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Glycogen storage disease refers to hereditary pathologies of carbohydrate metabolism, its cause is mutations of various genes encoding enzymes responsible for the synthesis and breakdown of glycogen. Due to enzyme defects, excessive glycogen deposition occurs in cells of various tissues, mainly in the liver and muscles. The authors present modern epidemiological data and features of the etiopathogenesis of glycogen storage disease, and give clinical characteristics of various types of this nosology. In accordance with the developed clinical guidelines, information is provided on laboratory, instrumental and morphological signs of glycogen storage disease in children, as well as on methods of treatment of glycogen storage disease. Due to the variety of clinical forms of glycogenosis, the article provides up-to-date information on three types of pathology that occur with predominant liver damage.

Background. The COVID-19 pandemic is a global challenge to States and health systems. The pandemic and its consequences can have a devastating impact on the health and development of children, especially those in vulnerable situations — children with disabilities.The aim of the study is a medical and social assessment of the effect of the COVID—19 pandemic and its consequences on families with children with disabilities.Methods. A descriptive study using the Google forms platform was conducted using the cross-sectional method. Two groups of parents of children aged 0–17 years with disabilities (group 1) and without disabilities (group 2) who apply to a medical organization for preventive examinations were interviewed.Results and discussion. A total of 175 electronic questionnaires were received. Parents from 46 regions of Russia participated in the survey. A significant majority of respondents were women — 172 people (98%), 3 men (2%). More than half of the respondents are residents of the megalopolis. The study showed that the COVID-19 pandemic had a negative impact on the health and education of children and on the lifestyle and families welfare in general. It was revealed that the financial situation of many families who took part in the study worsened, which affected the living conditions of children. During the COVID-19 pandemic, the health care system was being rebuilt taking into account new tasks to counteract dangerous infection, which was reflected in changes in the provision of medical care to children, and in some cases this led to a deterioration of their health. A significant number of parents who participated in the study believe that changes in the organization of medical care during the pandemic had a negative impact on their child’s health. Among the main health problems, parents highlight delays and cancellations of medical consultations, difficulties in obtaining urgent care and problems with drug provision. Among the main health problems, parents highlight delays and cancellations of medical consultations, difficulties in obtaining emergency care and problems with drug provision. The study shows that families with disabled children have been affected by the COVID-19 pandemic to a greater extent than families raising children without chronic health problems. If the deterioration of the financial situation is almost equally revealed in both groups, then problems related to medical care and education have a more noticeable impact on families with a child with a disability. The obtained results should be taken into account in times of new challenges when developing measures of state support for families with children, especially with children with disabilities. At the same time, it is important to pay primary attention to the organization of medical care for children (continuity of planned medical care for the child population and rehabilitation actions) and educational services (providing online learning opportunities for the child, taking into account individual ones).Conclusion. The COVID-19 pandemic and its consequences have had a negative impact on the standard and quality of life of people, especially families with children. The pandemic has had a significant adverse impact on the health and development of children, especially children with disabilities. The study showed a decrease in the financial situation of families, problems with children receiving medical care, difficulties in education, especially with regard to specialized pedagogical classes with disabled children, during the pandemic. According to the study, in order to prevent the negative impact of the pandemic, it is proposed not only to provide financial support to families, but also to maintain access to the educational process with the provision of the required devices, as well as the possibility of receiving medical care for children, especially children with disabilities, including planned.

Background. The commitment to vaccination of outpatient doctors is one of the factors that affects patients’ confidence in preventive vaccinations and, as a result, the incidence of controlled infections. Unfortunately, emotionally colored information is currently spreading among the population faster than scientifically proven facts all over the world.The aim of this study is the examine of the level of knowledge and attitude to vaccination of doctors in one of the children’s polyclinics in Moscow.Methods. An anonymous questionnaire survey was conducted among medical doctors of different specialties who expressed their attitude to various aspects of immunoprophylaxis and demonstrated knowledge in this field. Results. The survey demonstrated a positive attitude of respondents towards immunization, while some of them showed a cautious attitude towards the effectiveness and safety of vaccines, misconceptions (erroneous assumptions), increased susceptibility to “myths” about preventive vaccinations.Conclusion. The level of knowledge of medical doctors on vaccine prevention within a single health care institution range from insufficient training, including misconceptions, to a high level of knowledge and commitment regarding immunization. It is necessary to regularly maintain current theoretical knowledge of doctors and consolidate it in practice.

