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Objectives. The aim of the study was to confirm the compliance of the mechanical and thermophysical properties of titanate-zirconate mineral-like matrices intended for immobilization of the rare-earth-actinide fraction of high-level waste (HLW) with pyrochlore structures (Nd2ZrTiO7) and orthorhombic titanate of rare earth elements (Nd4Ti9O24+TiO2) with the Russian requirements for the final forms of radioactive waste sent for disposal. With regard to fractionated radioactive waste, this type of matrix is preferable when compared with conservative aluminophosphate and borosilicate glasses. This is due to larger capacity, and a better level of chemical, thermal, and radiation resistance.Methods. The synthesis of mineral-like matrices was carried out by remelting a granular precursor consisting of mineral-forming metal oxides and a solution imitating the rare earth-actinide fraction of HLW in an induction furnace with a cold crucible. The thermal diffusivity was determined by the laser flash method. The heat capacity of the matrix samples was measured by differential scanning calorimetry. Ultimate flexural and compressive strengths were determined using universal test machines. The elastic moduli (Young’s) were measured by the acoustic method. The temperature coefficients of linear expansion were determined using a high-temperature dilatometer.Results. The ultimate strength of the matrices (Nd2ZrTiO7) and (Nd4Ti9O24+TiO2) was found to be 150–179 and 20.6–57.8 MPa in compression and bending respectively. Young’s moduli vary from 3.7 ∙ 107 to 2.15 ∙ 108 kN/m2. With an increase in temperature from 50 to 500°C, the values of thermal conductivity have a pronounced tendency to decrease from 1.71 to 0.91 W/(m∙K). The temperature coefficients of linear expansion increase from 6.96 ∙ 10−6 to 1.01 ∙ 10−5 K−1 in the same temperature range.Conclusions. Comprehensive studies of titanate-zirconate mineral-like matrices show that their mechanical and thermal properties in certain cases significantly exceed the minimum requirements of regulatory documentation for the final forms of HLW.

Respiratory diseases persistently lead in the structure of general morbidity in both children and adolescents. Acute respiratory infections are the most common among them. Interest of pediatricians to phytotherapy is not accidental and is due to the fact that it has a mild therapeutic effect, enhances the effectiveness of complex therapy, has few side effects. Of particular interest are herbal remedies containing ivy extract (Hedera helix), the active ingredients are mainly found in ivy leaves, they are biologically active substances: Triterpene saponins, glycosides, also contain carbohydrates, essential oils, steroids, phenolcarboxylic acids, coumarins, flavonoids, carotenoids, tocopherols (vitamin E), B and C vitamins, tannins, phytoncides. Ivy preparations are prescribed as an expectorant in the treatment of infectious and inflammatory diseases of the upper and lower respiratory tract due to their proven multidirectional effects: secretolytic, mucolytic, bronchospasmolytic. They also have anti-inflammatory, reparative, antioxidant effects.This article presents a clinical example of an officinal ivy-based preparation used in the treatment of a 3.5 year old patient diagnosed with acute respiratory viral infection. Temperature increased to 38 °C, runny nose; on the second day of illness the temperature remained subfebrile and a dry cough appeared. Nasal vasoconstrictor drops and oral acetylcysteine were prescribed, but there was no relief. On the third day of the illness, against the background of subfebrile temperature, the cough persisted, single dry rales were heard in the lungs, wheezing appeared during physical exertion. Acetylcysteine was withdrawn and replaced by ivy-based drops (16 drops 3 times a day orally after meals in a small amount of water). After 2 days the cough was moist, the sputum was easily expectorated, the wheezing in the lungs was almost gone, there was no more wheezing and the temperature was normal. By the sixth day of treatment the cough was gone and the girl had almost recovered. Nevertheless, Gedelix was continued for another 4 days. Prospective results and detailed study of the effects of herbal preparations on the basis of ivy extracts served as the basis for their recommendation as a complex therapy of cough in children.

