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Aim - to define the parameters of physical development of children in orphanages. 72 children (45 boys, 27 girls) without chronic debilitating diseases and condition aged from 1 to 6 years from Tbilisi and Makhinjauri orphanages (Georgia) were assessed. Height and weight of all subjects were measured and BMI, height SDS (standard deviation score) and weight SDS were calculated. Data were compared to the normal values (national data). The retardation of the physical development were seen along almost all findings. The significant differences regarding age and gender were not revealed. The most expressed tendency to delay was expressed in the height of boys, particularly aged 3-5 years. Our data confirm that institution upbringing has a negative impact on the growth of children of 1-6 years of age. In children aged from 1 to 6 years who are healthy but live in orphanages there is a marked tendency to lag behind in physical development, mainly in height. The above-mentioned confirms the opinion about negative impact of upbringing in orphanages on the physical development of children.

The aim of the work was to define the distribution of phages administered per os to children for medical reasons, and the immune response. 102 children aged from 5 days to 15 years with different diseases of bacterial etiology (pneumonia, sepsis, urinary infection, pharyngitis/sinusitis, enteral infection) were monitored. Pyobacteriophage was being included into the complex therapy. The drug was administered per os. In 6/7 of blood, 48/55 urine and 64/75 stool samples taken on the 3-5th day of treatment different components of pyobacteriophage were revealed. The titers varied from 103 to 105 pfu/ml. No age differences were seen. In two weeks after the onset of the phagotherapy the antibodies to phages were tested in the blood serum using the neutralization reaction method. The blood samples were taken from 31 patients. In 14 of them the antibodies neutralizing 52.5-97.3% of the phage activity were seen. A significant age-related peculiarity was determined: in newborns and infants the antibodies were not revealed or their activity was low. Obtained results confirm the reasonability to use of peroral phagotherapy in gastro-intestinal infections. At the same time it was ascertained that the phages taken per os can permeate into the internal environment of the organism and thus the peroral phagotherapy can be used to treat systemic infections and urinary tract infections as well. Absence or low production of the antiphage antibodies in newborns and infants suggests high efficacy of the phagotherapy in this age group.

Environmental rearing conditions during the neonatal period are critical for the establishment of neurobiological factors controlling behavior and stress responsiveness. Early maternal deprivation in animals consisting of a single 24-h maternal deprivation episode during early neonatal life has been proposed as an animal model for certain psychopathologies including anxiety, depression and schizophrenic-related disorders. The aim of the present research was to show the mechanisms how the early maternal deprivation in humans influences the emotional status of children. To understand the effects of early deprivation on the regulation of the hypothalamic-pituitary-adrenal axis of children following social interactions, we examined the blood neurotransmitters levels (Norepinefrin NA; Dofamin DF; Serotonin SE) in a group of healthy institutionalized children at age from 6 to 36 months from Tbilisi Infant's House. A group of healthy children of the same age from Mother & child shelters formed the control group. Emotional status was assessed by Leusher's Color Test in a group of healthy institutionalized children at age from 3 to 6 years from Tskneti Orphanage. Institutionalized children showed elevations in blood NE and decreased SE and DF concentrations in comparison with non deprived children's blood. The higher was percentage of children with high level of anxiety in the group of children from orphanage than in the children with family care. The results suggest that early maternal deprivation may contribute to long-term regulatory problems of the stress-responsive system that may be resulted in altered emotionality and behavior in deprived children.

The primary purpose of the present article is to investigate the comparative characteristics of heart rate variability in healthy adolescents and male adults. The study was carried out on 41 male adolescents aged 15-16 years and 73 male adults aged 18-22 years. For assessment of heart rate variability statistical data of variability and spectral analysis of heart rate were estimated. Achieved results have proved once again that vegetative balance in healthy individuals is not identical that can be explained by various physiological processes of adolescent age. Such start conditions probably may affect the character of body response to different stimulative impacts. The study suggests that adults tend to have the prevalence of sympatic regular mechanisms whereas in mature age the cases of individuals with the balanced vegetative nervous system in quiescent mode without pathologies are much more frequent.

The article presents twenty-five year observation on 5 patients with Diamond-Blackfan anemia. In 2010 the new case of this pathology in neonate was diagnosed. Research suggests that rarely, the Diamond-Blackfan anemia may be may be the result of an aplastic anemia. To find out what the real cause of anemia is the number of reticulocytes and qualitative and quantitative indicators bone marrow should be investigated in newborns and infants.

There is substantiated appropriateness of the establishment of the University Center on Rare Diseases. It is indicated that the center could illustrate a successful integration of the clinical sector into the system of medical education. The model of the functioning of center and its regulations are presented. The main topics of the special teaching module on rare diseases for physicians are submitted as well.

Different methods being used in the rare diseases clinical trials are examined. There is shown the purposefulness of using fuzzy approaches for such studies. Some advantages of Fuzzy logic methods in comparison with Baysian approach are substantiated.