Hypophosphatasia is rare genetic disease caused by tissue-nonspecific alkaline phosphatase deficiency due to the mutation in the ALPL gene. Disease can manifest in utero, in childhood or in adults depending on its form and severity. This article presents modern data on the epidemiology, etiology, and clinical signs of hypophosphatasia in children, covers in details differential diagnostic search, and gives guidelines for its evidence-based treatment. Without timely treatment the prognosis of the disease is unfavorable in most cases. Such patients require follow-up by multidisciplinary team of physicians. The only effective method of treatment is enzyme replacement therapy with asfotase alfa. Symptomatic therapy is also crucial as well as physiotherapeutic procedures and therapeutic exercise programs (at rehabilitation stage).

The generally accepted standard in early breast cancer surgery today is breast-conserving surgery with external beam radiation therapy, which is comparable in results to previously widely performed radical mastectomy and even has an advantage in terms of overall survival and control. Until now, there are areas of discussion and a number of questions remain related to the methodology of irradiation of patients with breast cancer, namely: is it advisable to irradiate the axillary zone after radical resection for early breast cancer? Does irradiation of axillary lymph nodes provide regional control comparable to lymphadenectomy, and whether it can be an alternative to lymph node dissection? Whether provides an irradiation of axillary lymph nodes comparable with regional lymph node dissection the control over patients with a positive sentry lymph node? A lot of studies have been published so far, answers to questions derived from what we present in this work.

This article describes the implementation stages of the changes in preventive vaccination procedures in Children’s City Outpatient’s Clinic №133 of the Moscow Department of Health since December 2019. Comprehensive work has been performed on increasing the adherence to vaccination among doctors of various specialties, vaccination and immunization coverage of the registered pediatric population. As a result of this project medical prevention department was reorganized, data on vaccinations, medical exemption and refusals were added to the electronic medical records, monthly monitoring of vaccination coverage rate was initiated, as well as doctors training in preventive immunization via three forms of education. Center for Medical Prevention of the Moscow Department of Health, pediatric department of the Pediatric Faculty of Pirogov Russian National Research Medical University, the Union of Pediatricians of Russia have participated in this work. Intermediate results on efficacy of implemented measures have been presented.

Experts of the Union of Pediatricians of Russia have developed modern guidelines on management of children with acute respiratory viral infection. The term “acute respiratory viral infection” (ARVI) combines following nosological forms: acute nasopharyngitis, acute pharyngitis, acute laryngitis, acute tracheitis, acute laryngopharyngitis, upper respiration tract infection (unspecified). The issues of epidemiology, diagnosis, treatment, and prevention have been considered in detail.

The paper shows the use of the methods of hyperspectral imaging (HSI) in a range of 400–1000 nm and multivariate analysis for sorting Hass avocado fruits. The decomposition of the data matrix of HSIs of avocado fruits was carried out using the principle component analysis. The reflection bands in the visible and near-infrared spectral regions interrelated with the process of maturation and the moisture content of avocado fruits were revealed. It has been established that visualization upon avocado inline sorting by moisture is possible when using factor loadings as pseudo-color. Calibration models for determination of moisture and dry matter of avocado fruits were built based on the data of moisture measurement and hyperspectral images. The matrix of spectral data was formed by two methods: random selection of spectral signatures of HSIs from the whole surface of fruits or the image surface of HSIs of fruits (initial HSIs) as a region of interest (ROI). Based on the data of moisture measurement and selection of spectral signatures of hyperspectral images, calibration models were built for detection of moisture and dry matter of avocado fruits. Using sequential simulation by the projection to latent structures (PLS) method, accurate calibration models were developed to detect moisture (RP2 = 0.89) and dry matter (RP2 = 0.92) in the composition of avocado fruits. When building calibration models by the initial HSIs, models were obtained to predict moisture (RС2 = 0.99) and dry matter (RС2 = 0.99) in the composition of avocado fruits. It is proposed to use calibration models by the initial HSIs to determine moisture and dry matter in the intervals of the acceptable values according to the acting standard UNECE STANDARD FFV-42:2019.

Experts of The Union of Pediatricians of Russia have developed current clinical guidelines for management of children with community-acquired pneumonia, which were approved by the Scientific and Practice Council of Ministry of Public Health of the Russian Federation in January 2022. Particular attention is paid to the etiological structure, modern classification, diagnostic tests and flagship approaches to antibacterial therapy of community-acquired pneumonia in children based on the principles of evidentiary medicine.

