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The purpose of the study was to evaluate the clinical and laboratory features of infectious mononucleosis with liver damage in children hospitalized in an infectious diseases hospital.Materials and methods. A comparative retrospective study was conducted from January 2018 to June 2021. 200 Medical records of an inpatient were selected by random sampling. Inclusion criteria: age from 1 to 17 years, clinical presentation of infectious mononucleosis, absence of severe concomitant pathology. All patients underwent a standard laboratory examination, additionally determined the DNA of herpes viruses in the blood by PCR. Depending on the presence of cytolysis syndrome (ALT level > 31 U/l), all patients were divided into 2 groups: children with hepatic manifestations of IMN – 80 patients (40%) and without them – 120 (60%). Statistical analysis of the obtained results was carried out using the statistical program Statistica 8 (USA).Results. Epstein – Barr virus was the cause of the development of IMN clinic in 59% (118/200) of cases of monoinfection and in 14.5% (29/200) in combination with other herpesviruses. All participants in the study had moderate disease. An increase in the level of alanine aminotransferase (ALT) above 150 U/L was recorded in 9.5% (19/200) of the examined, no one had more than 1000 U/L, the median was 72.5 (MKR 48–138.5) U/L. Liver damage was more often recorded in children older than 3 years, girls predominated (53.8%, p = 0.017). In patients with liver damage, the following were recorded: moderately severe fever and lymphadenopathy (p < 0.05), hepatosplenomegaly (p < 0.001), lymphocytic leukocytosis (p < 0.05), thrombocytopenia (p < 0.001), atypical mononuclear cells were detected more often (p < 0.001), less often an increase in the level of CRP (p = 0.008).Conclusions. Our study showed that liver damage in IMN is registered in 40% of hospitalized children. Obviously, children with moderate forms of IMN need laboratory and instrumental monitoring of the state of the hepatobiliary system and appropriate correction of therapy.

Relevance. Invasive meningococcal disease (IMD) has high morbidity and mortality, with infants and young children among those at greatest risk.Materials & Methods. A phase III, open-­label, randomized study in toddlers aged 12–23 months evaluated the immunogenicity and safety of MenACYW­TT, a tetanus toxoid conjugated vaccine against meningococcal serogroups A, C, W, and Y, when coadministered with paediatric vaccines (measles, mumps and rubella [MMR]; varicella [V] in South Korea and Thailand; 6­in­1 combination vaccine against diphtheria, tetanus, pertussis, polio, hepatitis B and Haemophilus influenzae type b [DTaP­IPVHepB­Hib] in Mexico and pneumococcal conjugate vaccine [PCV13]) in the Russian Federation (NCT03205371). This manuscript reports the outcome of the part of the study conducted in the Russian Federation using PCV13 as the co­administered vaccine. Immunogenicity to each meningococcal serogroup was assessed by serum bactericidal antibody assay using human complement (hSBA) and, for a subset of subjects, baby rabbit complement (rSBA). Vaccine safety profiles were described up to 30 days postvaccination.Results. A total of 1,183 participants were enrolled in the study, out of which 400 were from the Russian Federation. The proportion with seroprotection (hSBA ≥1:8) to each meningococcal serogroup at Day 30 was comparable between the MenACYW­-TT and MenACYW-­TT + PCV13 groups (≥91% and ≥84%, respectively). The safety profiles of MenACYW­-TT and PCV13, when given alone or concomitantly, were generally comparable.Conclusion. Coadministration of MenACYW­-TT with pneumococcal conjugate vaccine in toddlers had no clinically relevant effect on the immunogenicity and safety of any of the vaccines.

Prolonged subfebrile condition (PSC) is a complex diagnostic and therapeutic problem caused by a wide variety of reasons, which often require a wide and expensive examination, consultations of various specialists, and repeated hospitalizations. Most often, PSC is associated with infections, some non-infectious diseases (predominantly connective tissue) and growths. To infectious causes of DS include: acute respiratory viral infections, herpes virus infections, toxoplasmosis, chlamydia, borreliosis, bartonellosis, etc. Separately, “psychogenic fevers”, subfebrile condition associated with taking drugs, and artifical subfebrile condition are distinguished. The condition of the children, as a rule, is benign and in most cases goes away on their own within 6-24 months.