The pediatric dosage form of Egroferon - a drug indicated for the treatment of influenza and acute respiratory infections (ARIs)

Rengalin liquid formulation on the basis of antibodies to bradlkinin histamine and morphine was specially designed for the treatment of cough in children. The three-component combination in therapeutically active against both dry and wet cough due to effect on diverse pathogenetic aspects of the cough reflex. The aim of the multicenter, comparative, randomized clinical trial was to estimate the efficacy and safety of rengalin in the treatment of cough in patients with acute respiratory infection (ARI) of the upper respiratory tract. Methods. One hundred forty six patients at the age of 3 to 17 years (the average age of 8.2+3.6 years) from 14 medical centres of Russia were observed. The patients sufferedfrom dry/nonproductive, frequent, sore cough preventing from day-time activity and/or night sleep (>4 by the Cough Severity Scale). The cough duration ranged from 12 hours to 3 days. For 3 days the patients of group 1 (n=71) and group 2 (n=75) were treated with rengalin and sinekod (butamirate) respectively. For the following 4 days the patients (in case of viscid expectoration were treated with ambroxole in the age doses. The results of the Per Protokol Analysis (n=67 rengalin group and n=73 sinekod group) with an account of the Non-Infectiority Design are presented. Results. In 3 days the number of the group 1 patients with significant improvement/recovery by the day and night estimates amounted to 90% and 88% respectively (vs. 81% and 88% in the group 2 patients, no night opisodes of cough after 3-days rengalin use being recorded in 52% of the patients vs. 34% in the sinekod group patients (p=0.0003). On the 7th day of the treatment with rengalin the number of the children with significant improvement of or recovery from day-time cought amounted to 99%and that of the patients with significant improvement of or recovery from night-time cough amounted to 93%, in 90% of them no night-time cough being recorded (p=0.0008). As for the patients of the reference group, the respective values were 93% and 90%, no night-time cough being recorded in 81% of the patients. The time required for development of productive/moist cough during the 3-day treatment course in the patients of both the group was the same (2.9+0.3 days in the patients of group 1 and 2.9+0.4 days in the group 2 patients. Moreover, in 34% of the rengalin dry cough became residual (as rare episode of tussiculation with scantly exudation). After 3-day course of the rengalin therapy, 66% of the patients was treated with ambroxole (versus 95% in sinecod group (p0.0001 by the results of the frequency analysis). The total duration of cough in the patients of groups 1 and 2 was 6.5±0.8 and 6.7±0.7 days respectively (the comparability truth, p=0.0001). The severity of the day-time cough by the area under the curve estimates for 7 days of the treatment in the rengalin group patients was equel to 14.3+5.6 numbers - days and that of the patients of the sinekod® group was equal to 15.9±6.1 numbers - days. The severity of the night-time cough was equal to 4.2+2.7 number - days respectively. In 2 patients (3%) treated with sinekod® signs of ARI generalization was observed after the 3-day treatment (p>0.0001). The research physicians-investigators (CGI-EL Scale) the combination of the anti- and protussive activities in one drug to be efficient and absolutely safe for the chilgren. The therapeutic efficacy in the patients of the rengalin group was higher in 3 days (2.1±0.5 numbers) and even in 7 days (2.7±0.5 numbers). The results value in the patients of the sinekod® group being 1.8±0.4 and 2.5±0.6 numbers (one-way ANOVA for repeated estimates ANOVA: Visit - F1/138=146, p

The inflammatory process in the bronchial mucosa of various origins (infectious, allergic, irritative, etc.) cause changes in the sputum production and its rheological properties, slowing of mucociliary clearance. Mucoactive therapy is one of the important components of the management of bronchopulmonary diseases. The article provides a detailed review of the modern literature, as well as the authors’ own experience regarding the cough therapy methods, including techniques used in the bronchial obstructive syndrome. The use of combination drugs, which simultaneously affect various pathogenetic mechanisms of inflammation and cough, including those in the respiratory diseases with bronchial obstructive syndrome, becomes a promising direction of mucoactive therapy. Due to relative safety and clinical efficacy, the modern combination therapy, including a fixed-dose combination of salbutamol, bromhexine, guaifenesin (Ascoril, Ascoril expectorant), is increasingly becoming the drug of informed choice in mild bronchial obstruction in childhood in pediatric practice.