Background. Studies have shown that vaccination in the first hours/days after birth shifts the immune response from intrauterine Th2 towards Th1-type activation and reduces the risk of atopic conditions. However, we did not find published data from prospective studies on this topic.Objective. The aim of the study is to define the presence of negative correlation between vaccination against tuberculosis and hepatitis B in the first hours/days of life and atopic dermatitis development in infants.Methods. Continuous prospective study of children cohort born from April to June 2021 and observed in one outpatient’s clinic was carried out. Data from 307 infant’s records (F. 112/y), vaccination record cards (F. 063/y), prenatal and delivery records (F. 113/y-20, section № 3), and neonatal discharge summaries were analyzed for the decreed period. The child vaccination status (by the time of vaccination against tuberculosis and hepatitis B), presence of risk factors for allergic disease development, and presence of atopic dermatitis were evaluated.Results. Atopic dermatitis (AD) was significantly less likely to be diagnosed by the age of 1 year in infants from the group of BCG-M vaccinated at maternity hospital than in those vaccinated later or not vaccinated at all (15.2% versus 66% and 35.7%, respectively; p < 0,01). AD was less likely to develop in children with risk factors for allergic disease who were vaccinated against tuberculosis in the maternity hospital than in those vaccinated later or unvaccinated at all (18, 75 and 62.5%, respectively; p < 0.01). The ratio of children with diagnosed AD by the age of 12 months was significantly less in the group of children vaccinated against hepatitis B in the maternity hospital than in those vaccinated later or unvaccinated at all (17.6, 44.9 and 31.8%, respectively; p < 0.01). These ratios for children with risk of allergic disease development were 24%, 50% and 44.4%, respectively (p = 0.043). It has also been shown that timely vaccination with both vaccines in the early neonatal period significantly reduces the risk of AD in general infant population compared to non-vaccinated individuals or those who had only one vaccine (odds ratio [OR] 0.374; 95% confidence interval [CI] 0.253-0.552; p < 0.01). Whereas the disease development in children with allergic risk is less likely with timely vaccination (20.8% versus 53.3%; OR = 0.252; 95% CI 0.145–0.440; OR = 0.374; 95% CI 0,253–0,552; p < 0,01).Conclusion. The obtained results may indicate possible risk reduction for AD development due to timely preventive vaccination against tuberculosis and hepatitis B, especially in children with allergic risk. The study is currently ongoing.

Epidemiological surveillance of preventive vaccinations implementation is the most crucial component in the immunoprophylaxis organization. Assessment of documented vaccination coverage indicators allows to determine the quality of routine preventive vaccination and indirectly evaluate the possible state of population immunity to vaccine preventable diseases. Continuous quality control of routine vaccination, therefore, is a component of the system for epidemic management of infectious diseases. Specific decisions should be based on its results to improve preventive vaccination quality.Сomparative analysis of the vaccination history in adolescents (studying in schools in large cities of different federal districts of Russian Federation) and recommended national immunisation schedule allowed to identify widespread systemic mistakes of vaccination status. These issues led to the uprise and spread of vaccine preventable diseases. The study results confirmed the topicality of awareness-raising activities among medical staff working on preventive vaccination. Moreover, long-standing need of vaccination schemes correction is also important through development of medical technology aimed on improvement of catch-up vaccination approach.

This article is devoted to the issue of rotavirus infection in pediatric population and demonstrates worldwide prevalence of rotavirus among the causes of viral gastroenteritis and its persistent leadership among the causes of fatal diarrhea in children of the first 5 years of life. Specific prevention of rotavirus infection has been actively carried out around the world since 2005. Nowadays, we have adequate experience in the use of various rotavirus vaccines bolstered by their implementation in immunisation schedules for infants. The authors provide data on the efficacy and safety of rotavirus vaccines licensed and used in Russian Federation, involving the results of studies on safety, immunological and clinical efficacy of one of the pentavalent rotavirus vaccines.

Every year more countries recommend vaccination for pregnant women. Nowadays, the spectrum of vaccines that can be used during pregnancy is expanding. Experts of the Union of Pediatricians of Russia have completely updated the section about the pregnant women immunoprophylaxis within updating clinical guidelines on normal pregnancy management. This section is presented in the following article.

The purpose of this study is to assess the risk to public health from exposure to road noise in the historical city center of St. Petersburg., the source of which is automobile (freight, passenger, public) transport. The presented article is devoted to an urgent problem – the assessment of the noise environment and the levels of the emerging risk to the health of the population exposed to traffic noise in dense urban areas. The risk assessment was carried out based on the results of field measurements of noise levels in the zone of influence of traffic flows. The quantitative risk assessment was carried out in accordance with the methodological recommendations of MP 2.1.10.0059-12 «Assessment of public health risk from exposure to traffic noise» and Instructions 2.1.8.10-12-3-2005 «Assessment of the risk to public health from exposure to noise in populated areas». The relevance of the work is confirmed by the fact that motor transport is becoming an increasingly priority source of noise pollution of streets, house territories, residential areas. The analysis of the results of the performed acoustic measurements indicates that the values of the equivalent and maximum sound levels at all four control points exceeded the normative noise exposure levels from 6 to 29.9 dBA. At the same time, the actual values varied from 61.2 dBA to 74.9 dBA for L(A)eq. and from 70.4 to 85.7 L(A)max. The obtained result indicates a significant noise impact of motor transport on the nearest residential area, which can lead to adverse health consequences.

