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MALNUTRITION IN CHILDHOOD: HOW JUSTIFIED ARE OUR DOUBTS?
S.N. Borzakova, L.V. Bogomaz, A.E. Tikhomirova, Z.I. Kostoeva, E.N. Makarova, K.I. Grigoriev

Summary. The article reflects the results of an examination and questionnaire survey of 60 preschool children in two cities – Moscow and Galich (Kostroma region) – for compliance with age-related nutrition rules and compliance with generally accepted norms regarding the caloric content of food and the intake of macronutrients. Conclusion-suggestion: it is necessary to train pediatricians and parents on practical issues of teaching and monitoring proper nutrition of children.
Keywords: malnutrition, balanced nutrition, children

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ATOPIC DERMATITIS:STRATEGIES FOR LONG-TERM OUTDOOR THERAPY
V.R. Voronina

Summary. Atopic dermatitis is a chronic, pruritic, inflammatory skin disease that occurs most frequently in children. Еpidermal barrier dysfunktion and features of the immune response lead to the long term therapy necessity. Current approaches include the use of reactive and proactive topical anti-inflammatory therapy regimens. Efficacy and safety of 1% pimecrolimus crеme in long-term therapy of children with atopic dermatitis are presented.
Keywords: atopic dermatitis, topical treatment, long term treatment, pimecrolimus

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ASSESSMENT OF BODY WEIGHT IN INFANTS BORN WITH MILD INTRAUTERINE DEVELOPMENT DELAY
V.V. Derevtsov, E.V. Neudakhin, D.O. Ivanov, A.V. Derevtsova

Summary. One hundred and sixty-six children born on time were examined. Of these, 141 children were born to mothers with a medical history. They were divided into groups: group 1 – 72 children with mild intrauterine development delay (subgroup 1a – 57 children with hypotrophic type; subgroup 1b – 15 children with hypoplastic type), group 2 – 69 children without intrauterine development delay. The control (3rd) group consisted of 25 practically healthy children born to practi- cally healthy mothers. All children were examined in dynamics: at the age of 2–3 days (n = 166), 1 month (n = 146), 3 months (n = 138), 6 months (n = 131), 12 months (n = 119). The data of anamnesis, physical examination, body weight were analyzed. The body weight in grams was estimated. No medical intervention was performed. Nonparametric methods of statistical analysis were used. It was found that the 1a and 1b subgroups, as well as the groups 1, 2 and 3 were statistically significantly different according to the estimated indicator, the detection of violations at the early stages of the development of the pathological process contributes to the identification of groups of dispensary observation and the solution of the issue of corrective measures, including with the use of Elkar®, in children from mothers with complicated pregnancies.
Keywords: children, body weight, intrauterine growth retardation, hyperplastic and hypertrophic types, chronic stress, energotropic therapy, L-carnitine

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CLINICAL EFFICACY OF HEMOSTATIC THERAPY IN PEDIATRIC ENDOSCOPIC PRACTICE
A.S. Koshurnikova, A.V. Plotkin, S.G. Tereshchenko

Summary. The aim of the study is to develop new approaches to hemostatic therapy when performing endoscopic examinations in pediatric practice. Material and methods. Seventy children from 5 days of life to 17 years old were included in the work, admitted to the hospital with gastrointestinal bleeding (GCC) Forrest 1B, 2A, 2B against the background of erosive and ulcerative pathology of the mucous membrane of the upper and lower gastrointestinal tract. Because of GCC, the children were distributed as follows: group 1 – 25 people with GCC against the background of erosive and ulcerative defects of the mucous membrane of the upper sections of the gastrointestinal tract, group 2 – 17 people with pressure sores from long-standing foreign bodies in the lower third of the esophagus, group 3 – 7 newborns (3–7 days of life) with hematemesis via a nasogastric tube, group 4 – 12 children with colon polyps on a wide leg, group 5 – 3 children with a manifestation of ulcerative colitis, group 6 – 6 people with severe contact bleeding after biopsy of the mucous membrane in the esophagus. Endoscopic hemostasis was performed by irrigation through the endoscope channel, through the nasogastric tube and through enemas with incomplete silver salt of polyacrylic acid. Results. Effective endohemostasis in groups 1, 2, 4, 6 was assessed visually and in all cases was achieved at 1–2 minutes; there were no relapses of bleeding; in a control study on the day 5–7, positive dynamics was noted – healing of the mucous membrane and the formation of a red scar; pronounced deformation and stenosis of the lumen of the hollow organ in the location of ulcerative defects was not observed. In group 3, the drug Haemoblock® was administered exclusively by a probe according to the developed methodology; the effectiveness of hemostasis on day 1–3 was 100%. In group 5, in all children, the drug Haemoblock® was used for the first time in the form of therapeutic enemas, there was a decrease in the severity of bleeding from the mucous membrane of the colon with the formation of clots; visualization of the source of bleeding persisted. Conclusion. Methods of Haemoblock® usage in endohemostasis of different locations and etiology allow to achieve maximum (100%) efficiency in clinical practice of endoscopic department of multi profile children hospital. The use of an incomplete silver salt of polyacrylic acid (Hemoblock®) reduces the risk of recurrent gastrointestinal bleeding, is easy to use in pediatric endoscopic practice, and does not lead to the development of infectious complications and allergic reactions.
Keywords: endohemostasis, children, gastrointestinal bleeding, ulcerative colitis, Hemoblock®

