The aim of the study was to find a connection between various pathological conditions observed in pregnant women with the development of intrauterine pneumonia (IUP) in their newborn children, in this research, another poor of interest was study the clinical course of this pathology in children with different premorbid backgrounds. The study was conducted on the basis of the Regional budgetary health institution «Kursk regional children's hospital No. 2» of the health Committee of the Kursk region. The materials of the study were extracts of newborns from the maternity hospital, medical records of the inpatient neonatal Department (medical documentation form No. 003/y) and personal data of mothers. Statistical processing was carried out with the help of the company's package StatSoft Statistica 8.0 for Windows. Our study showed that the burdened history of mothers plays a significant role in the development of intrauterine pneumonia and was observed in 85.0% of these women. It was found that the presence of IgG in mothers to various infectious agents leads to a significant increase in the incidence of IUP in newborns (p < 0.05). The features of the clinical picture of pneumonia in fullterm newborns were revealed. Revealed the frequent combination of IUP with perinatal hypoxic-ischemic lesion of the Central nervous system. It is established that the clinic is manifested mainly by respiratory disorders and to a lesser extent intoxication syndrome. The diagnostic significance of determining the level of C-reactive protein was established. High efficiency of cephalosporin antibiotics against pathogens of this pathology in newborns is proved. The data obtained in the course of the study are applicable in practice to identify the risk group of mothers, children who are prone to the occurrence of intrauterine pneumonia, optimization and alertness in the diagnosis and appointment of timely antibacterial therapy on the basis of empirical data. 

Acute bronchiolitis is often a viral inflammation of the terminal bronchioles, with the development of severe broncho-obstructive syndrome. The maximum frequency of this pathology is recorded in children under one year old. The high prevalence of viral agents capable of inducing the development of this pathology, the lack of effective etiotropic treatment, the severity of respiratory failure (RF), as well as the high incidence of adverse consequences after bronchiolitis, actualize the study of this issue. Moreover, different territories have differences in epidemiological and etiological data regarding acute bronchiolitis. We carried out a prospective observation of 150 children who were hospitalized for acute bronchiolitis in the Children`s city hospital № 3 in 2018-2019. The disease had a strict winter seasonality (60,7% of cases of acute bronchiolitis were recorded in the winter months). Treatment in the intensive care unit and intensive care required 19 children (13%), 131 patients received treatment in the specialized department of the infectious diseases hospital. The first degree of RF at admission had 66 children, the second – 32 children, the third – 19 children, while RF was absent in 33 patients. Patients with third grade of RF received respiratory support using mechanical ventilation. A complicated flow of the disease, in the form of the development of secondary viral-bacterial pneumonia, was recorded in 17 (11,3%) patients. Etiological verification by PCR was performed in 85 (56,6%) patients. The leading etiological agents in Novosibirsk were: respiratory syncytial virus – 33 (38,8%), bocavirus – 19 (22,4%), adenovirus – 15 (17,6%), metapneumovirus – 10 (11, 8%), other viral agents – 8 (9,4%) cases. Certain etiological features were observed, in particular bronchiolitis caused by the respiratory syncytial virus was significantly more often (p = 0,001) recorded in premature infants, in turn, bocavirus bronchiolitis was reliably (р = 0,0001) more often characterized by a more pronounced intoxication syndrome, with higher numbers of fever. The development of a severe course of bronchiolitis, requiring mechanical ventilation was significantly more often recorded in premature babies born before 36 weeks of gestation (OR 3,8, 95% CI 3,6-37,5, р ≤ 0,05), as well as in children who were on artificial feeding (OR 11, 95% CI 2,4-49,7, р ≤ 0,05). This fact allows us to consider prematurity and the presence of artificial feeding as a risk factor for the severe course of acute bronchiolitis in children. 

The article presents the clinical features of bronchitis in young children with various concomitant pathologies, proving the aggravating effect of comorbidity on the course of one of the most common diseases of the respiratory system. Bronchitis against the background of thymomegaly proceeds with prolonged febrile fever followed by prolonged subfebrile condition, as well as microcirculatory disorders. The combination of bronchitis with atopic dermatitis is accompanied by respiratory disorders with a predominance of hyperproduction of bronchial secretions. Concomitant anemia leads to severe hypoxic disorders due to impaired oxygen transport in the tissue, even with mild symptoms of bronchial damage. The combination of bronchitis with purulent otitis media is characterized by severe fever and symptoms of intoxication. In children with connective tissue dysplasia, bronchitis acquires a recurrent course with a longer duration of symptoms of inflammation. The presence of features of the course of bronchitis, comorbid with concomitant pathology, dictates the need to make additions to the diagnostic and treatment program. 

Congenital syphilis is still a public health concern, and syphilis can go unnoticed in pregnant women, even in developed countries with active antenatal care. Currently, according to the International Classification of Diseases (ICD-10), early (in children under 2 years of age) and late congenital syphilis (in children over 2 years of age) are distinguished. Features of the clinical course of early congenital syphilis make it possible to divide it into early congenital syphilis of infancy (up to 1 year) and early childhood (from 1 to 2 years). The signs of congenital syphilis are diverse and a high index of suspicion must be maintained to make the diagnosis. Early congenital syphilis usually appears in the neonatal period and seldom later than 3-4 months of life and hardly ever in children older than one year of age. We report 20-month-old boy with congenital syphilis who presented bone lesions in the lower extremities and cutaneous eruptions and remained undiagnosed until his mother was diagnosed with secondary syphilis. The article also highlights the possible difficulties in diagnosing syphilis in children of early childhood. 