The article presents data on the etiology, modern methods for diagnosis and treatment of respiratory system diseases and examines in detail cough as the main symptom. Particular attention is paid to hypertussivity, which is defined as a cough that occurs in the absence of obvious reasons. In addition, the emphasize was put on the role of anatomical and physiological features in the development and characteristics of cough, especially in young children. The authors draw attention to the complex mechanism of the cough, which development involves many body systems such as nervous, immune, endocrine and respiratory. The article describes the main treatment methods, drugs prescribed to the patients with cough, which are divided into «antitussive» drugs used as cough suppressants and «protussive» drugs used in situations, in which mobilization of secretions is desired, combined drugs. The role of new combined drugs, in particular, Rengalin, which affects the central and peripheral links of the cough reflex, was noted.

The use of combined medicines simultaneously influencing various pathogenetic mechanisms of inflammation and coughing becomes an essential direction of mucoactive therapy in childhood. One of these is thiamphenicol glycinate acetylcysteinate, which has both mucolytic and antibacterial effects, which significantly expands the possibilities of therapy in bacterial etiology of acute and exacerbation of chronic respiratory diseases, increases the effectiveness of therapeutic measures, improves compliance.

Coughing in acute respiratory infections, regardless of the level of infection: upper or lower respiratory tract is a frequent clinical symptom in childhood. The analysis of the modern literature and the data of the authors’ own researches testify to the fact that the prescription of mucoactive therapy in a complex of therapeutic measures (etiotropic, basic therapy, bronchopulmonary drainage, etc.).) should be differentiated and determined not only by the nature and severity of coughs, separated sputum, but also by individual characteristics of the patient, the severity and course of bronchopulmonary pathology, the age of the child, the presence of adverse environmental factors (in particular, passive smoking), the level of compliance with the patient. The use of combined medications simultaneously influencing various pathogenetic mechanisms of inflammation and coughing becomes a promising direction of mucoactive therapy. One of them is Eucabal® syrup containing liquid extracts of thyme and plantain. Due to the synergy of its components, Eucabal® syrup has an expectorant and anti-inflammatory effect, which is important in the initial period of acute respiratory viral infections (tracheitis, bronchitis tracheobronchitis), especially in dry, painful cough with hard-to-remove sputum. In case of acute respiratory viral infections accompanied by a wet cough with a viscous, difficult to separate sputum, mucolytic agents are shown first of all. One of the modern widely used drugs of this group is acetylcysteine (ESPA-NAC®) in a convenient dosage form.

Thanks to the innovations in the information technology field, computer acoustic diagnosis is beginning to be used in the clinical practice. Computer bronchophonography is one of the promising domestic innovations in the field of methods of measuring the functional state of the respiratory system. This method can be used at any stage of medical care to identify bronchial obstruction, monitor the effectiveness of treatment and preventive measures in patients with bronchopulmonary diseases, which is especially important in early and preschool years. However, further research is required in this current field, both from research and practical perspectives. In the article, the authors present their own experience in using and interpreting the results of bronchophonography in children.

The authors presented an analytical review of domestic and foreign literature on the clinical efficacy and safety of release-active drug in the treatment and prevention of acute respiratory infections in children.

