The article discussesthe currentstate of the care level for fetuses, newborns and children with congenital abnormalities of the cardiovascular system. There are considered the features of prenatal diagnostics of heart defects and aspects of the management of pregnancy and childbirth of women with the specified pathology in the fetus. The authors made the analysis of the existing problems in the diagnosis and treatment of congenital heart defects and heart rhythm disorders in children. The article substantiates the introduction of the perinatal cardiology concept and formulates the main issues to be solved at this stage of development.

Infantile cerebral palsy (cerebral palsy) is one of the most common diseases of the nervoussystem in children. The etiology of cerebral palsy may differ, but structural changes in the brain in children are similar, regardless of clinical form. The paper summarizes the results of the recent studies on structural changes in the brain due to cerebral palsy. The literature sources demonstrate that the term of etiological factors impact on the developing brain of the fetus determines the characteristics of brain damage and localization of the damage, as well as the nature of the response from the nervous system.

The review focuses on autoimmune encephalitis with antibodies to NMDA receptors, previously unknown autoimmune disease of the central nervous system, described in 2007. Anti-NMDAR encephalitis develops in adults and children, due to the tumor process and without it, it is manifested by characteristic syndrome of neurological and mental disorders. The authors separate anti-NMDAR encephalitis, which develops after the resolution of encephalitis caused by the herpes simplex virus-1. They describe the clinical manifestations of anti-NMDAR encephalitis in children and the effectiveness of early immunotherapy. Perspectively they discuss the pathogenesis of the disease, as well as the connection of herpes simplex virus infection and the development of anti-NMDAR encephalitis.

Bone sarcomas account for 7% in the structure of malignant tumors in children, osteosarcomas take 35–50% of them. A significant proportion of patients are diagnosed at the spread stages of the disease, dictating the need to search for new approachesto treatment. Herewith the optimal therapeutic strategy is unknown, the results of treatment of children remain unsatisfactory. Part II describes the achievements in the field of personalized therapy, illustrating the vector of development of the principles of treatment of such complex diseases, which were fatal for most patients a few years ago.

It is fundamental truth that breast milk is the best food for a newborn, providing it with energy, high-quality nutrients, as well as a large variety of biologically active components necessary for adequate physical and psychomotor development. Acting either as part of complex biological structures or separately, the breast milk components, including personalized microbial and immune, regulate morphogenesis at the molecular and cellular level, determine the metabolism nature, guide the development of mucosal immunity in the child’s body. It is impossible to identify any component of breast milk as the main component that determines its functional activity and provides the benefits of natural feeding. The purpose of this review is to describe the role of prebiotics in breast milk and infant formula for the formation and maintenance of a healthy baby intestinal microbiota, which is a key element in the formation of normal digestion, a functionally sound immune system and metabolism.

The article contains the first-ever data on correlation of the level of N-terminal fragment of natriuretic peptide in the serum of fullterm newborns with circulatory failure and persistent pulmonary hypertension syndrome; while the N-terminal fragment of natriuretic peptide can serve as a marker of circulatory failure in newborns. The study demonstrates that the dynamics of this peptide allows us to evaluate the effectiveness of the therapy.

Aim of the study. To identify the leading antenatal and intranatal risk factors for bronchopulmonary dysplasia based on the analysis of their prevalence and information content Materials and methods. We performed a prospective follow-up of 124 infants of gestational age of less than 32 weeks with the classical form of bronchopulmonary dysplasia (study group). The control group included 119 newborns with gestational age of less than 32 weeks without bronchopulmonary dysplasia. The parents of the compared groups were questioned, with the following assessment of the prevalence and informative value of antenatal and intranatal risk factors. Results. The leading antenatal and intranatal risk factors for the development of bronchopulmonary dysplasia are: acute respiratory viral infection in II-III trimester, threatened miscarriage, intrauterine growth retardation, Apgar score at the 1st (3 or less) and 5th minute (5 or less), body weight of less than 1400g at birth, body length less than 36 cm at birth, cesarean section, more then 6-hours waterless period. Conclusion. The  combination of  these intranatal and antenatal risk factors can be attributed to a group with high risk of bronchopulmonary dysplasia.

The results of diagnostics of obstructive uropathies and some other congenital changes in the kidneys, which were obtained using neonatal sonographic screening for 2018 in the neonatal unit of the Third Children’s Clinic of the Slovak Medical University, are presented. The results of thisstudy were compared with statistical data from the National Centerfor Medical Information of Slovakia for 2017–2018. The disadvantages of prenatal diagnosis in different regions of the Slovak Republic, as well as some administrative disadvantages of neonatal ultrasound screening at the present time, are shown. The importance of early diagnosis of obstructive uropathy is also shown.