Objective: to study the activity of HSV 1,2, EBV, CMV, HHV6, HHV7 in children of different age groups, to determine the frequency of various symptoms and syndromes in the examined children depending on hhv7 monoinfection and combined herpetic infection in the age aspect.Materials and methods: 56 children aged 2 to 18 years were examined at the state MEDICAL research Institute named after Prof. A. F. Agafonov in Kazan, at the BIOMED medical and diagnostic center in Kazan and at the LUCH children’s clinic in Naberezhnye Chelny (boys accounted for 62.5% of cases, girls-37.5%). Verification of the diagnosis and evaluation of the dynamics of etiological markers of the infectious process in all observed children was performed by PCR. Blood and saliva were examined to detect markers of human herpes virus type 7 (in qualitative PCR), and blood, oropharyngeal flushing, and urine were examined in semiquantitative PCR to determine other viruses from the herpes family (HHV6, CMV, EBV). In enzyme immunoassay is determined At the same time, we studied options for combining laboratory markers of herpesvirus activity and changes in the main laboratory parameters used in routine practice. We studied the dynamics of the observed parameters against the background of complex antiviral therapy for the next 3 months after the initial examination. The frequency of occurrence of various symptoms and syndromes was determined depending on the activity of various representatives of the herpes family, their combination, and the age of the subjects.Results of the study: HHV7-monoinfection is more typical for the age group of 7-14 years. The significance of mixed HHV6+HHV7 infection decreased with age. The combination of activity of 4 herpesviruses was more often registered in the age categories 2-7 years and 14-18 years. More often, patients had tonsillitis, generalized cervical lymphadenopathy, periodic temperature rise to subfebrile or febrile numbers, pharyngitis, recurrent ARI, rhinitis, which allows us to consider them as the main manifestations of HHV7 infection.Conclusion: HHV7 infection is significant in the modern pathology of the child. The presence of such syndromes as recurrent tonsillitis, cervical lymphadenopathy or isolated enlargement of submandibular lymph nodes, periodic fever, pharyngitis, recurrent ARI in combination with hepato - and/ or splenomegaly, fatigue, and headache is often associated with HHV7. HHV7-viremia is relatively rare, despite obvious clinical and laboratory signs of inflammation indicating the presence of a viral disease, which, apparently, and is the cause of underdiagnosis and lack of proper attention to this infection.

The article presents current information about the etiology, epidemiology, clinical manifestations of parvovirus infection in children. The problems of the use of laboratory tests, treatment and prevention ofinfection.

A clinical case of development of secondary hemophagocytic syndrome is presented on the background of sepsis caused by Serratia proteamaculans, in a child of monthly age, culminating in recovery. Hemophagocytic syndrome in the child developed on the 32nd day of life and was accompanied by fever, hepatosplenomegaly, anemia, thrombocytopenia, elevated blood levels of triglycerides and ferritin. Blood culture was positive for Serratia proteamaculans. Isolate of Serratia proteamaculans was resistant to aminopenicillins (including protected ones), 1–4 generations of cephalosporins and aminoglycosides but sensitive to ciprofloxacin and moderately sensitive to imipenem and meropenem. The duration of fever in the child was seven days, thrombocytopenia, hyperfertritinemia and hypertriglyceridemia – 28 days. The normalization of the indices of ferritin, triglycerides and platelets coincided with the reduction of bacteremia and high values of the C-reactive protein. The duration of bacteremia was three weeks: the isolation of Serratia proteamaculans from the blood occurred three times. Elevated levels of C-reactive protein in the blood were noted for 30 days. Reduced hemoglobin and red blood cells counts were noted for eight weeks. Positive dynamics of the hemophagocytic syndrome occurred as a result of measures aimed at treating sepsis – antibiotic therapy with imipenem in combination with ciprofloxacin, appointed by the decision of the medical commission on the basis of the sensitivity of Serratia proteamaculans to antibiotics, intravenous immunoglobulin, and infusion therapy. Glucocorticosteroids and cytotoxic agents (etoposide, cyclosporin A) have not been used in this case.

The purpose was to study the clinical and epidemiological features of respiratory syncytial virus infection in hospitalized children the first year of life with lower respiratory tract diseases in different regions of the Russian Federation (Russia) during the 2015–2016 epidemic season.Materials and methods: in the original study data of a multicentre observational study conducted on the basis of children’s hospitals in St. Petersburg, Arkhangelsk, Kazan, and Saratov are presented. Etiology of acute respiratory viral infections were confirmed by examination of smears from the posterior pharyngeal wall by polymerase chain reaction. The study sample included 991 child’s first year of life with lesions of the lower respiratory tract.Results. In the etiological structure of the surveyed children in the season of 2015-2016, RSVI ranged from 14% to 46,2%, an average of 33%. RSVI dominated in the Centers of St. Petersburg (38,3%), Arkhangelsk (36.2%) and Kazan (42.5 per cent).RSVI significantly more often (p

The article shows the results of the analysis of trucking’s acting theoretical provisions on calculation of a rolling stock’s productivity and cost. It has been established that the existing theoretical provisions of trucking are assigned for changeable daily schedule of a rolling stock’s work. It is necessary to develop a methodology that allows considering opportunity of using unit of a rolling stock in trucking under specific agreement.