The distribution of the disorders causing Fever of Unknown Origin (FUO) may differ according to the geographic area and the socioeconomic status of the country. FUO has not been appropriately investigated in children and adolescents in Georgia and therefore a study was undertaken to determine its causes and clinical characteristics. A total of 52 children fitting the classical FUO criteria seen in our clinic between 2003 and 2005 were investigated retrospectively. 27 (51,9 %) were boys and 25 (48,0%) were girls. 3 children (5,7 %) were less than 3 years old, 4 (7,6%) were 3-9 years old, 14 (26,9 %) were 10-14 years old and 32 (61,5%) were 15-18 years old. The mean age was 15,9 +/-4,8 years (range 1 year-18 years). 25 children (48,0 %) had a prolonged fever that had lasted for 15-30 days, 15 (28.8 %) for 31-60 days, and 12 (23.0 %) had fever lasting for more than 60 days. The most common causes of FUO were sepsis (10/52), tuberculosis (9/52), pneumonia (8/52), pyelonephritis (5/52), collagen tissue disorder (2/52), neoplasm (2/52), and miscellaneous (9/52). In 7 (13,4 %) of the cases the etiology could not be found. Some derivative hematological parameters--leukocytic index of intoxication, organism's allergisation index, ratios lymphocytes/neutrophils and eosinophils/lymphocytes and adaptation reactions can be helpful to distinguish severe infections. Precise evaluation of hematological changes can be useful for differential diagnosis of FUO. The most common cause of FUO in children and adolescents in Georgia remains infection.

The goal of the work was to study a prevalence of juvenile systemic hypertension among 15-16 years old adolescents of Tbilisi, its clinical characteristics and several indices of mental capacity. In the result of an analysis of 378 adolescents' blood pressure records only 6 (1.6%) had high normal values and 32 (8,46%) revealed juvenile systemic hypertension. Four youths from 6 with high normal values refused to participate in a further investigation. For this reason the study was continued only in 32 youths with juvenile systemic hypertension. In the contingent noted 6 (18,75%) had overweight, 9 (28,12%) had hereditary predisposition, 15 (46,9%) revealed excessive use of salt, 3 (9,4%) had moderate consumption of alcohol and 7 (21,9%) noted insufficient physical activity. Juvenile systemic hypertension in youth was predominantly asymptomatic, only 9 (28,12%) had mild headache in the evening, 12 (37,5%) had light fatigue and 5 (15,6%) weak dizziness. Fourteen youths noted diminished work-status and being behind in learning process. In the persons with juvenile systemic hypertension diminution of the attention concentration was observed during a fulfilment of a simple sensor and motor task in condition of monotonous work (increment of answers missed up to 13+/-12%). A psycho-emotional loading test has proved the fact of mental capacity lowering within the persons with juvenile systemic hypertension that is expressed in the increment of errors made up to 12+/-3,1% and answers missed up to 11+/-2,3%. Our investigations confirm the reasonability of blood pressure monitoring among adolescents for the early detection of the juvenile systemic hypertension and the conduction of an opportune preventive measures for avoiding of cardiovascular diseases in a mature age.

The aim of the study was to describe the clinical and epidemiological features of children and adolescents with visceral leishmaniasis in Georgia. We performed a retrospective analysis of demographic, clinical and laboratory data from children and adolescents under age of 18 (n=200) with visceral leishmaniasis admitted to the referral center -- Tbilisi S. Virsaladze Institute of Parasitology between 2000 and 2005. Diagnosis was based on detection of amastigotes in the bone marrow punctate. Age ranged from 4 months to 15.9 years, the average age was 2.79+/-0.17 years. There were 84 girls and 116 boys. 190 cases came from Eastern Georgia (123 from the capital), 10 cases -- from Western Georgia. The period between manifestation of first clinical signs of the disease and admission to the referral center varied from 1 week to 1 year (6.8+/-0,6 weeks in average). Main clinical and laboratory presentations were splenomegaly and hepatomagaly, anemia, pancytopenia (84.5%). Among associated diseases, the most frequent were bronchitis and pneumonia (7.0%) and jaundice (3.5%). In all patients glucantime was used for treatment. One patient died. Visceral leishmaniasis can be considered as an important etiological agent of the fever of unknown origin in Georgia, particularly in Eastern Georgia and in children under six. Health care workers should be trained for the early recognition and appropriate management of visceral leishmaniasis and its complications.

IDA is still the major medico-social problem in pediatric hematology, especially in early childhood. In this correction ferroresistant forms of IDA are interesting. The aim of our investigation was: studying the Efficacy of Tot'hema in the treatment of Iron Deficiency Anemia in Early childhood with concomitant copper deficiency. We observed 42 patients with IDA (age 0,4 - 3 years) in open control investigation. The carried-out investigations revealed that IDA in early childhood is often proceeded by the concomitant copper deficiency and ceruloplasmin, mainly in premature infants and in children with prolonged diarrhea in anamnesis. In such cases it is important to investigate the copper metabolism together with the peripheral blood index and iron metabolism. Tot'hema improves hematologic and biochemical index, completely supplies iron and copper deficiency, prevents of iron resistant form of IDA. Tot'hema has no side effects.

The project "Leaving of babies at children's homes and deinstitutionalization" was implemented at the children's home of Tbilisi. The purpose was to find out what influence was produced by deinstitutionalization on the physical and psychomotor development of deprived babies. The study lasted for 12 months. 3 groups of children were investigated. Group 1 comprised children selected for deinstitutionalization, age-matching healthy children who stayed at the children's home were in group 2, and healthy children randomly selected from 2 nurseries of Tbilisi were in group 3. The parameters of anthropometry and psychomotor development were evaluated according to the Denver screening test at the very beginning and in 12 months. The children from the children's home almost caught up, in 12 months after deinstitutionalization, with their control matches. Whereas, the children, who were brought up at the children's home, were behind the group-1 children and controls by all parameters. Projects promoting the upbringing of deprived children in their own or foster families are recommended for implementation.