Inhaled glucocorticosteroids are the main drugs used to control bronchial asthma in children. P450-cytochrome of  3A (CYP3A) family is involved in  their metabolism. CYP3A5-isoenzyme plays the leading role in  the respiratory tract. We described 6986A>G polymorphism in the CYP3A5 gene encoding this isoenzyme.

Aim of the study. To evaluate the association of CYP3A5 (6986A> G) gene polymorphism with the effectiveness of drugs in children with bronchial asthma.

Materials and methods. We examined 108 children from 6 to 17 years with bronchial asthma. The allergist carried out the dynamic outpatient polyclinic follow-up of patients, assessed the symptoms of the disease and corrected the corresponding basic therapy. All children underwent genotyping for the 6986A> G polymorphic marker of the CYP3A5 gene.

Results. Ten (9.26%) children were heterozygous for the 6986A> G polymorphic marker of  the CYP3A5 gene (AG genotype). The authors obtained statistically significant differences in the frequency of the AG genotype between the patients receiving control therapy for bronchial asthma of the 1st – 2nd stage and the patients with control therapy of the 3rd and higher stages in accordance with GINA criteria (p=0.031). In the group with severe bronchial asthma, the number of heterozygotes for the 6986A> G polymorphic marker of the CYP3A5 gene was significantly higher than among children with a mild course of the disease (p=0.029).

Conclusion. The AG genotype and A-allele (CYP3A5 gene, A6986A> G polymorphism) are associated with the need for greater volume of control therapy for bronchial asthma and they are risk factors of a more severe course of the disease.

The article presents the data of the clinical observation of a newborn with congenital bullous epidermolysis. The feature of this case is the course of this disease in the newborn with retardation of intrauterine development. Nowadays there is no aetiopathogenetic treatment of patients with inborn bullous epidermolysis and all existent methods of treatment of such patients are palliative. This study demonstrated a significant improvement of the baby’s clinical status.

The article describes a clinical case of early diagnosis of hereditary thrombophilia in a child in the neonatal period, based on clinical, laboratory and genetic examination. Clinical suspicion to hereditary hemostatic disorders, careful analysis of hereditary and family history allowed to identify and confirm with the help of PCR polymorphism of genes associated with hemostatic system in a child of two weeks of age. Early diagnosis allows to make an individual plan of observation and dynamic examination to prevent increased thrombosis and possible vascular catastrophe in the child, to prevent metabolic and hemostatic disorders in both the mother and her relatives, and in the probable future siblings of the patient, and in the long term and in his descendants.

Currently the issue of antibiotic resistance is urgent due to the unreasonable prescription of systemic antibiotics in the treatment of the upper respiratory tract infections. Frequent use of systemic antibiotic therapy in childhood leads to disruption of the microbiota and the development of secondary immunodeficiency. Alternative topical antibiotic therapy together with mucolytics allows the antibiotic to penetrate directly to the inflammation site and destroy biofilms. The article outlines the use of thiamphenicol glycinate acetylcysteinate in children with prolonged adenoiditis. In Russia this antibiotic is presented by Fluimucil® IT; it is manufactured in the form of a lyophilisate for both injectable solutions and solutions for inhalations and irrigation of mucous membranes. Thiamphenicol glycinate acetylcysteinate helps to improve the course of the disease, in some cases, to avoid invasive procedures and reduce the use of systemic antibiotics.

Purpose of the study. Evaluation of the clinical efficacy of polymethylsiloxane polyhydrate (Enterosgel) in the complex treatment of children of the first year of life with diseases of the digestive system.

Patients and methods. The authors carried out a retrospective analysis of the clinical course of diseases of the digestive organs of noninfectious etiology, the study included 38 patients of the first year of life (age 0.40 [0.25; 0.58] years; a continuousstudy of patients), who were treated with Enterosgel in the complex treatment. The comparison group consisted of 12 children (age 0.42 [0.25; 0.60] years) with diseases of the digestive organs, who did notreceive Enterosgel in complex treatment. The authors carried out a comparative assessment of the symptoms of intoxication, the nature of the stool, indicators of clinical blood tests and length of stay in the hospital.

Results. The patients treated with Enterosgel demonstrated faster relief of intoxication symptoms and stool normalization; the length of hospital stay decreased 2 times, negative changes in blood tests and side effects of the drug were not observed.

Conclusion. Complex treatment with Enterosgel of the diseases of the digestive organs in children of the first year of life is accompanied by more rapid relief of pathological symptoms and it reduces stay in the hospital, it is not accompanied by side effects, allowing us to recommend Enterosgel for the complex treatment of children of the first year of life.

