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Objective – to determine the differences in the morphological parameters of stomata and the component composition of cuticular waxes of silver linden (Tilia tomentosa Moench) leaves under conditions of lighting and shading in the crown of a tree. Material and methods. The sun-adapted and shadeadapted fully developed leaves of silver linden were selected as the test objects in our study. The component composition of the cuticular waxes was investigated by gas chromatography method, and stomata size and quantity values were determined on the epidermal imprints of the abaxial side of leaves. Results. The adaptive changes in leaves of the alien invasive plant species silver linden were established under conditions of increasing light intensity and temperature and reducing air humidity. Conclusion. The leaf surface area, leaf weight per unit area, density of stomata, and the content of the long chain components of the cuticular waxes increase, the length and the width of stomata decrease under conditions of lighting.

The article is dedicated to food allergies. There still is no accurate estimate of the socioeconomic burden of food allergies and its impact upon the healthcare budget despite increasing prevalence thereof and lack of clear prognostic criteria. The authors present a modern classification of predominant clinical manifestations based on pathogenetic mechanisms of development. They describe therapeutic approaches, propose recommendations on diet broadening for both patients with food allergy manifestations and risk group children, define cross-sensitization and discuss a problem of non-immune reactions to foods.Keywords: food allergy, tolerance, food allergens, cow milk protein, therapeutic formulae, panallergens, cross-sensitization, risk group children, elimination diet, supplementary feeding, diet, tolerance window.

The article is dedicated to the issues of organization of long-term follow-up monitoring of the patient population in real clinical practice. Every medical intervention is analyzed from the position of positive evidence of its effectiveness, safety and clinical-economic benefits. Although randomized clinical trials (RCTs) are the gold standard of evidence-based medicine, they feature a range of drawbacks; in some cases, such trials are infeasible are extremely complicated to perform due to certain aspects. Along with that, results of RCTs may not completely correlate with clinical practice. Thus, a register – a system of long-term clinical monitoring of a patient population – is a significant source of information on effectiveness and safety of medical interventions. This tool of follow-up observation of a patient’s condition is irreplaceable in medicine, particularly, in allergology both for epidemiological purposes and to assess effectiveness and safety of therapeutic interventions: e.g., use of IgE antibodies – biopharmaceutical omalizumab.Keywords: register, long-term follow-up monitoring system, effectiveness, safety, uncontrolled severe persisting bronchial asthma, omalizumab, children.

The article is devoted to one of the most «problematic» aspects of Pediatrics — use of immune-response modulating drugs. Complexity is due as to the abundance of similar agents on the pharmacological market also to the evident absence of the proved efficacy and safety of most of them. The authors focused their attention on the category of patients, to whom these drugs were most commonly prescribed — i. e. children with recurrent acute respiratory infections. Along with the classification the characteristics of the different groups of immune-response modulating drugs are presented. Key words: children with recurrent acute respiratory infections, acute respiratory infections, immune-response modulating therapy, ribosomal-proteoglican complex. (Pediatric pharmacology. — 2011; 8 (6): 108–113).

The most important component in the treatment of children with infectious and inflammatory diseases is antibiotics. However, widespread, and sometimes not enough justified use of antibiotics often leads to complications, among which a violation of the gastrointestinal tract microecology i. e. an antibiotic-associated diarrhea occupies a special place. Currently, the most promising avenue for the prevention and complex treatment of antibiotic-associated diarrhea in children is the use of probiotics. The article presents data of domestic probiotic preparation in the complex treatment of antibiotic-associated diarrhea in children. Key words: antibiotic-associated diarrhea, probiotics, antibiotics, intestines dysbiosis. (Pediatric pharmacology. — 2011; 8 (6): 103–107).

Cough is one of the most common complaints, the cause of the parents visit to the doctor. This symptom is usually associated with the pathology of the broncho-pulmonary system, but may also occur in a wide range of diseases, diverse in its pathogenesis and the place of affection. So, the algorithm of the patient with a cough treatment should include not only the medical history clinical and laboratory examination, but plus the experts advices, without which the diagnostic search cannot be successful. In addition, the topical application of the effective and safe drugs in ARI in young children remains the issue of the day.Key words: cough, children, symptomatic therapy, a combined herbal medication.

