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NEUROSONOGRAPHIC FEATURES AND LONG-TERM OUTCOMES OF INTRACRANIAL HEMORRHAGES IN PREMATURE INFANTS
E.A. Sarkisyan, P.A. Mazmanyan, K.V. Nikoghosyan, P.V. Shumilov

Summary.
Introduction. Intracranial hemorrhage is a serious neurological complication of the neonatal period in very low and extremely low birth weight newborns.
Objective. To study the features of intracranial hemorrhages in premature infants with further assessment of neurological outcomes in early childhood.
Methods. Preterm infants with a gestational age of less than 32 weeks and / or with a birth weight of less than 1500 g were included in the study. In the studied group of children multiple dynamic ultrasound examinations of the brain were done; neurodevelopmental outcome was assessed by 2 years of age using the Bailey-III test.
Results. The study revealed that grade III intraventricular hemorrhages and hemorrhagic parenchymal infarction in the studied cohort of children were more common than grade I-II intraventricular hemorrhages.
Conclusion. In the group of children with IVH, there was a high mortality rate, and among the survivors, permanent brain lesions were identified with subsequent high risk of neurological abnormalities.
Keywords: рrematurity, cranial ultrasound, intraventricular haemorrhage, haemorrhagic parenchymal infarction, cerebral palsy

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ATOPIC DERMATITIS. DIFFERENTIATED APPROACH TO THE MANAGEMENT OF PATIENTS TAKING INTO ACCOUNT PHENOTYPES
O.B. Tamrazova, A.S. Stadnikova, G.A. Novik, A.V. Taganov, G.E. Bagramova, L.V. Goncharova

Summary. Atopic dermatitis (AtD) is a multifactorial genetically determined inflammatory skin disease, one of the elements of the pathogenesis of which is the dysfunction of the epidermal barrier. Most often, AtD is divided into IgE-mediated ("external") and non-IgE-mediated ("internal") subtypes. The most common in the population is the "external" subtype of AtD (70–80%), characterized by a violation of the epidermal barrier of the skin (high frequency of mutations of the filaggrin protein). The "internal" subtype is more common in women, the skin barrier with this subtype is preserved. With the "external" subtype, sensitization to food allergens is noted, with the "internal" subtype, allergy to metals is noted. Scientists also described the European-American and Asian subtypes of AtD. Based on the molecular mechanisms underlying the clinical phenotypes of AtD, scientists have proposed a classification of the disease into endotypes. The use of this classification makes it possible to apply an individual approach to the treatment of patients with ATD. Classification of AtD by endotypes includes the following signs: activation of type 2 cytokines, type 1 cytokines and IL-17/IL-22, violation of the epidermal barrier and deficiency of intercellular lipids.
Immune imbalance in AtD, namely the production of cytokines IL-4 and IL-13 contributes to the additional suppression of the expression of all structural proteins of the epidermis and, in particular, filaggrin. In addition, IL-4 inhibits the synthesis of ceramides, increasing the permeability of the epidermal barrier of the skin. Despite the accumulated knowledge about various subtypes of AtD and violation of the epidermal barrier, in clinical practice, emollients
Keywords: atopic dermatitis, filaggrin, emollients, filagrinol, epidermal barrier, subtypes, Admera

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INFECTIONS AND SOMATIC DISEASES: AN INDISSOLUBLE RELATIONSHIP.
Review of the XIV All-Russian Scientific and Practical Conference with international participation "Infectious aspects of somatic pathology"
A.A. Cheburkin, L.N. Mazankova

Summary. The article contains an analytical review of the reports presented at the XIV All-Russian Scientific and Practical Conference with international participation "Infectious aspects of somatic pathology". The role of infectious and parasitic triggers in the formation of diseases of the nervous, cardiovascular system, rheumatic, allergic diseases, post-viral changes in the respiratory tract as prerequisites for the development of somatic pathology, causal relationships between infections, allergies and immunity is discussed.
Keywords: children, infection, infectious diseases, somatic diseases

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CAPILLAROSCOPY OF THE NAIL BED
P.V. Berezhansky, T.I. Yushina, T.A. Gutyrchik, A.B. Malakhov, A.N. Shapiev, N.A. Gutyrchik, Yu.V. Vekshina, N.D. Dustbabayeva