Misdiagnosis of epilepsy is a common phenomenon (up to 20% of the total population of patients with epilepsy and up to 30–40% in the population of pharmacoresistant epilepsy) and dangerous, leads to significant social restrictions and is accompanied by significant unjustified medical expenses. The objective reasons for misdiagnosis include a large number (about 40) of conditions that are similar and often indistinguishable in their clinical manifestations from epileptic seizures, descriptive character and lack of obligatory diagnostic criteries (especially electroencephalographic), limiting medical access to the necessary research methods. The subjective errors include insufficiently collecting anamnesis, exaggerating the possibility of developing a more rare disease (in this case epilepsy), a false impression of the doctor that if epilepsy is not diagnosed, then it will have the most terrible consequences. The situation of misdiagnosis is aggravated by the fact that neurophysiologists are more likely to overestimate the EEG in the direction of epileptic and epileptiform (interictal) phenomena. Subjective errors are eliminated by learning and self-learning. Even the most experienced epileptologists can make mistakes with the diagnosis, and in a certain sense mistakes are inevitable. We can’t always wait for the final diagnosis and often have to start treatment without being 100% sure of the diagnosis of epilepsy. Therefore, it is necessary to practice the periodic revision of the diagnosis of epilepsy, especially in cases where the disease is difficult to treat.

In this article topical issues in treatment of acute respiratory infections in children and place of both exogenous interferons and interferon inducer drugs in their treatment are reviewed, including mechanisms of action, advantages and disadvantages of their application, special features of use in children. The latest clinical and laboratory data on the efficacy meglumine acridone acetate use in this pathology are given here. Depletion of inflammatory manifestations, correction of immune system imbalance were observed, leading to reduction of symptoms severity and disease duration, which, along with the good tolerability of the drug allows us to recommend it for widespread use in children.

Active studies of atopic dermatitis (AtD) have revealed new disease pathways and confirmed the complex treatment approach need, including different forms of emollients (creams and bath treatments). Study aim: to show effectiveness of locally produced moisturizing cream and bathing oil combination (Lipobase baby trademark) in the complex treatment of babies and toddlers with AtD.

Patients and methods. Thirty children (60% boys) aged from 6 to 36 months with mild/moderate AtD were included in open prospective non-comparative study 30 days long. Initial and after each 2 weeks SCORAD and dairies for 10 points skin itch and sleep disturbance scores, moisturizers consumption and adverse events were evaluated. Global evaluation of treatment effectiveness score were performed by patient’s doctor.

Results. Medium compliance for moisturizers consumption was 89.2% days. Medium SCORAD results decreased from visit 1 to 3: from 23.5±7.3 points to 18.7±4.9 points and to 14.6±3.1 points. After 2 weeks complex therapy including investigated moisturizers, medium day skin itch score was reduced from 6.4 to 3.6 points, also as sleep disturbance score from 2.6 to 1.2 points. Direct moderate correlation (r=0.64, p=0.012) was revealed between number of days without skin itch or sleep disturbance and compliance to moisturizers consumption. No any adverse event caused by investigated products was registered.

Conclusion. Inclusion of locally produced moisturizing cream and bathing oil (Lipobase baby trademark) in the complex AtD therapy improve the treatment efficacy.

Conflict of interest: Products of medical cosmetics for use in this Protocol are provided by the Pharmatek Company LLC. Representatives of the Company did not participate in the statistical processing, interpretation of the results and preparation of this publication.

The article discusses the role of meat and meat products in the diet of younger children. It contains the data on the chemical composition of raw meat, traditionally used in the children’s diet. The authors outline modern sanitary and hygienic requirements to meat products for children of early age. They present new types of pate canned meat and canned poultry meat, their ingredients and chemical composition. There are recommendations on their use by children over eighteen months of life. 

Objective of the study. To analyze the modern literature on the legal regulation of the determination of the sex of newborns with disturbances of sexual development in Russia and abroad, as well as the right of these children for self-determination of their sex upon coming of age. Material and methods. The review is based on the domestic and foreign literature published overthe past 7 years, including in Pubmed. Results. There were revealed the modern problems of the legal regulation of determining the sex of newborns with developmental disorders in the territory of the Russian Federation. Conclusion. The right to the sex self-determination of  the children born with impaired sexual development upon coming of  age requires careful analysis by medical experts, as from a legal point of view it contributes to a more complete implementation of the constitutional principle of equality regardless of gender and ensures human rights in accordance with their perception and attitude.