The article presents materials on the effectiveness and safety of food products enriched with pre – and probiotic components, vitamins and trace elements for the prevention of acute respiratory infections (ARI) and as a therapeutic food in young children. Data on the role of bifidobacteria BB-12, inulin, vitamins and trace elements in the formation of the immune response are presented. The results of modern studies confirming the importance of these components in childhood are shown. Data on products enriched with components necessary for the prevention of acute respiratory infections are presented. It was shown that preventive intake of food products enriched with bifidobacteria BB-12, inulin, vitamins, macro-and microelements calcium, D3, safely modulates the activity of the immune system, which provides prevention of repeated episodes of ari in young children. The inclusion in the diet of foods enriched with probiotics, vitamins and trace elements in ARI significantly accelerates recovery and the period of convalescence. Fermented milk drink immunobaby for children older than 8 months, enriched with prebiotic (inulin), sourdough of lactic acidophilus bacilli, probiotic (bifidobacteria BB-12), vitamin and mineral complex containing Zn and vitamin D3, can be recommended for permanent, preventive and therapeutic nutrition of young children. Juice-containing drink for children older than 12 months enriched with prebiotic – inulin, minerals (calcium, iron) and vitamins (C, E, A, D3) is an additional source of necessary trace elements both during the period of ARI disease and during convalescence. The effectiveness of the drink is clinically proven. The composition of drinking yoghurts for children older than 8 months, enriched with prebiotic – inulin, and probiotic (bifidobacteria BB-12) can provide natural aid to digestion both in the acute period of infection, with pronounced antibiotic therapy, and for preventive purposes. The effectiveness is clinically proven. 

A retrospective study of the efficacy, safety and tolerability of long-term use of a specialized amino acid mixture without phenylalanine (Phe) in children with phenylketonuria (PKU) was carried out. We analyzed data from 14 patients with PKU, including 4 boys and 10 girls. The average age at initiation of dietary therapy was 23 days. The average weight of children at birth was 3.69 ± 0.65 kg. The mean plasma Phe level at the time of birth was 10.05 ± 2.7 mg/dl, with repeated testing it was 20.29 ± 4.48 mg/dl. By the end of the first month of life, on the background of diet therapy, the mean plasma Phe concentration in children was 2.58 ± 2.01 mg/dL. Later (mainly at the 6th and 11th months of life), some fluctuations in Phe were observed in individual patients, which in all cases was associated with objective reasons (the period of teething, the introduction of complementary foods, etc.). By the first year of life, the average Phe level in the blood of patients was 3.94 ± 3.03 mg/dl. At the end of the follow-up period, 85.7% of patients had a target blood Phe level not exceeding 6.0 mg/dL (n = 12). In the course of individual growth and development, a systematic increase in body weight was observed in all children. By the first year of life, the majority of patients (92.86%) showed satisfactory indices of individual development with no weight deficit, which was observed in only one child. In turn, the use of diet therapy was characterized by its good tolerance. None of the studied patients had any dyspeptic symptoms, atopy or other adverse events associated with the use of the mixture. Based on the results of the study, it was concluded that the long-term use of the used specialized amino acid mixture without Phe in young children with PKU was good, safe and tolerable. 

The purpose of the study is to summarize and evaluate the results of studies on the effectiveness and safety of the use of a combined drug based on recombinant interferon α-2b in combination with vitamins E and C in the complex therapy of urogenital infections in pregnant women. We have analyzed of available publications that had data on the results of the use of recombinant interferon α-2b in combination with vitamins E and C. From more than one hundred publications, 11 were selected that meet the inclusion criteria, containing detailed information and conclusions on randomized and non-randomized qualitative open clinical trials, which included 874 patients (520 in the main group, 354 in the comparison group). The variety of endpoints and approaches to evaluating results did not allow for a meta-analysis of data that meets modern standards. At the same time, the analysis of publications confirms the effectiveness and safety of using the drug in various forms in the complex therapy of urogenital infections in pregnant women. The analysis of the conducted studies has shown the effectiveness of using interferon α-2b in combination with vitamins E and C in various forms in the treatment of urogenital infections that complicate the course of pregnancy and childbirth, and chronic placental insufficiency. After treatment with the drug, pregnant women are significantly less likely to detect herpes viruses, atypical bacteria, improve the morphometric parameters of the placenta and colposcopy picture. There was a significant improvement in the immune response, which is accompanied by a decrease in the frequency of complications and repeated diseases. 

