BRONCHIAL ASTHMA AND OBESITY IN CHILDREN
S.E. Ryabova, Yu.L. Mizernitsky

Summary. Bronchial asthma and obesity are common diseases in the pediatric population, and the relationship between them has long received much attention. Bronchial asthma is a disease that is based on chronic allergic inflammation of the bronchi and hyperreactivity of the airways. Adipose tissue is an active endocrine organ that produces a huge amount of various pro- and anti-inflammatory factors. Violation of their balance can not only change the activity of the inflammatory process in the bronchi in asthma, lead to the progression of the disease, but also serve as an additional risk factor for the formation of the disease. The effectiveness of therapeutic interventions also demonstrates their features in patients with asthma in combination with obesity. A practicing doctor should include children with bronchial asthma in comorbidity with obesity in group of patients at risk of an uncontrolled course of the disease, conduct a dynamic assessment of the function of external respiration (spirography, peak flowmetry) for timely correction of basic therapy and additional treatment due to a more severe course disease, a number of its clinical features and less effective standard therapy regimens.
Keywords: children, bronchial asthma, obesity, therapy

DRY COUGH IN A CHILD: FROM DIAGNOSTIC ISSUES TO THERAPY
A.B. Malakhov, N.G. Kolosova, V.D. Denisova, A.Yu. Sedova

Summary. Cough is common in childhood. This leads to numerous medical consultations, affects the quality of life and places a significant burden on children, family and society. Approaches to cough therapy primarily involve the establishment of the causes of cough and the features of the mechanism of formation of the cough reflex in childhood and knowledge of the mechanisms of action of the drugs used to treat cough. The need for the treatment of cough proper, that is, the appointment of so-called antitussive therapy, occurs mainly in the presence of an unproductive, dry, obsessive cough in the child. In this case, the drugs of choice are antitussive drugs of central action that suppress the function of the cough center of the medulla oblongata. In childhood, butamirate (OMNITUS) is often used in this case, which selectively affects the cough center, does not cause respiratory depression, has an extremely low incidence of side effects, retains effectiveness with prolonged treatment, starting to have the maximum effect after the first application.
Keywords: children, cough, whooping cough, treatment, antitussive drugs, butamirate, OMNITUS

HERPESVIRUS INFECTIONS IN CHILDREN OFTEN SUFFERING FROM ACUTE RESPIRATORY DISEASES: POSSIBILITIES FOR IMPROVING DIAGNOSIS AND THERAPY
I.M. Osmanov, L.N. Mazankova, S.N. Borzakova, A.V. Vinokurov

Summary. The article presents a review of the literature on the frequency and clinical forms of herpesvirus infections (HVI) detected in the population of children with frequent respiratory infections without severe immunodeficiency. Data on the possibilities of rational treatment tactics are analyzed. The problem is considered from the perspective of a primary care pediatrician. A description of a clinical case is presented when the infectious process, manifested as an acute respiratory infection, was caused by a viral-bacterial combination involving several herpesviruses.
Keywords: herpesvirus infection, acute respiratory infection, mixed infections, clinical manifestations, children, frequently ill children, recurrent infections, immunodeficiency states, diagnosis of viral diseases, treatment, clinical case, antiviral therapy, immunotherapy, preparations of recombinant interferon alfa-2b, VIFERON®

ASSOCIATION OF COVID-19 VACCINATION DURING EARLY PREGNANCY WITH RISK OF CONGENITAL FETAL ANOMALIES
A. A. Khudyakova

PRESEPSIN FOR THE DIAGNOSIS OF NEONATAL EARLY-ONSET SEPSIS: A SYSTEMATIC REVIEW AND META-ANALYSIS
A. A. Khudyakova

FECAL CALPROTECTIN LEVELS IN PEDIATRIC COW’S MILK PROTEIN ALLERGY
A. A. Khudyakova

TOPICAL CORTICOSTEROID WITHDRAWAL SYNDROME: SYMPTOMS, SIGNS AND TREATMENT APPROACHES
D.V. Zaslavsky, A.N. Barinova, S.L. Plavinsky

Summary. Topical corticosteroid withdrawal syndrome is an insufficiently studied complication of local corticosteroid therapy for various dermatological diseases and cosmetic features. The literature review provides data on the features of clinical manifestations, signs and approaches to the treatment of this condition. It is noted that the best method of prevention is to limit the use of high doses of topical corticosteroids and alternative approaches to therapy are discussed on the example of atopic dermatitis, which is the most common cause of the use of high doses of corticosteroids leading to the appearance of withdrawal syndrome.
Keywords: topical corticosteroid withdrawal syndrome, atopic dermatitis, withdrawal syndrome treatment, withdrawal syndrome prevention, activated zinc pyrithione, 'withdrawal dermatitis’, Skin-cap cream