Aim. To reveal of markers of inflammation and progression of calcification in patients with degenerative aortic stenosis (DAS). Material and methods. A single-stage study was done in 85 patients with degenerative calcification of aortic valve (42 patients with DAS and 43 patients without DAS). The techniques for assessing the severity of aortic valve calcification included ultrasonic diagnostics and multislice spiral computed tomography. Markers of inflammation and lipid profile were investigated. Results. Higher blood levels of total holesterol and holesterol of low density lipoprotein were revealed in patients with DAS in comparison with patients without DAS. They also had higher levels of inflammation markers: C-reactive protein and interleukin-6. There were significant correlations between DAS severity, lipid metabolism disturbances and inflammation markers. Conclusion. Atherogenesis and inflammation may have pathogenic influence on progression of aortic valve calcification and DAS development by lipid infiltration and endothelium cells damage.

The article is focused on the main issues of the regulation of water-electrolyte metabolism in children, possible variants of its disorder in acute diarrhoeal diseases. The clinical features of dehydration depending on the severity and qualitative component of losses are described, recommendations on laboratory diagnosis and treatment are provided.

Infection-associated hemophagocytic syndrome is a life-threatening condition characterized by prolonged fever, hepatosplenomegaly, and cytopenia—most commonly, thrombocytopenia and anemia. It is characterized by proliferation and activation of benign histiocytes, causing dysfunction of various organs. Herein, we report about two clinical cases of hemophagocytic syndrome, associated with cytomegalovirus and Epstein – Barr virus.

The paper focuses on questions of etiotropic, pa diarrhea in children. The recommendations are given with the basic principles of evidence-based medicine including summary data from randomized clinical trials and metaanalyses. The new lines of the treatment are discussed suchas the possibility of application of antiemetic, antidiarrheal, antisecretory, probiotic drugs in pediatric practice.

The paper focuses on questions of etiotropic, pathogenetic, and symptomatic treatment of acute infectious diarrhea in children. The recommendations are given with the basic principles of evidence-based medicine including summary data from randomized clinical trials and metaanalyses. The new lines of the treatment are discussed such as the possibility of application of antiemetic, antidiarrheal, antisecretory, probiotic drugs in pediatric practice.

Neonatal sepsis is a significant health issue associated with high mortality. Immune responses associated with neonatal sepsis, such as proinflammatory cytokine production, are believed to play a central role in the pathogenesis of this disease. In the present study, serum levels of the proinflammatory cytokines TNF-α, IL1-β, and IL-6 and the anti-inflammatory cytokines IL-4 and IL-10 were evaluated for 25 subjects with neonatal sepsis. We observed that subjects with late onset of sepsis (LOS), as well as those with early onset of sepsis (EOS), had a substantial increase in serum TNF-α. In contrast to EOS, subjects with LOS demonstrated a significant increase in serum levels IL-6 and IL-10. Additionally, we observed a significant difference in cytokine profiles between acute and postacute cases of neonatal sepsis. For instance, the level of proinflammatory cytokines, such as TNF-α and IL-6, was elevated in the acute phase, whereas the production of anti-inflammatory cytokines, such as IL-10, became substantially upregulated during the postacute phase. Additionally, no correlation was observed between cytokine levels and CRP levels or lymphocyte counts. Thus, in contrast to CRP levels and lymphocyte counts, examination of the cytokine profile can provide valuable information when determining the most effective therapy for treating neonatal sepsis. This information may be useful to physicians when determining if anti-inflammatory or immune stimulatory therapy is warranted.

Anthracycline antibiotics are highly effective in the treatment of cancer, but their cardiotoxicity limits use of these antibiotics. A cardiotoxic action of anthracyclines provokes development of dilated cardiomyopathy with or without symptoms of cardiac insufficiency (CI). Anthracyclines have a long-term cardiotoxic action, therefore, with time, the rate of cardiomyopathy development increases. Follow-up echocardiography is an optimal method for assessment of cardiac function. Such parameters as left ventricular ejection fraction and the degree of the anteroposterior shortening are most essential. Cardiac failure symptoms are managed in the same way as in other pathology.

To identify the most informative cardiovascular markers of aging, the association of age and several morpho-functional parameters, assessed by instrumental and laboratory methods, was investigated. Myocardial hypertrophy and left ventricular diastolic dysfunction could be used as cardiovascular markers of aging. Enhanced progression of vascular wall aging correlated with cardiovascular complication development. Vascular aging progression should be assessed for identifying young patients with high risk of myocardial infarction.