The pandemic caused by the new coronavirus infection remains the topical health issue and constitutes serious threat to the entire world. Nowadays, active immunization against new type of coronavirus infection continues in Russian Federation and in all other countries. Vaccination is the crucial component in comprehensive program for COVID-19 prevention and control. Mass immunization of population can prevent both admissions and hospitalization in conditions of high incidence of COVID-19 and thereby reduce the burden on the health system. Despite the remaining complications in combating the SARS-CoV-2 pandemic, preventive vaccination is by far the most effective method for protection against this infection Clinical studies on the efficacy of various preventive vaccinations in different regions of the world are extremely relevant especially under conditions of the emergency use authorization for vaccines against new coronavirus infection, the changing epidemiological situation, and the wide variability of different types of vaccines. All countries will need continuously updated data on vaccine efficacy to address new challenges such as weakening post-vaccine protection, new SARS-CoV-2 strains, and need for other preventive measures to mitigate the pandemic.

Background. Worldwide private health care system plays significant role in promoting immunization programs for the children population. The role of private medical facilities in Russia in combating children vaccination issues has not been previously studied.Objective. The aim of the study is to study immunization and immunization coverage in children population according to the national immunization schedule (NIS) in outpatient clinics of different forms of property.Methods. The study of medical documentation of children in private (n = 1) and public (n = 2) facilities in Moscow and Moscow region was performed. Immunization (complete vaccination course in those who should be vaccinated by age) and immunization coverage (at least one dose of vaccine by those who have to be vaccinated) were estimated against the NIS schemes according to the data from preventive vaccination cards (form 063/y) and from preventive vaccination lists (form 112/y).Results. The study includes 313 cards of children from private outpatient clinic and 305 — from public outpatient clinic. Immunization and immunization coverage of children against tuberculosis were similar in these facilities: 293 (94%) and 294 (96%) (p = 0.114), respectively, as well as immunization coverage against hepatitis B — in 282 (90%) and 269 (88%) (p = 0.448). Rates of immunization and immunization coverage against the remaining NIS infections were higher in the private clinic. Maximum differences were noted in immunization (178 (57%) in private and 19 (6%) in public facilities; p < 0.001) and immunization coverage (238 (76%) and 52 (17%), respectively; p < 0.001) against pneumococcal disease. Immunization coverage of children for epidemic indications was also higher in private clinic: the largest differences were in immunization against hemophilic and meningococcal infections.Conclusion. Children followed up in private outpatient clinic have higher immunization and immunization coverage rates against most of the NIS infections.

Experts of the Union of Pediatricians of Russia have developed modern guidelines on management of children with atypical hemolytic uremic syndrome (aHUS). aHUS is ultra-rare (orphan) disease with progressive and relapsing course during the life with potentially life-threatening state. This article covers issues of disease etiology, pathogenesis, and classification. Specific attention is paid to the diagnosis, differential diagnosis, and therapy of aHUS according to the evidence-based approaches.

Experts of the Union of Pediatricians of Russia have developed modern guidelines on the management of children with acute obstructive laryngitis and epiglottitis. Croup is the most common cause of acute upper respiratory obstruction in children aged from 6 months to 6 years. Usually respiratory viruses are the pathogenic agents of the disease. The etiological factor of epiglottitis is Haemophilus influenzae type b in the vast majority of cases (> 90%). However, nowadays, epiglottitis caused by this pathogen agent is more common in adults in countries with mass immunization against hemophilic infection. This article considers in detail etiology, pathogenesis, and classification issues. Special attention is given to diagnosis, differential diagnosis, and therapy (via evidence-based approach) of acute obstructive laryngitis in children.