THE USE OF A COMPLEX OF EXOGENOUS CYTOKINES AND ANTIMICROBIAL PEPTIDES IN THE CONSERVATIVE TREATMENT OF CHRONIC TONSILLITIS IN CHILDREN
E.P. Karpova, V.A. Belov

Summary. One of the urgent problems of otorhinolaryngology remains the search for pathogenetically sound, effective and safe methods of treating chronic tonsillitis. The article presents modern indications for conservative therapy and surgical treatment based on clinical recommendations. The data on the role of the cytokine system in the pathogenesis of local and systemic reactions during the formation of chronic tonsillitis are presented. The article presents an analysis of the literature data on the possibility, validity, clinical efficacy and safety of cytokine therapy in chronic tonsillitis. The data on the anti-inflammatory, antibacterial and antiviral activity of the complex of natural cytokines Superlimph in chronic tonsillitis are presented.
Keywords: chronic tonsillitis, cytokines, cytokine therapy, antimicrobial peptides, protegrines, defensins, treatment, children, Superlimph

A VARIETY OF SKIN DISEASES ASSOCIATED WITH KERATINIZATION DISORDERS IN CHILDREN'S PRACTICE: RESULTS OF EXTERNAL THERAPY WITH DRUGS CONTAINING UREA
O.B. Tamrazova, A.S. Stadnikova, A.V. Taganov, A.S. Vorobyova, L.V. Goncharova, A.G. Sukhotina

Summary. Keratinization is a complex physiological process that takes place in the cells of the epidermis and ends with the deposition of keratin and lipids in the stratum corneum, as a result of which the stratum corneum of the skin acquires strength and plasticity. The group of diseases characterized by keratinization defect is very diverse and is mainly hereditary. The article presents general information about the epidemiology, etiology and pathogenesis of diseases with keratinization disorders; classification of ichthyosis, palmar-plantar keratodermia is given; the connection of genetic mutations with the manifestations of the main syndromes is presented. Clinical manifestations of diseases with keratinization defect of both acquired and hereditary nature are described. The authors draw attention to the fact that therapeutic measures in the treatment of diseases with keratinization disorders are symptomatic. The article presents historical and modern Russian and foreign data on the experience of using urea in the treatment of these diseases and the effectiveness of this method. The results of own clinical observation of patients with diseases associated with keratinization disorders, in addition to the standard therapy of which TOPICREM UR-10 cream was used, are also described softening cream for roughened skin (hereinafter TOPICREM UR-10)*.
Keywords: hyperkeratosis, keratinization, ichthyosis, psoriasis, lichen, keratosis, children, treatment, dry skin, urea, TOPICREM UR-10

VITAMIN-K-DEPENDENT HEMORRHAGIC SYNDROME OF NEWBORNS: MODERN APPROACHES
L.A. Levchenko, E.A. Sarkisyan, K.V. Nikoghosyan

Summary. Vitamin K dependent hemorrhagic syndrome develops in newborns in the first months of life due to physiologically low plasma concentrations of vitamin K and poses a serious risk for children. The purpose of this article is to describe the prevalence of the disease and to discuss current prevention methods of the prevention of vitamin K dependent hemorrhagic syndrome in newborns and infants. The disease can be largely prevented by prophylactic vitamin K administration. All newborns should receive vitamin K prophylaxis and the date, dose and route of administration should be documented. Healthy newborn babies should receive 1 mg of vitamin K1 intramuscularly at birth; or 3 x 2 mg vitamin K1 orally at birth, at day 4-6 of life, and at week 4-6; or 2 mg of vitamin K1 orally at birth and a weekly dose of 1 mg orally for 3 months. Intramuscular administration is the preferred route of giving vitamin K because of the effectiveness and reliability of administration. The success of oral administration depends on adherence to the protocol, and this can vary depending on the population and health care setting. Parents' refusal of vitamin K prophylaxis after adequate information has been provided should be recorded, especially because of the high risk of late vitamin K dependent hemorrhagic syndrome.
Keywords: newborn, vitamin K, vitamin K dependent hemorrhagic syndrome

