Vol 27, No 1 (2020)

The relevance of the influenza control is attributable to its social significance. It is generally recognized that vaccination is most effective among all medical measures implemented in the control of infectious diseases, especially airborne infections. In the World Health Organization documents, annual vaccination is recognized as the main measure for influenza epidemic control. The purpose of vaccination as a mass event is reduction in the incidence of influenza, especially its severe forms. Due to the high variability of influenza viruses and enormous damage to the national health and economy, as well as the introduction of a number of new influenza vaccines in the practice, evaluation of the effectiveness of domestic influenza vaccines is of great importance for public healthcare. Analysis of the data on the effectiveness of influenza vaccines will allow the development of a number of scientific-based measures aimed at reducing the incidence, hospitalization and mortality from influenza due to a more rational use of vaccines for different age categories of the population.

A review presents a modern view of the development and approaches to therapy for atopic dermatitis (AtD) in children based on litera- ture review and authors’ own research. The important role of atopy, mutations in the filaggrin gene, activation of Th2 lymphocytes, innate lymphoid cells (ILC), dendritic cells, mast cells, basophils, eosinophils, Langerhans cells, keratinocytes, Th1 cells, Treg, increased production of immunoglobulin E (IgE), mediators, chemokines and cytokines (IL-4, IL-5, IL-8, IL-9, IL-13, IL-17, IL-25, IL-31, interferon γ and tumor necrosis factor α), impaired skin barrier function in the pathogenesis of AtD is demonstrated. The clinical and immunologi- cal characteristics of IgE-mediated and non-IgE-mediated AtD are presented. The therapeutic efficacy of pathogenetic therapy for AtD using topical glucocorticosteroids, calcineurin inhibitors, emollients, antihistamines, anti-IgE therapy and allergen-specific immuno- therapy has been shown

Nutritional deficiency (ND) is a condition that develops due to insufficient intake, consumption or assimilation of nutrients, which leads to a change in body weight and body composition, a change in immunological resistance, a decrease in physical and psychomotor deve-lopment, and a deterioration in the clinical outcome of the disease. Nutritional support (NS) provides the nutrient enrichment through the use of specialized mixtures when it is not possible to meet the nutrient requirements with conventional foods or a healthy diet. The stages of NS from screening for ND to prevention and correction of its possible complications are presented. It is emphasized that timely and adequate correction of ND is the key to maintaining health and improving the quality of life of children and their families.

Up to date, community-acquired pneumonia (CAP) has remained a common cause of morbidity and mortality in children. Streptococcus pneumoniae and Haemophilus influenzae retain their leading position in the etiology of CAP in children under 5 years of age. The unreasonable use of antibacterial drugs in previous decades has led to an increase in the antibiotic resistance of these pathogens to в-lactams and macrolides. This was the reason for the correction of the strategy for starting antimicrobial therapy for CAP: the pediatrician must take into account not only the etiology of the pathogen, but also the presence of risk factors for infection with antibiotic-resistant strains, the current situation with pathogen resistance in the patient’s region of residence, and other factors. Currently, oral amoxicillin remains the first-line drug in the treatment of CAP; in the presence of risk factors for antibiotic resistance, inhibitor-protected penicillins should be the starting drugs. Given the increasing resistance of S. pneumoniae to macrolide antibiotics, this group of drugs should now be considered as a second-line therapy. Thus, modern medical advances with the introduction of new methods of etiological diagnostics, data from epidemiological studies, as well as specific prophylaxis of the main causative agents of pneumonia in children, have changed the old paradigms in the etiotropic treatment of CAP, which must be taken into account in practical healthcare.