The steady increase in the prevalence of allergic diseases causes the social significance of this pathology. These statistics often do not reflect the true morbidity picture. The social and economic burden of allergy forces experts to seek new ways of preventing the beginnings and development of this pathology. The relationship between bronchiolitis caused by respiratory syncytial virus (RSV) infection in the early childhood and further development of asthma was proved by numerous randomized trials. The use of the drug for RSV monoclonal antibodies will reduce not only the incidence of the infection, prevent the development of bronchiolitis, but reduce the risk of asthma in early childhood.Key words: asthma, children, respiratory syncytial virus, prophylaxis.

Due to the prevalence of allergic disease remains an urgent problem of atopy. Genetic factors play an important role in increasing the incidence, but we cannot forget about the Еnvironmental risk factors. The epigenetics explains the hereditary modifications of gene activity without changes in DNA sequence (for example, histone modifications, DNA methylation and chromatin’s architectonic changes). Study of biomechanics and airway remodeling in asthma causes remain one of the most actual at present. A special category of patients with asthma — young children — requires special attention due to the anatomical, phenotypic, and emotional specifics. Selection of the basic treatment for such patients should be aimed for maximizing the effective deposition of the drug.Key words: asthma, airway remodeling, preschool children, basic therapy.

The article presents a review of studies of prebiotic Lactofiltrum efficacy in complex treatment of atopic dermatitis (AD) in children. AD takes significant place in the structure of allergic diseases in children. 70–80% of patients with AD have intestinal dysbiosis resulting in disorder of barrier function of intestine. Protocols of AD treatment of children include not only elimination diet, antihistamine drugs, topical treatment but enterosorbates. Drugs based on hydrolyzed lignin are actively used during recent years. One of these drugs is prebiotic with sorbent effect Lactofiltrum.Key words: children, atopic dermatitis, enterosorbates, treatment.(Voprosy sovremennoi pediatrii — Current Pediatrics. 2011; 10 (2): 180–183)

The leading pathology in children is acute respiratory infections (ARI) according to the expert data of WHO. The incidence of prolonged and recurrent types of ARI increases during recent years. Patients with these diseases subsequently form the group of children with compromised immunity. Immunogens and immunomodulators are the drugs of nonspecific prophylaxis which are used for the prevention of ARI. The group of bacterial immunomodulators is big but most well-studied systemic drug from this group is Ribomunyl. Ribosomal complex is effective and safe in pediatric practice. The article presents the clinical case of treatment with ribosomal complex in immunocompronised child with allergic pathology.Key words: children with compromised immunity, allergy, acute respiratory infections, treatment.(Voprosy sovremennoi pediatrii — Current Pediatrics. 2011; 10 (2): 211–215)

The most important biochemical processes in human organism are carried out with vitamins and microelements involved. Acting as biological catalysts, vitamins have an impact on metabolism and provide protection against unfavourable environmental factors. The key source of vitamins and microelements for a person is food. The content of vitamins in a diet varies and depends on a range of various reasons. However, now the diet may not fully meet vitamin and microelement requirements. The result of this is widespread prevalence of sub-clinical deficiency of vitamins and microelements. Patients from one of the risk groups, children with atopy, are especially susceptible to this condition. Hypoallergenic diet prescribed as part of the therapeutic measures, is often the cause of imbalanced and irrational nutrition. Modern vitamin complexes may solve the issue of subnormal supply of vitamins and apparent hypovitaminosis in children with allergic diseases.Key words: polyvitamin complexes, atopy, allergic diseases, subnormal supply of vitamins, children.

Allergic rhinitis (AR) is global problem of world health care system. Last 50 years the prevalence of AR increased. AR influences social life, sleeping, school progress and capacity for work. AR is frequently combined with bronchial asthma; it is able to induce exacerbation of asthma. The treatment of AR should be directed to the control of symptoms, prophylaxis of complications, improvement of sleeping and quality of life of patients and their parents. Intranasal corticosteroids are the drugs of choice in treatment of children with AR, these medications stop all symptoms of the disease including eyes symptoms.Key words: children, allergic rhinitis, intranasal corticosteroids, treatment.(Voprosy sovremennoi pediatrii — Current Pediatrics. 2010;9(6):45-51)