TISSUE INHIBITOR OF MATRIX METALLOPROTEINASES TYPE 1 AS A RISK FACTOR FOR THE DEVELOPMENT OF COMPLICATIONS OF ALPORT SYNDROME IN CHILDREN
Z.R. Bashirova, I.M. Osmanov

Summary. Alport syndrome is a rare hereditary disease that manifests itself as progressive renal failure. The progression of fibrosis in the renal parenchyma is determined by the development of tubulointerstitial fibrosis. The basis for the formation of tubulointerstitial fibrosis is an imbalance between the synthesis and degradation (proteolysis) of the components of the extracellular matrix. The main role in the destruction of extracellular matrix components belongs to matrix metalloproteinases (MMP) and their inhibitors (TIMP). The aim of this study was to determine the association of MMP-2, MMP-3 and MMP-9 and their inhibitors TIMP-1 and TIMP-2, plasminogen activator inhibitor type 1 in the blood and urine with criteria for the severity of Alport syndrome in children. Materials and methods. The study included 32 children with Alport syndrome. The level of MMp-2, MMP-3 and MMP-9 and their inhibitors TIMP-1 and TIMP-2, plasminogen activator inhibitor type 1 in blood serum and urine was determined by enzyme-linked immunosorbent assay. The criteria for the severity of Alport's syndrome were chosen: the severity of arterial hypertension depending on the percentile of systolic and/or diastolic blood pressure, daily excretion of protein in the urine, standardized on the body surface, sensorineural hearing loss. Results. The analysis of the association of matrix metalloproteinases and their inhibitors in blood serum and urine with the criteria for the severity of Alport's syndrome found that the risk factor for arterial hypertension is an increase in tissue TIMP-1 in urine (relative risk 4.57 (2.75-7.6); sensitivity 82%, specificity 70%, positive predictive value 64%, negative predictive value 86%); a risk factor for daily loss of protein in the urine of a nephrotic level in children with Alport syndrome in children is also an increase in tissue TIMP-1 in the urine (relative risk 1.87 (1.16-3.01); sensitivity 100%, specificity 76%, positive predictive value 68%, negative predictive value 100%). Conclusion. Our study demonstrates that a TIMP-1 in urine can be used in pediatric practice to predict complications of Alport's syndrome in the form of arterial hypertension over 95th percentile depending on the percentile of systolic and/or diastolic blood pressure and daily urinary protein excretion, standardized to the body surface of the nephrotic level for the timely start and choice of treatment tactics.
Keywords: matrix metalloproteinases, tissue inhibitor of matrix metalloproteinase-1, children, Alport syndrome, proteinuria, arterial hypertension

FEATURES OF DISPENSARY FOLLOW-UP AND RECOMMENDATIONS FOR THE SELECTION OF A REHABILITATION PROGRAM FOR CHILDREN WITH HEART LESIONS ASSOCIATED WITH COVID-19
S.N. Ivanov, N.V. Kukhtinova, M.A. Novikova

Summary. The management of children with a new coronavirus infection (COVID-19) and its long-term consequences should constitute a large amount of work for pediatricians. Issues of long-term follow-up, the choice of a specific content of the rehabilitation program, especially for patients with SARS-CoV-2 mediated damage to the cardiovascular system, remain under study. Well-known the energotropic, trophotropic and cardioprotective properties of L-carnitine are the basis for the inclusion of L-carnitine’s medicine (Elcar®) in the long-term complex treatment of this group of patients, theeffectiveness of which is demonstrated in the above clinical observation.
Keywords: COVID-19, heart diseases, children, dispensary observation, L-carnitine

THE SIGNIFICANCE OF OMEGA-3-POLYUNSATURATED FATTY ACID DEFICIENCY IN CHILDHOOD AND ADOLESCENCE
I.N. Zakharova, I.M. Osmanov, I.D. Maikova, I.I. Pshenichnikova, Yu.V. Koba, V.V. Pupykina, E.V. Skorobogatova, A.V. Miroshina

Summary. Omega-3 polyunsaturated fatty acids (PUFAs) are essential nutrients necessary for the normal growth, development and preservation of the health of children and adolescents. Despite the importance of omega-3 PUFAs for maintaining health, their consumption remains below the recommended level. Omega-3 PUFAs deficiency is widespread today. Its greatest severity is observed in younger age groups, which increases the risk of adverse health consequences. A promising solution to this problem is the use of an additional subsidy of omega-3 PUFAs.
Keywords: omega-3, deficiency, children, adolescents, erythrocyte omega-3 index, omega-3 polyunsaturated fatty acids subsidy