Background. One of the effective ways to maintain the epidemic well-being of vaccine preventable diseases is to estimate immunization rates and coverage.Objective. The aim of the study is to conduct comparative analysis of immunization levels among children in various regions of Russian Federation. Methods. Children aged from 6 months to 15 years conducted comparative analysis of indicators of documented immunization and immunization coverage according to forms 112/y and 036/y in four federal districts of Russian Federation. The immunization rate was estimated in individuals who had completed vaccination scheme according to the national immunization schedule (NIS) (of 2014). Immunization coverage was estimated by number of persons with at least one vaccination in past medical history.Results. The analysis was performed on 2687 children medical records from the Central, Ural, Siberian and Volga federal districts (FD). BCG immunization rates in all FDs tend to be 100%. There are high levels of immunization against hepatitis B, as well as against measles, rubella and parotitis (the lowest values are noted in the Central Federal District: against hepatitis B — 74%, against measles, rubella, mumps — 69%, high — in the Volga Federal District: against hepatitis B — 95%, against measles, rubella, mumps — 97%). There is significant mismatch in immunization rates and immunization coverage for pertussis, diphtheria, tetanus and poliomyelitis in all FDs (from 20% to 40%) indicating that there are disturbances in vaccination schemes. Low immunization rates are noted against pneumococcal infection (from 12% in the Siberian Federal District to 36% in the Volga Federal District) and influenza (from 0.5% in the Volga Federal District to 9% in the Ural Federal District).Conclusion. The highest immunization rates for all infections included in the NIS (apart from influenza) were revealed in the Volga Federal District. Influenza immunization rate is critically low in all FDs.

Children with chicken egg protein allergy are denied performing vaccination against measles, mumps, influenza in Russian Federation thus far, thus it is unreasonable. This article presents a clinical case of 2 years 6 months old boy with cow’s milk protein allergy symptoms and high levels of specific IgE antibodies (sIgE) to chicken egg protein. He was unreasonably denied performing vaccination against measles, rubella, and mumps at the place of residence according to false interpretation of the clinical situation as the absolute contraindication for vaccination. Lately, the child was successfully vaccinated against these infections at Research Institute of Pediatrics and Children’s Health in “Central Clinical Hospital of the Russian Academy of Sciences”. The examination dynamics is presented, as well as the data on the extended allergy diagnostics of separate components via the ISAC allergochip. Finally, the prognosis on food allergy resolution and recommendations on nutrition and further vaccination were given for this patient.

Background. Modern preventive vaccination is intended to protect and enhance the health of every person considering age and health issues. Vaccination of children with chronic diseases in our country remains extremely topical and arguable problem that associated with many pending issues for doctors of various specialties, including those working as primary care specialists.Objective. The aim of the study is to develop major approaches and to prove scientifically the efficacy and safety of preventive vaccination for children with various chronic diseases.Methods. We have conducted comprehensive study of 100 children aged from 1 month to 17 years 11 months. Children were divided into 4 groups according to the specific disease. Vaccinal and infectious history was analyzed. The post-vaccination period was estimated due to the results of the questionnaire completed by parents. Vaccination immunogenicity was estimated based on the results of the level of specific antibodies to various controlled infections (measles, rubella, parotitis, hepatitis B, pertussis, haemophilus influenza type b).Results. Protective titers of antibodies against haemophilus influenza type b were revealed in 96.2% of all examined patients, tetanus and hepatitis B — in 95.2%, against pertussis — in 92.5%, rubella — in 91%, measles — in 87.5%, parotitis — in 71.9%, chickenpox — in 69% children a month after the completed vaccination. The postvaccinal period was characterized as favorable in most patients. Major changes in overall health status occurred after vaccination in 42% of children was the following: subfebrile fever, capriciousness, or fatigue. Local reactions have developed only in 15% of cases.Conclusion. The results of this study have demonstrated the preventive vaccination efficacy and safety in children with various chronic diseases

Background. T-cell response is shifted towards Th2-type predominance in newborns. This makes them particularly vulnerable to exposure of various external pathogens, development of severe infections, moreover, it is also a risk factor for allergic diseases development. Various methods of switching the immune response to Th1-type are currently under research, and one of them is vaccination.Objective. The aim of the study is to provide data on the prevalence of allergic pathology among children vaccinated against tuberculosis and hepatitis B, as well as the effect of vaccines on immune response type.Results. Data on both increase and decrease in the prevalence of atopic conditions in children vaccinated with BCG and against hepatitis B were analyzed, thus, most of them cannot be considered reliable. The results of several large studies do not reveal any correlation between vaccination and the presence of allergic disease in children. There is data that BCG and hepatitis B vaccines shift the immune response towards Th1-type activation.Conclusion. Vaccination in the early neonatal period may affect switching of the immune response towards Th1-type. That, in turn, can affect the prevalence of allergic pathology in vaccinated children. However, the data available for now is not sufficient to reliably estimate the possible effect of vaccination on atopic conditions manifestation in the future.

Influenza vaccination coverage has been expanding in recent years in Russian Federation. The topicality of influenza vaccination becomes more significant now at the beginning of seasonal increase in its prevalence, moreover, along with active immunization against coronavirus infection. Vaccination is crucial part in combined program of influenza prevention and control. Nowadays, the priority in influenza prevention is quadrivalent vaccines that can ensure the development of the most stable immunity. Russia has all the necessary resources to create and effectively implement modern influenza vaccines that meet international standards. Despite the remaining difficulties in combating influenza, preventive vaccination is by far the most effective method of protection that has proven its safety and efficacy.