Summary. Nail fold is one of the most accessible sites for studying changes in the microcirculation in various microangiopathies. The characterization of changes in microvasculature can provide useful clues towards the diagnosis and prognosis of a disease. The diagnostic utility of nail fold capillaroscopy has improved and expanded over the past couple of decades. Beyond connective tissue diseases, it is now explored for its role in various systemic and dermatological diseases. Incorporation of nail-fold capillaroscopy in the diagnostic criteria of systemic sclerosis has generated interest among dermatologists, including allergic diseases of the respiratory tract.
Keywords: nail fold capillaroscopy, technique of execution, evaluation of results

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THE EFFECT OF THE NOVEL CORONAVIRUS INFECTION (COVID-19) ON THE LEVEL OF ANXIETY IN CHILDREN
E.P. Isaeva, O.V. Zaitseva, E.E. Lokshina, S.V. Zaitseva, O.A. Murtazaeva, N.A. Sirota, E.V. Tatarnikova, D.A. Pankratov, I.V. Zyabkin

Summary. The novel coronavirus disease (COVID-19) pandemic is currently one of the most actual global health problems. Children still remain the least studied group in research of the long-term consequences of COVID-19 in the context of the ongoing COVID-19 pandemic. Current data indicate that children make up 10 to 18% of those infected with the new coronavirus (SARSCoV-2) although the epidemiological situation is constantly changing due to the evolution of the virus. In many adults, who have had COVID-19, symptoms of the disease can persist for a long time during the post-COVID syndrome, significantly affecting the quality of life, working capacity, increasing the anxiety. Studies in children assessing the impact of coronavirus infection in the post-COVID period on the level of anxiety are isolated and contradictory. Aim: to study the anxiety level in children after a novel coronavirus infection (COVID-19). Materials and methods. The study included 62 children aged 5 to 17 years after a mild COVID-19. The average follow-up period after the disease was 6 months (from 3 to 12 months). The examination included tudying clinical data, to assess the level of anxiety used clinical and psychological methods by Prikhozhan. Results. In children 3–12 months after COVID-19, a significant increase in complaints was found compared to the period before the disease. The majority of children (61.3% – 38) showed an increase in anxiety from low to high levels, 15 (24.2%) showed a transition from an average level to a high level of anxiety, 7 (11.3%) of children had a low level of anxiety increased to the average level (p > 0.05), only in 2 (3.2%) children the level of anxiety remained unchanged. There was no statistically significant difference among boys and girls.
Conclusions. Our study demonstrates that 61.3% of children after COVID-19 have a high level of anxiety, which indicates that the transferred novel coronavirus infection has a significant and lasting impact on the psycho-emotional sphere of the child.
Keywords: children, novel coronavirus infection, COVID-19, anxiety, post-COVID syndrome

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A. A. Khudyakova

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MUCOACTIVE HERBAL PREPARATIONS IN THE PREVENTION AND THERAPY OF DISEASES OF THE ENT ORGANS AND RESPIRATORY TRACT IN CHILDREN
A.I. Asmanov, N.D. Pivneva

Summary. Over the past decade, there has been a notable increase in the frequency of respiratory diseases around the world and particularly in Russia. The problems of modern therapy of acute inflammatory diseases of the respiratory tract are irrational drug prescription and polypragmasia. Some trends in modern pharmaceutical industry lead to unjustified prescription of antibacterial drugs, including patients with viral infections, majority of which is up to 97% or more than 5–6 drugs per disease. From the standpoint of modern evidence-based medicine, it is known that the use of natural products based on herbal components ensures safety and absence of most common side effects, and comprehensive effect on various steps of the inflammatory process allows to use these drugs as monotherapy in many cases. The extract of Pelargonium sidoides is included in guidelines of the Ministry of Health of the Russian Federation as a drug for the treatment of acute sinusitis and bronchitis. Objectives – a review of studies focusing on the use of extract to determine the main clinical situations in which its use is most appropriate.
The article presents the results of numerous domestic and foreign randomized placebo-controlled studies demonstrating its high efficacy and safety of Pelargonium sidoides in the treatment of ENT diseases, upper respiratory tract infections and bronchitis not only in adults but also in children. The article also determines the main clinical situations in which its use is most appropriate. Based on analyzed and presented material, the authors concluded that the use of Pelargonium sidoides-based drugs in the treatment of acute respiratory infection is effective and safe. Extract has demonstrated polytropic effect: antiviral, antibacterial, immunomodulatory, mucolytic, anti-inflammatory, antioxidant, cytoprotective. The drug is able to reduce not only symptoms of inflammation in the shortest possible time, but also to have an antiviral and mucolytic effect, which significantly reduces duration of the disease and improves functions of the upper respiratory tract organs.
Keywords: sinusitis, bronchitis, pelargonium sidoides, phytotherapy