Left ventricular hypertrophy, hypoalbuminemia, and anemia are the risk factors for cardiovascular complications in patients with CKD 5. In addition, mortality from cardiovascular complications depends on the quality of life. In this regard, the purpose of this study was to study the structural parameters of the heart, hemoglobin and albumin levels in patients with CKD 5 on renal replacement therapy, depending on the quality of life indicators according to the SF-36 questionnaire. 65 patients on hemodialysis, peritoneal dialysis, and kidney transplant recipients were examined. Patients did not have clinical and laboratory signs of protein-energy insufficiency, blood hemoglobin was at least 100 g/l. All patients underwent general and biochemical blood tests, echocardiography, and SF-36 questionnaire. It has been shown that patients with CKD 5 on renal replacement therapy, with quality of life indicators below 50 points on the SF-36 scale, are more likely to have left ventricular myocardial hypertrophy, lower blood albumin and hemoglobin values. 

Allergy prevention issues are in the focus of emerging science and attention of health care professionals worldwide. The last decade has been marked by a change in approaches to prenatal and postnatal prevention of allergy through elimination diets during pregnancy and breastfeeding. New data reveal the feasibility of early introduction of certain food allergens as complementary foods in order to prevent food allergies in infancy. The preventive strategy of long-term exclusion of highly allergenic foods from the diet of children at risk for the development of allergies changed the vector towards their controlled introduction into the diet during the «window of tolerance» or «critical window», which was defined as 4-6 months of life. Active debate is underway regarding the allergy prevention role of partially hydrolyzed protein formulas in early life nutrition. The change of paradigms in this area testifies to the medico-social significance of the problem, an increase in the number of clinical observations aimed at finding new ways to realize the possibilities of the alimentary factor in the prevention of allergic diseases. The article reflects the latest scientific trends and current recommendations. 

There has been developed a local directional symptomatic slow-acting drug (SYSADOA) injection method into the zone of pathologically changed articular lip (of cartyloid cavity). The drug was administered once 1 every 3 days, with 3-5 injections required for the treatment of one joint. The treatment course was 9-15 days. After the course had been completed, all patients were improved the structure of the articular lip, and, along with the suppression of pain syndrome, the cysts disappeared or significantly decreased in size, the density of the fibrous cartilage ring decreased. In patients with a cartilaginous lip cyst in the long-term period, a more pronounced positive dynamics was determined than in the presence of cysts in the femoral head region. After treatment, blood serum and urine collagen degradation rates decreased and metabolic changes developed characterizing the balance shift between resorption and bone formation towards the predominance of the latter. The developed method for treating early coxarthrosis with local administration of the drug with chondroprotective effect made it possible to reduce pain syndrome, the duration of NSAID intake, and reduce the duration of conservative treatment. 

There were registered the small numbers of cases of imported malaria in the Russian Federation last decades. This leads to the lost of skills to recognize this disease by the general practitioners and they make many mistakes in the cases of the contact with malaria patients. In African countries, by contrast, the widespread prevalence of malaria tends to evaluate any symptom in individuals who get a positive malaria test as symptoms of malaria without a differential diagnosis from other diseases. The clinical manifestations of malaria are nonspecific, different systems are involved in the process, in addition, different types of malaria plasmodia cause different changes. The most studied in malaria are hematological disorders, pathology of the kidneys, the central nervous system, and respiratory complications. All of them can occur both in uncomplicated and in severe malaria, in different periods of the diseases. The clinical manifestations of malaria are differ between immune and non-immune individuals. In the latter case, symptoms may appear with a lower level of parasitemia, severe malaria is more often recorded, and mortality is higher. The diagnosis of malaria must necessarily be confirmed by the detection of parasitemia. In Russia, microscopic examination of a blood is used for this, abroad immunological (express tests) and molecular biological methods may be used. However, laboratory testing does not reveal the stage of parasite developing in the liver and may give negative or questionable results in the cases with a low level of parasitemia, therefore, if there is clinical suspicion, it must be repeated. Improving the diagnosis of malaria requires constant vigilance and careful collection of the patient's epidemiological history. In endemic regions with high rates of asymptomatic parasitemia, newly emerging symptoms should be classified as malaria after differentiation with the other causes. In non-endemic, for example, the Russian Federation, regions the cases of the patients with an appropriate history (even in people who visited areas of possible infection several years ago) must be rule out as malaria first of all. 

From 3 to 4 December 2020, the First International Conference «World Medicine in Everyday Practice», organized by the pharmaceutical and biotechnology company Adamed Pharma, was held online. The conference was attended by more than 6,5 thousand from 9 countries of the world, the focus of which was on topical issues of management in the era of COVID-19 of patients with cardiovascular, endocrine and surgical pathology, as well as bronchial asthma, COPD, severe colitis caused by Clostridioides difficile, disorders sleep, depression and other illnesses. Leading experts from various fields of medicine delivered lectures on topics that are significant for doctors around the world, demonstrated a picture of a pandemic in the future of various regions of the planet, assessed the current state of knowledge about COVID-19 and the clinical consequences of a new coronavirus infection in medical practice. The participants of the event expressed their intention to continue the discussion of topical problems of modern medicine in a series of international meetings initiated by Adamed Pharma, which provided doctors from different countries with a unique opportunity to exchange views and share best practices in the treatment of patients with various diseases against the background of COVID-19.