Background. Monitoring of documented vaccination is one of the indicators of the epidemiological supervision quality of preventive vaccination. It is crucial for epidemical situation prevention. Objective. The aim of the study is to estimate immunization and immunization coverage levels according to National Immunization Schedule (NIS) for children population in Russia. Methods. Immunization rates were estimated according to preventive vaccination cards (form №063/y) and children development cards (form №112/y) among children aged from 6 months to 15 years in 8 towns of Russia. Immunization was determined by the ratio of people who has fully performed all the vaccines from NIS (version of the year 2014), while immunization coverage – by the ratio people who has received at least one dose of corresponding vaccine. Results. The study has included data from 2,687 vaccinated children. The highest levels of immunization and immunization coverage were against tuberculosis (98.1% each), hepatitis B (85.9% and 96.5%), measles, mumps and rubella (84.4% and 93.9%). Immunization against diphtheria, pertussis and tetanus significantly differed from their immunization coverage (60.5% and 94.9%), as well as for poliomyelitis (65.0% and 94.9%). Relatively low immunization and immunization coverage levels were observed for pneumococcal infection (27.6% and 47.1%) and influenza (5.8% and 30.5%). The increase in the immunization level with age was observed for all vaccines, except pneumococcal vaccine. Conclusion. Immunization and immunization coverage against infections included in NIS vary significantly. The highest immunization and immunization coverage levels for all age groups were revealed for tuberculosis vaccine, and the lowest — for influenza vaccine.

This article presents the experience of teaching the discipline «Preventive Vaccination in Healthy Children and Children with Chronic Diseases». Its significance in preparation of students of pediatric departments of higher educational institutions of Russia is validated. It is shown that the majority of students have positive attitude to vaccination, however, they are not sufficiently informed about the organization of the process itself and they need to obtain such knowledge.

Nowadays all news about the new coronavirus disease type arouses interest and concern among specialists around the world. Children often are not exposed to the COVID-19 virus or they just have mild course of the disease according to currently available data. These data may also explain why children have much lower incidence of COVID-19 in comparison to adults. The results of epidemiological observations performed by different researchers’ groups on the likely “protective” effect of routine vaccine prevention programs against new type of coronavirus disease led to initiation of clinical studies. This article presents the analysis of the vaccinal status and characteristics of vaccination and any other background in 143 Moscow children undergone SARS-CoV-2 infection. Overall, the general vaccination background in children who have undergone COVID-19 is characterized with low vaccination level and mismatch with the National Immunization Schedule. The most unfavorable vaccination background was mentioned in infants. The vaccination rate in all children of the first year of life (in 100% of cases) had gap to the routine schedule. The lowest rate of appropriate vaccination was recorded in case of viral poliomyelitis (in 30% of children) in reconvalescents new type of coronavirus disease. The vast majority of children undergone COVID-19 were not vaccinated against flue, only a few were vaccinated against pneumococcal infection. Now there are several studies focused on determining the protective role of vaccines in relation to the new type of coronavirus disease morbidity and course severity.

This article refutes one popular-science review that has appeared on the MDedge news site in January 2020. It has stated that there was no effect of vaccination with 7-valent pneumococcal conjugate vaccine (PCV-7) against invasive forms of Streptococcus pneumoniae in children with bronchial asthma. The author of this publication refers to the article «Asthma and the Risk of Invasive Pneumococcal Disease: A Meta-analysis» that described episodes of invasive pneumococcal disease and pneumonia development in children with bronchial asthma and in healthy children who was vaccinated with pneumococcal conjugate vaccine. It was concluded that the PCV-7 provides limited protection against colonization only with vaccine pneumococcus serotypes (according to the obtained data), and, thus, there was high risk of carriage of non-included serotypes in children with bronchial asthma (BA). The analysis of the article mentioned above has revealed that the representativeness of the data is extremely low. For example, the study groups were selected incorrectly, the PCV-7 administration scheme was not analyzed, whereas its violation may cause ineffective immunity development and as result disease development. Another crucial aspect is the lack of any data on the BA severity and inhaled corticosteroid therapy in vaccinated children. Nowadays, there are numerous scientific studies on the clinical efficacy of PCV in the prevention of IPD including the children with BA. Most world-class experts support the necessity of PCV-7 usage in children with BA for the prevention of IPD and suggest their patients over 6 years old on inhaled corticosteroid therapy to perform additional administration of pneumococcal polysaccharide vaccine.