Acute respiratory infections (ARI) are widespread in children regardless of age and region of living; they are characterized with big amount of infectious agents and absence of a trend to morbidity decrease. Drugs for nonspecific prophylaxis (immunostimulators and immunomodulatory agents) are frequently used for prevention of ARI. There are plenty of immunomodulating agents; the wellstudied medication with systemic action with good efficacy and safety in pediatric practice is ribosomal-proteoglycan complex. The article presents the description of clinical experience of treatment with this complex in pediatric practice.Key words: children, acute respiratory infections, prophylaxis, treatment, ribosomal complex.(Voprosy sovremennoi pediatrii — Current Pediatrics. 2010;9(6):127-130)

One of necessary conditions in treatment of children with allergic diseases is eliminational hypoallergenic diet. Endogenous and exogenous vitamin deficiency is a result of the dietotherapy. Administration of vitamins and minerals complexes is necessary in children with allergic pathology. The choice of supplementary drug should be made according to character and severity of disease, composition of drug, its form of delivery. The article reviews an experience of vitamins and minerals complexes administration in children with different allergic disorders.Key words: children, allergic diseases, vitamins, deficiency.(Voprosy sovremennoi pediatrii — Current Pediatrics. 2010;9(6):113-116)

Atopic dermatitis (AtD) is one of the most widespread types of allergic lesions of skin in children. Increase of severe types of AtD with lesion of big parts of skin, high frequency of exacerbations, presence of concomitant atopic diseases, and inefficiency of standard therapeutic approaches, torpid clinical course and early development of disability, causes an anxiety. Present standard approaches can be ineffective in children with severe clinical course of AtD and they are not able to prevent progression of disease, development of severe exacerbations and child’s disability. One of therapeutic alternatives for these patients is treatment with immunosuppressive agents. The article describes questions of treatment with cyclosporine in systemic therapy of severe resistant forms of AtD in children. Author discusses effectiveness and safety of a drug, formulated rules of treatment of severe AtD with cyclosporine. Key words: children, atopic dermatitis, cyclosporine, treatment.(Voprosy sovremennoi pediatrii — Current Pediatrics. 2010;9(5):117-120)

Cough is one of the most frequent reasons parents take their child to a doctor. Most frequently it develops against the backdrop of respiratory infections of viral, mixed viral-bacterial and bacterial aetiology. Currently the issue of applying efficient and at the same time safe medications for acute respiratory infections in young children is quite pressing. The article provides data from studies in which a complex plant drug is administered in children with respiratory infections. The results obtained indicate the efficacy of including herbal syrup in the therapy for children with acute respirator infections. The medication lowers the intensity of the cough providing a soft expectorant and spasmolytic effect, and reduces medicinal burden on the child’s system. Key words: cough, respiratory infections, children. (Pediatric Pharmacology. – 2010; 7(4):95-100)

The article describes actual pediatric problem — frequent development of respiratory infections in children. Authors present the results of Russian multicenter study of effectiveness and safety of pidotimod (Imunorix) in frequently ailing children. It was shown that treatment with pidotimod during 30 days resulted in decreased rate of acute respiratory infections and their complications including ones with necessity of antibacterial therapy compared to children from control group. The dynamics of immunological rates in blood serum was studied.Key words: frequently ailing children, acute respiratory infections, prophylaxis, pidotimod.(Voprosy sovremennoi pediatrii — Current Pediatrics. 2010;9(2):40-44)

The article describes in detail the therapy for bronchial asthma with combined preparations. The key advantage of combining longacting inhalant corticosteroids and β2-agonists in one inhalant is the simultaneous delivery of effective inhalant preparations to the lungs. Such approach increases the commitment of patients to the prescribed therapy thus making it easier to achieve compliance. Key words: bronchial asthma, control, combined preparations. (Pediatric Pharmacology. – 2010; 7(1):68-71)

Bronchial asthma remains disease with wide prevalence in children different age. Inhalation corticosteroids are medications of first line of therapy in children. The article describes the ways of treatment with budesonide (Pulmicort) in children preschool age. The data from different studies prove the effectiveness and safety of treatment with as turbuhaler, as nebulizer form of this drug. Key words: children, bronchial asthma, inhalational corticosteroids, budesonide.(Voprosy sovremennoi pediatrii — Current Pediatrics. 2010;9(1):76-80)