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INFECTIOUS DISEASE RISKS IN NEWBORNS AFTER NON-TRADITIONAL PERINATAL PRACTICES
A. A. Khudyakova

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ULTRASOUND EXAMINATION OF BRAIN LESIONS IN PREMATURE NEWBORNS WITH VERY LOW AND EXTREMELY LOW BIRTH WEIGHT
P.A. Mazmanyan, E.A. Sarkisyan, K.V. Nikogosyan, L.A. Levchenko

Summary. Prematurity remains an urgent and widespread health problem throughout the world. The risk of develop- ing complications of prematurity, including severe and persistent brain damage, is inversely proportional to gestational age. Objective: to study the structure and frequency of perinatal brain lesions in premature infants using ultrasound examination. Material and methods. This study, conducted in two perinatal centers in Yerevan (Armenia), included 100 preterm infants with a gestational age of ≤32 weeks. The study group included all children examined by ultrasound examination of the brain in the neonatal period according to the adopted protocols. Results. Brain lesions were detected in 93% of premature babies, while the incidence of hemorrhagic lesions of the brain was 17%. Severe intracranial hem- orrhages (grade III intraventricular hemorrhage and hemorrhagic parenchymal infarction) are much more common than mild intraventricular hemorrhages. A bilateral increase in periventricular echogenicity was observed in 80% of children. An interesting finding was the development of increased echogenicity in the caudothalamic notch with later cystic trans- formation in 22% of infants. There was also late development of basal ganglia and thalamus echogenicity. Conclusion. A correlation was found between active resuscitation at birth and/or the absence of antenatal steroid prophylaxis with the development of grade II–III intraventricular hemorrhages and hemorrhagic parenchymal infarction.
Keywords: prematurity, perinatal brain lesions, intraventricular hemorrhage, hemorrhagic parenchymal infarction

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MODERN MEDICAL CARE FOR CHILDREN WITH INFLAMMATORY BOWEL DISEASES
I.M. Osmanov, I.N. Zakharova, A.S. Koshurnikova, E.V. Skorobogatova, D.K. Dmitrieva

Summary. Inflammatory bowel diseases are chronic diseases of the gastrointestinal tract characterized by episodes of abdominal pain, diarrhea, blood in the stool, weight loss, and decreased growth rate. There has been a persistent, rapid increase in the morbidity of inflammatory bowel diseases worldwide. The pathogenesis of inflammatory bowel diseases remains unclear, but it has been suggested that it depends on genetic factors, environmental factors and immune response disorders. The article discusses the specifics of laboratory and instrumental diagnostics, approaches to conventional therapy. The possibilities of introducing biological therapy into the clinical practice of pediatric departments of a pediatric multi-profile urgent treatment hospital are discussed.
Keywords: inflammatory bowel disease, Crohn's disease, ulcerative colitis, diet, biological therapy, Picoprep®

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RHINITIS IN A CHILD OF THE FIRST YEAR OF LIFE
A.P. Gulieva, E.P. Karpova, D.A. Tulupov, A.L. Zaplatnikov

Summary. The review of the problem of diseases of the nasal cavity in children of the first year of life is presented, the features of anatomy, physiology, immunology that determine the clinical course of rhinitis in infants are described. Such features include the increased susceptibility of the child in the first year of life to respiratory viral and bacterial infections, the pronounced negative effect of rhinitis symptoms on the quality of life of the child, the difficulty of drug control and the slow resolution of clinical symptoms. The analysis of modern data on the causes of nasal symptoms in a child is carried out. The main issues of treatment of acute rhinitis / rhinosinusitis in children of the first year of life are considered. The existing indications for systemic antibacterial therapy for suspected acute bacterial rhinosinusitis have been critically analyzed. The available possibilities of symptomatic treatment of acute nasal obstruction in young children with the use of nasal decongestants, in particular 0.01% oxymetazoline («Nasivin® baby»), are considered separately. This is the only decongestant allowed to children from the first days of life. The exceptional importance of dynamic medical monitoring of the patient's condition is noted. The absence of positive dynamics in the child's condition for several days against the background of treatment or the progressive deterioration of the child's condition at any time requires a timely review by the doctor of treatment tactics. Taking into account the information presented in this article, the authors point to the need to develop an algorithm for managing young children with nasal symptoms, as well as interdisciplinary coordination of this algorithm with the participation of experts of pediatric specialties related to the treatment of upper respiratory tract pathology.
Keywords: children of the first year of life, young children, acute rhinitis, acute rhinosinusitis, symptomatic treatment, oxymetazoline, «Nasivin»®