The Ministry of Health of the Russian Federation jointly with professional association and experts in the field of pediatrics, infectious diseases and resuscitation has revised guidelines “Clinical Features and Management of the Disease Caused by New Coronaviral Infection (COVID-19) in Children” in order to provide the child population with effective medical care during the pandemic of the new coronaviral infection. The practical experience of specialists from various countries was considered during the development of this document. Special attention should be given to the evidence base of the presented data, as well as to the efficiency and safety issues of medications used in treatment of coronaviral infection and its complications. The authors highlight the problems of prevention, diagnostics and management of pathological conditions caused by COVID-19 in the article according to the presented guidelines. Patient’s management is presented depending on the age and severity of the disease itself. The therapy is considered with regard to etiological, pathogenetic and symptom focus.

The Ministry of Health of the Russian Federation jointly with professional association and experts in the field of pediatrics, infectious diseases and resuscitation has developed guidelines “Clinical Features and Management of the Disease Caused by New Coronaviral Infection (COVID-19) in Children” in order to provide the child population with effective medical care during the pandemic of the new coronaviral infection. The practical experience of specialists from various countries was considered during the development of this document. Special attention should be given to the evidence base of the presented data, as well as to the efficiency and safety issues of medications used in treatment of coronaviral infection and its complications. The authors highlight the problems of prevention, diagnostics and management of pathological conditions caused by COVID-19 in the article according to the presented guidelines. Patient’s management is presented depending on the age and severity of the disease itself. The therapy is considered with regard to etiological, pathogenetic and symptom focus.

In Russia, a universal varicella vaccination (UVV) program has not been implemented, and varicella vaccination coverage is low. We assessed the efficacy, antibody persistence, and safety of one- and two-dose varicella vaccination schedules in Russian children with a ten-year follow-up period, as part of an international phase IIIB, observer-blind, randomized, controlled trial (NCT00226499). Children aged 12–22 months were randomized (3:3:1) to receive two doses of tetravalent measles-mumps-rubella-varicella vaccine (V2 group), one dose trivalent measles-mumps-rubella (MMR) vaccine and one dose of varicella vaccine (V1 group), or two doses of MMR vaccine (V0 [control] group), 42 days apart. Main study outcomes were: vaccine efficacy (VE) against confirmed varicella cases, anti-varicella zoster virus (VZV) seropositivity rates and geometric mean concentrations, and reporting of (serious) adverse events ([S]AEs). The total vaccinated cohort in Russia comprised 1000 children; 900 were followed up until study end (year [Y] 10). VE estimates against confirmed varicella (Y10) were 92.4% in the V2 group and 74.7% in the V1 group. Anti-VZV seropositivity rates remained ≥99.4% in the V2 group and ≥89.7% in the V1 group from day 42 post-vaccination 2 until Y10. Occurrence of (un)solicited AEs and SAEs was similar across groups and confirmed the safety profile of the vaccines. No vaccination-related SAEs or deaths were reported. These results are consistent with the global trial results, i.e., the highest VE estimates observed following the two-dose schedule compared to the one-dose schedule. These data may inform decision-making related to potential implementation of a UVV program.

The trend in the development of railway transport also includes the solution of such an important environmental, technological, sanitary and, to some extent, aesthetic problem as the transfer of all operated mainline passenger trains to environmentally friendly toilet complexes (EFTC). For the disposal of EFTC waste, a system has been created for the disposal of fecal waste in parking lots, which are then transported by sewage disposal machines and dumped into general treatment facilities. At the moment, as one of the possible options for industrial waste disposal of EFTC, wastewater sludge incineration plants are being considered. The method of waste incineration reduces the time, labor and financial costs of waste turnover, and taking into account the epidemiological risks of fecal waste, it has high development prospects. This article discusses similar combustion processes using the example of technologies implemented at wastewater sludge incineration plants, emissions from enterprises and the processes of formation of pollutants. And also, within the framework of this work, a comparative analysis of the control of emissions of pollutants from the combustion of sewage sludge into the atmosphere in the Russian Federation and in the EU, countries were carried out.

Modern advances in oncology can achieve significantly better results in terms of life expectancy in patients with metastatic brain disease. The combination of surgery, systemic therapy, whole brain irradiation and local methods of radiation therapy lead to good indicators for controlling the manifestations of the disease in the brain. Of course, intensification of treatment increases the risk of iatrogenic complications. The use of aggressive stereotactic radiotherapy regimens leads not only to high local control of irradiated metastases, but also to the risk of so-called radiation necrosis. The use of the most up-to-date diagnostic methods does not always allow one to unequivocally differentiate radiation necrosis from continued metastasis growth. The above example shows the need for a careful assessment of such situations and a multidisciplinary approach to interpreting the results of stereotactic radiotherapy.

