dental specialists.

Conflict of interest: The authors of this article confirmed the lack of conflict of interest and financial support, which should be reported.

The article demonstrates the prospectivity of the professional remote education for parents in the International internet school for parents (baby-inform.com) created by the All-Russian Public Organization “Union of Women-Doctors of Russia” (the member of  the World Association of Women-Doctors). The  project includes “School of  the future parents for antenatal clinics” and the “Room of a healthy child for children’s clinics”. For the first time in Russia there was tested the remote screening diagnostics of the development of children from 2 to 16 months in Moscow (n=545) using the Internet version of the KID-survey via the “Internet school”. 21.84% of children had a developmental lag, 48.62% had general development corresponded to the age, and 29.54% of children were ahead of the age indicators. The highest percentage of children with developmental lag wasfound in the areas “self-service” (23.85%) and “motor development” (23.3%) as compared to “speech development” (20.73%), “cognitive development” (20.55%) and “social” (19.48%). The implementation of Internet-School has been begun in the Far East.

Conflict of interest: The author of this article confirmed the lack of conflict of interest and financial support, which should be reported.

Febrile seizures are the age-dependent and predictively favorable condition, which is observed in children under 6 years. All febrile seizures are divided into simple (2/3 of all cases), complex and febrile status. Complicated seizuresinclude attacks with focalsymptoms, prolonged and recurring throughout the day. Simple febrile seizures are short, generalized, not repeated. Simple seizures do not harm the child’s neuropsychic development, they do not transform into epilepsy, and do not need chronic prescription of anticonvulsant therapy. A child with normal development and simple febrile seizures does not need an obligatory EEG and MRI of the brain. All the patients of 18 months old or less with the first episode of febrile seizures need to be hospitalized. The risk of recurrence of seizures and their transformation into epilepsy is higher in a child with complex seizures. There is a small group of children with prolonged seizures and / or febrile status, often with neuropsychiatric developmental delay, which needs to be monitored by a neurologist and further examination. Sometimes doctor prescribes long-term anticonvulsant therapy for the children of this group. Febrile seizures can be prevented with special dosage of anticonvulsant drugs quickly reaching a therapeutic concentration in the child’s brain. Febrile seizures are not a contraindication to vaccination and revaccination, attention should be paid in case of DTP vaccination in children with repeated prolonged seizures and / or febrile status.

Conflict of interest: The author of this article confirmed the lack of conflict of interest and financial support, which should be reported.

Each period of childhood is characterized by its own peculiarities of growth and development, the degree of morphological and functional maturity of individual organs and systems, the specifics of physiological and metabolic processes. Rational feeding and nutrition play a significant role in a child’s health. The authors presented modern approaches to the complementary food for children, its timing, taking into account the child’s readiness to receive new food, the composition of the dish, feeding technique, the formation of proper eating habits and behavior. The literature actively discusses the problem of the formation of taste preferences at early age; thisisthe period for the first acquaintance with varioustastes. The article demonstratesthe advantages of using products of industrial production. It is particularly important to overcome the negative attitude to new products – it determinesthe attention of the specialists to the problem of the introduction of complementary foods.

Conflict of interest: The authors of this article confirmed the lack of conflict of interest and financial support, which should be reported.

The scientific activity of M. Wilms is characterized by a versatility of his surveys and breadth of research. M. Wilms contributed to the development of clinical surgery and oncology by proposing new methods for diagnosing and treating the main forms of malignant tumors of the genital organs and kidneys; he made a significant contribution to the practice of world medicine. M. Wilms conducted classical studies of  teratoid tumors of  the ovaries and testes, mixed tumors, kidney tumors. The  tumor described by M. Wilms in 1899, is one of the most frequent malignant neoplasms in children, it usually occurs from 2 to 5 years, but it can be detected at any age, even in very old people. A talented scientist and teacher demanding of himself and his students, Max Wilms published over 130 scientific works, he was the only author of the vast majority of them.

Conflict of interest: The authors of this article confirmed the lack of conflict of interest and financial support, which should be reported.