Over the recent years, standardised epidemiological studies of asthma and asthma'like symptoms in the population of children have been conducted. ISAAC (International Study of Asthma and Allergy in Childhood) questionnaire has been predominantly used as a tool to assess the prevalence of clinical implications and diagnosed conditions in children. However, this technique has limitations in terms of subject age (children aged 6–7 and 13–14). We have conducted a study on the prevalence of Asthma and allergy in adolescents (children aged 15–17) using the standardised GA2LEN (Global Allergy and Asthma European Network) questionnaire in two Russian cities from central region and Siberia (Moscow and Tomsk). It has been found that the prevalence of asthma'like symptoms in adolescents was three times the level of clinically diagnosed asthma, which accounted for no more than 7%, with this indicator having no variance depending on the region of residence.Key words: asthma, GA2LEN, prevalence, epidemiology, adolescents.

The article is devoted to an important matter of pediatrics — hypovitaminosis prevention among children. The author generally provided for the functions of vitamins in ensuring the normal vital functions of the organism, as well as described the properties of certain vitamins and microelements, their uniqueness and irreplaceability. Therefore, considering great troubles in ensuring the optimal contents of these substances in the ration, the author showed the necessity of the preventive prescription of the vitamin and mineral complexes. Besides, their application is expedient during the period of recovery from acute infectious diseases and in the comprehensive therapy of the chronic somatic diseases. The author points out to the necessity to choose the dosage form of a vitamin and mineral complex with due regard for the daily requirement for the vitamins and minerals among children from different age groups.Key words: vitamins, microelements, hypovitaminosis, prevention, children.

The problem of balanced nutrition remains to be quite urgent in the modern pediatrics. Despite the fact there are many high quality foodstuffs in the Russian market, the occurrence of the vitamin deficient statuses is still high. The authors of the article describe the important functions of vitamins and microelements in the human body, as well as demonstrate the necessity to additionally administer them as correctly balanced pharmacological forms.Key words: vitamins, vitamin deficiency, correction, children.

The esophageal reflux is quite often accompanied by cow milk allergy in infants. For that matter, the authors recommend to examin all infants with esophageal reflux to be sure if they have allergy or not. The authors represent diagnostic methods for both disorders. Besides the authors represent the results of the research work on effectiveness of amino acid mix for cmatreatment which they used in patients with esophageal reflux.Key words: allergy to the protein of the cow milk, esophageal reflux, amino acid mixture, children.

The article provides the data on the new application and effectiveness aspects of the probiotics from the viewpoint of the evidence based medicine. It demonstrated the decrease of the chronic nasopharynx pathology backsets in the event of probiotic prescriptions. The authors highlight the results of the research, in which the given medications were successful applied to prevent the antibiotic associated diarrhea among the children, suffering from the respiratory diseases.Key words: probiotics, lactobacillus, bifidobakterium, intestinal dysbiosis, children.

Allergic rhinitis is often combined with bronchial asthma and allergic conjunctivitis, favoring the development of another pathology of superior respiratory tract and deteriorating the prognosis. authors demonstrate the common character of pathogenesis of allergic bronchitis and allergic rhinitis, con vincingly explain the necessity of using modern antihistamine medications. The efficiency of second generation of this group drug is shown not only in complete control of allergic rhinitis symptoms but also in the improvement of the course of bronchial asthma, increase in efficiency of bronchial asthma treatment and improvement of children's quality of life.Key words: allergic rhinitis, bronchial asthma, pathogenesis, treatment, quality of life, children.

In this article authors consider frequent development of respiratory infections in children, which is a relevant problem in pediatrics. Criteria of including patients into sickly children group as well as reasons and risk factors of development of this category, are presented. Types of frequent infections preventive treatment are shown. A new immunocorrective medicine pidotimod is presented in more detail and its efficiency in immunomodulation and reduction of morbidity among such children is convincingly proven, as exemplified by a number of multicenter studies.Key words: acute respiratory infections, sickly children, prophylaxis, immunomodulators, pidotimod.