Background. Vaccination of infants with 13-valent pneumococcal conjugate vaccine (PCV) was implemented in national immunization schedule in 2014. In this regard epidemiological monitoring of routine immunization results with vaccination coverage and efficiency control is required. Objective. Our aim was to study correlation between pneumococcal disease routine immunization in infants and morbidity and mortality rates due to community-acquired pneumonia in children under 18 years of age and morbidity rate due to acute otitis media in children under 14 years of age. Methods. Morbidity (Form № 2, 2011–2017 yrs) and mortality (Form № 51S, 2009–2017 yrs) rates due to community-acquired pneumonia, morbidity rate (Form № 12, 2009–2017 yrs) due to acute otitis media, vaccination coverage rate (Form № 5, 2014–2017 yrs, and Form № 6, 2016–2017 yrs) were analysed according to the data of Forms of Federal Statistical Monitoring. Medical exemptions and refusals to vaccinate rates were estimated according to the data from doctors who was performing infants vaccination. Results. During PCV routine vaccination within national immunization schedule in Russian Federation the 35% reduction of mortality due to community-acquired pneumonia in children under 1 year of age as well as reduction of morbidity with acute otitis media have been established. Moreover, low percentage of etiology clear community-acquired pneumonias (29%) complicates the estimation of vaccination efficiency. It has been revealed that despite the high pneumococcal disease vaccination coverage rate of infants under 2 years of age (87%), considerable part of children (73%) are vaccinated untimely in most Russian Federation regions. 9.3% (3.4% due to medical exemptions) of children (among 1st year infants) remained unvaccinated due to medical exemptions and refusals to vaccinate in 2016, and 8% (3.4%) in 2017 respectively. Conclusion. Implementation of PCV routine immunisation for three years in a row leads to reduction of morbidity rate due to acute otitis media among children under 14 years of age and infant mortality rate due to community-acquired pneumonias. Though, the estimation of routine immunisation efficiency can be difficult due to such factors as untimely start of vaccination, medical exemptions and refusals to vaccinate and limited laboratory diagnostics of community-acquired pneumonias etiology.

Background.The human papillomavirus (HPV) is one of the most common sexually transmitted viruses and, according to WHO, the cause of 7.5% of all women deaths from cancer. Every year, more than 500.000 new cases of HPV-associated cancer are registered in the world, approximately 90% of which fall into cervical cancer category. Aim. The aim of the work was to determine the economic and socio-demographic burden of HPV-associated diseases in Russia by analyzing the following indicators: fertility, life expectancy and cost of vaccines, as well as the impact of HPV vaccination. Methods. Mathematical modeling was performed using epidemiological data on prevalence and mortality of HPV-associated diseases in Russia, taking into account current data on the types of HPV-related diseases, the effectiveness of vaccination, statistics by sex and age structure of diseases, and age-specific birth rates. The calculations were based on 50% and 70% vaccination coverage, and the average life expectancy of 12-year-old girls. Treatment cost was calculated based on the fees charged by mandatory health insurance system. The weighted average cost of 1 dose of quadrivalent vaccine in 2018, and average cost of visiting a pediatrician before each vaccination were taken into account. To estimate the cost, a discount rate of 3.5% per year was used. The economic burden of HPV-associated diseases, direct and indirect medical costs were calculated. Results. The economic burden of HPV-associated diseases is estimated at 63.638 billion rubles. 70% vaccination rate would reduce the economic burden by 41.792 billion rubles, prevent 4,841 deaths from malignant neoplasms and reduce losses associated with a fall in the birth rate by 1,100 children per year. The estimated economic effect of vaccination per vaccinated girl will be 13,327 rubles, and the total economic effect over the entire simulation period will be 31.653 billion rubles. Conclusion. Taking into account the results of modeling, vaccination of 12-year-old girls against HPV in Russia is a cost-effective measure in the prevention of HPV-associated diseases.

Containment, prevention and elimination of infectious disease is the state duty for citizens. Development of the National Immunization Calendar as well as challenges in preventive vaccination system both are significant investment into the future. Advantages of vaccination are not limited only by infection diseases control. Experts of World Health Organization recognize positive influence of immunization on economic. Vaccines give unprecedented opportunities on alleviation of human sufferings but it can be possible only due to perfect work of immunization calendar. It is necessary to estimate our National Immunization Calendar alongside with suggested by World Health Organization and professional associations plans. It is essential to estimate experience and facilities of modern vaccinology. This entailed the optimal preventive vaccination schedule, which can be implemented in the structure of existing national calendar.