Background. The issues of choosing the most effective method for calculating pancreatin (lipase units per body weight and/or fat content of meals) and optimal doses of pancreatic enzymes in cystic fibrosis (CF) continue to be widely discussed among specialists. Objective. Estimation of the dose of pancreatin for children with CF using two calculation methods in order to develop an individual correction algorithm for enzyme replacement therapy. Methods. 140 children (80 boys, 60 girls) aged 1 to 18 years (mean age 6.4±5.2 years) with a confirmed diagnosis of CF and pancreatic deficiency (fecal elastase-1 < 200 pg/g) were examined. Children were divided into age groups: group 1 consisted of children aged 1 to 2 years (n=40); group 2 - 3 to 5 years (n=41); group 3 - 6 to 9 years (n=43,); group 4 - 10 through 18 years (n=26). Doses of pancreatin were evaluated by a questionnaire method using diet diaries, which included data on food consumption and the dose of pancreatin for 3 days. When comparing the actual dose of pancreatin with the recommended dose for CF, the recommendations of the ESPEN-ESPGHAN-ECFS expert group (2016) were considered to be reference. Results. The analysis showed that the daily amount of fat in meals statistically significantly increases from 64.1 to 104.0 g at the age of 1 to 18 years (p1-4<,0.001). At the same time, the dose of pancreatin (lipase units per day) in this group is statistically significantly reduced -from 10,620.0 to 7,000.0 U/kg (p1-4<,0.001). A similar trend was observed in the doses of pancreatin per the main and additional meals. The dose of pancreatin per main meals progressively decreased with age and was at the lower level of recommended values in children of the 4th (10-18 years) age group. Doses of pancreatin for additional meals (lunch, afternoon snack, meal at night) were particularly inadequate and did not exceed the lower level of recommended values in all age groups. Calculation of pancreatic enzymes by the second method using an estimate of the fat content in meal showed that in the general group of children, the dose of pancreatin was 1,500 U/g of fat in meal per day, which is lower than the recommended range of 2,000-4,000 U/g. Conclusion. The results obtained indicate the need to develop an individual approach algorithm for enzyme replacement therapy in children with CF using a more correct calculation method - for the actually consumed fat with meal.

Background. To date, the question of the health status and the influence of risk factors on the formation of chronic diseases in adolescents studying in various subject-oriented education programs have not been sufficiently studied. Comprehensive scientific research in the field of school medicine would help to better understand the characteristics of the formation of chronic pathology and expand the possibilities of influencing modifiable risk factors. Objective. Evaluation of the health status of grade 9-11 girls studying in different specialized classes, depending on the type of educational program and year of study. Methods The study design involved organizing informational meetings for schoolgirls and their parents, the teaching staff of the school and medical staff in order to explain the relevance of this study and obtaining informed consent, as well as a clinical and anamnestic examination of girls with a detailed analysis of the unified follow-up card. The results were processed by methods of variation statistics using the software package for the Microsoft Excel PC and on-line calculators for calculating statistical criteria. Student's t-test was used for comparison of relative values. Results. Of the 208 observed grade 9-11 schoolgirls, only 29 (13.9%) had the first group of health. 37.5% of high school students had the second group of health, and 48.6% - the third ones. Among the risk factors for the development of chronic diseases, a low level of knowledge on the development and functioning of the organs of the reproductive system, a violation of the daily regimen and nutrition, a high percentage of smoking and lack of exercise should be noted. The health status of girls studying in specialized classes was characterized by a higher frequency of occurrence of the first group of health; however, the development of arterial hypertension, more pronounced menstrual irregularities, and a higher frequency of low body weight were revealed. At the same time, there were no profile differences in indicators within the group; therefore, not the orientation of the educational program, but the fact of the transition to the study of a particular specialty is of importance. Also, there were no significant age differences. Conclusion. As a result of this study, an understanding of the current state of health of adolescent girls was obtained, which made it possible to identify the risk groups of students requiring a more detailed examination, as well as the developent of the principles of differentiated medical and social support and correction.

This paper reviews the development stages of theoretical knowledge about the interferon, its properties and important role in the human immune system as well as interferon-based medications for preventive and therapeutic use. There have been created various interferon-based medications with different administration routes for the treatment of acute respiratory viral infections (ARVI), viral eye diseases, herpetic infections of the skin and mucous membranes, allergic and gynecological diseases. This article also discusses the domestic experience with the use of original interferon-based medication Grippferon® for the prevention and treatment of ARVI, including influenza, parainfluenza, respiratory syncytial virus, adenovirus and coronavirus infections, as well as measles and rubella in patients of all age groups (especially in elderly people, pregnant women and nursing mothers, children from the first days of life, newborns and premature babies with low and very low birth weight). An increase in the efficacy of the interferon-based medications has been proven, given that they are used when the first disease symptoms appear.