As population based studies conducted in Russia showed, deficit of vitamins and microelements is quite widespread among the population, and children are no exclusion. The article demonstrates the functions of these compounds that are essential for the normal operation of the body — their antioxidant and immunomodulatory activities, as well as the consequences of their deficit. Besides, authors explain persuasively the advisability of use of the new combined drug, which includes vitamins, microelements and probiotics, and demonstrated its high efficiency in terms of clinical study.Key words: vitamins, microelements, probiotics, properties, deficit, deficit reduction, children.

In the article, the authors justify the necessity to apply non medicamentous treatment methods to the children with bronchial asthma. The scientists familiarize us with a new me dication, whose effect is based on the noninvasive impact of the electromagnetic radiation of the knowingly non thermal intensity. It is for normalization of the disturbed function of the respiratory system. The researchers showed the efficiency of the above said innovative medication, while treating bronchial asthma among children with no side effects whatsoever.Key words: bronchial asthma, nonmedicamentous treatment methods, children.

Vitamins are biologically active substances, which regulate many biochemical processes within the human body. in modern conditions, peculiarities of the household and children's nourishment do not allow for complete satisfaction of the need in all the vitamins only thanks to the food. In relation to this, it's quite desirable to provide the additional inflow of the vitamins into the child's body, which may be performed through the individual intake of the children's multivitamin medications.Key words: vitamins, children, hypovitaminosis, vitamin and mineral complex.

Practically in all the cases of broncho-pulmonary system diseases, including acute bronchitis, the cough occurs as a clinical syndrome. The main cough function — is the restoration of the airway by removing secretions and restore mucociliary transport of bronchial secretions (mucociliary clearance). Among the variety of antitussives the combined drugs are widely used to treat cough. The combination of several active substances in one medicinal product can produce more effective therapy thanks to the multi-directional action of the components, as well as to improve its safety because of the possibility of using lower doses of drugs due to the combined synergies of their impact. The paper presents the experience of using combined medications in the treatment of cough in children. Key words: cough, respiratory diseases, treatment, and antitussive combined medications, children. (Pediatric Pharmacology. — 2011; 8 (5): 98–100.)

Coughing is the most frequent symptom that accompanies diseases of the bronchopulmonary system. However, it may develop in a number of diseases that vary in its pathogenesis and location. Despite the variety of potential causes, in most cases acute respiratory infections (ARIs) play the key role in the etyology of coughing. Key methods of therapy for coughing in ARIs include efforts to improve the bronchial drainage function, restore mucociliary clearance, antiinflammation and, if necessary, broncholytic therapy. However, if coughing disrupts the well-being and condition of a patient (non-productive, short, compulsive, vomitory, chest pain causing, sleep and appetite disturbing), cough suppressive medications are administered. To this end, combined preparations containing codeine are successfully used in pediatric practice. Key words: coughing, combined antitussive preparations, children.(Pediatric Pharmacology. – 2010; 7(6):78-80)

The article deals with issues of vitamins application for treatment of hypovitaminosis in children with allergic diseases. Advantages of administration of polyvitamin complexes are specified.Key words: children, allergic diseases, hypovitaminoses, polyvitamins.

The article analyzes current situation of bronchial asthma non medicated therapy. The need to apply such therapy is associated with the on going trend of more frequent severe bronchial asthma cases, as well as not always efficient standard schemes of medicated treatment. The authors announce a physiotherapy device «aster» — it is based on innovative technologies and designed for noninvasive impact of electromagnetic waves with non thermal intensity upon the «pulmonary triangle» body area. A randomized multicentered survey of Russia's pediatricians union is being conducted to prove the efficiency of this device for children with bronchial asthma and basic therapy adequate to the severity degree. The application of this device is expected to reduce symptoms and eliminate dysfunctions of respiratory system typical for bronchial asthma, which cannot be totally eliminated with the current anti inflammatory agents.Key words: bronchial asthma, non medicated therapy.

The research is dedicated to the efficiency evaluation of the budesonide based nebuliser therapy to reduce the exacerbation of bronchial asthma among children and teenagers. it was uncovered that the efficiency of such therapy reached 100%, which is manifested both in the decrease of the symptomatology intensity and improvement for the indices of the external respiration function, while there are no side effects whatsoever.Key words: bronchial asthma, budesonide, nebuliser, children.