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TOPICAL ASPECTS OF THE USE OF INTERFERON-BASED DRUGS IN PEDIATRICIAN'S PRACTICE
Osmanov I.M., Mazankova L.N., Borzakova S.N., Vinokurov A.V.

Summary. The article is devoted to the main directions of the use of interferons for the treatment of various pathologies in children. Important, from the point of view of practical application, information about the classification, methods of obtaining, mechanisms of action of interferons is given. The main groups of drugs used in children, developed on the basis of various types of interferons and registered in the Russian Federation, are considered. Data on pharmacodynamics and methods of their administration are indicated. A review of the use of drugs in acute infectious diseases, including interferon therapy for COVID-19 in children, is presented. The features of one of the most widely used in children drug interferon α-2b – VIFERON^® are discussed. The author's own experience of its use for the treatment of a new coronavirus infection in children in a hospital setting is presented. The immediate tasks for improving the therapy with interferon preparations in children, as well as the main directions for the modification and development of new drugs using the methods of molecular biology and biotechnology, are considered.
Keywords: interferons, cytokines, classification, mechanism of action, pharmacokinetics, IFNα, IFNβ, IFNλ, registered drugs, pegylated interferons, interferon α-2b VIFERON^®, treatment of COVID-19 in children

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THE EFFECTIVENESS OF ENERGOTROPIC THERAPY IN THE TREATMENT OF VEGETATIVE DYSTONIA IN ADOLESCENTS
M.Yu. Galaktionova, V.L. Gritsinskaya

Summary. Treatment and prevention of vegetative dystonia remains relevant due to its high prevalence in the pediatric population, as well as the risk of transformation into chronic diseases of the cardiovascular system. In order to determine the therapeutic effectiveness of the energotropic drug levocarnitine (Elkar^® , PIK-PHARMA, Russia) in the complex treatment of vegetative dystonia in adolescents, a comparative study of complaints, the severity of clinical manifestations, indicators of the functional state of the autonomic autonomic nervous and cardiovascular systems was conducted. Materials and methods. The main group included 125 patients who were treated with levocarnitine at a dosage of 1.0 g, the duration of therapy was 4 weeks. The control group consisted of 121 adolescents. The study used clinical, anamnestic, ultrasound and neurophysiological research methods.
Results. Against the background of energotropic therapy, 80.9% of patients by the end of the 2nd week from the start of treatment had a decrease in anxiety, improved mood, increased efficiency and concentration of attention. Stabilization of blood pressure indicators was established in 35.9% of cases. The number of adolescents with maladaptive variants of the clinoorthostatic test significantly decreased, which indicated a positive dynamics of the parameters of vegetative activity provision. The main temporal and spectral parameters of heart rate variability in adolescents after treatment with levocarnitine indicated a decrease in parasympathetic and an increase in sympathetic effects on heart rhythm.
Conclusion. The use of levocarnitine in the treatment of vegetative dystonia led to a significant decrease in the frequency of registration of maladaptive variants of the clinoorthostatic test and clinical symptoms that determine the severity of the course of various variants of vegetative dysfunction in adolescents.
Keywords: adolescents, vegetative dystonia, levocarnitine, Elkar^®

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FEATURES OF THE USE OF ULTRATHIN VIDEO ENDOSCOPES IN PEDIATRIC PRACTICE
A.S. Koshurnikova, T.A. Grenkova

Summary. The features of the use of ultra-thin endoscopes Olympus in the pediatric practice of the Z.A. Bashlyaeva Hospital are presented. Recommendations for the treatment of this category of endoscopes are given.
Keywords: endoscopy, children, diseases of the digestive and respiratory organs, diagnostics, new technologies in endoscopy in children, ultrathin video endoscopes, epidemiological safety in endoscopy