In recent years, a lot of attention has been paid to studying the level of cytokines in various infectious pathologies, since this scientific direction is rightly promising and justified. The article presents literature data on the significance of the cytokine link in the immune response and the results of our own observations of 108 patients aged 3 to 17 years with enteroviral meningitis. In addition to the standard diagnostic plan, all patients underwent immunological examination of blood serum in the acute phase of the disease in order to assess the level of cytokines (TNF-α, IFN-γ, IL-1, IL-4, IL-8). The analysis of the obtained data made it possible to establish correlations of different levels between the values of cytokines and other parameters.

Body temperature rise with and without other clinical symptoms, including respiratory ones is one of the most frequent causes for contacting an outpatient clinic or for emergency and urgent medical care in paediatric practice. In most acute respiratory diseases, an increase in body temperature (up to 3 months – above 38°C; in initially healthy children older than 3 months. – above 39–39.5°C) will not cause persistent health problems, and a fever at body temperature of 37.7–38°C shall be mainly reduced in the presence of pathological symptoms (impaired appetite, state of health, discomfort, myalgia, headache, toxicosis, etc.) in children at risk with febrile convulsions. The article reviews present-day knowledge on etiopathogenesis, clinical features of fever, provides practical recommendations on the prudent use of antifebrile therapy in children, which should be administered in a short course and using a differentiated approach. Paracetamol is currently considered as the first-line drug among anti febrile drugs.

Cough is one of the most common reasons for seeking medical treatment, and there are many reasons for its occurrence. Conventional expectorants are the most widely used medications in paediatric practice to this day, among which one may identify a large group of drugs with reflexive action that usually contain plant-derived substances. The article reviews present-day knowledge on the mechanisms of action and clinical efficacy of these drugs, provides practical recommendations on the rational use of expectorant therapy for bronchopulmonary diseases in children. It is known that the efficacy of treatment with medicinal plants is caused by their complex multicomponent composition. The use of combination drugs that have a simultaneous effect on various pathogenetic mechanisms of inflammation and coughing is becoming a promising area of mucoactive therapy. Due to relative safety, affordability and efficacy, the modern official herbal medicine is increasingly becoming the subject of informed choice in paediatric practice.

Diagnosis of bronchial asthma (BA) for babies in the first years of life is of particular interest in the practice of paediatric pulmonologist, as there is currently no reliable diagnostics, including functional criteria, to verify the disease at this age. The purpose of the study was to find additional clinical and functional criteria to forecast the formation of BA in early childhood.The study found that children who had undergone acute obstructive bronchitis (AOB) against the background of the perinatal CNS involvement (PCNSI), and consequently having pathoreceptor disorders and variability of the heart rate, had a longer and heavier period of AOB. It has been shown that the presence of PCNSI is an unfavourable factor in the prediction of repeatepisodes of AOB and development of BA. As a result of the follow-up study and the ROC analysis, additional criteria for the projection of BA in early childhood were identified, taking into account the functional state of the respiratory and vegetative nervous system. The additional criteria developed for the projection of BA in young children, together with the clinical and disease history data can contribute to early diagnosis of the BA, which has an important clinical significance for the timely delivery of curative and preventive measures

The analytical review is devoted to modern methods of immunotherapy of respiratory infections in childhood. The article provides literature data and the authors' findings related to the evaluation of clinical effectiveness of the bacterial extract Broncho-Vaxom in the prevention and treatment of acute respiratory infections in children.

The article presents the results of our studies and literature data in order to evaluate the efficacy and safety of antitussive drug of a new class (Rengalin®) containing release active antibodies to mediators of inflammation to morphine, bradykinin and histamine. Clinical studies in this promising area are not numerous but confirm the results of experimental studies and testify to the efficacy and safety of Rengalin in the cough treatment. The first in Russia clinical study (2012) of the drug Rengalin for the treatment of dry cough in children aged 3 - 10 y.o. (n = 61) with acute respiratory infections (acute rinopharingitis, laryngotracheitis, tracheitis) in a conditions of a clinic showed its clinical efficacy and safety similar to the effect of butamirate citrate (Sinecod®). Data few works of other researchers confirm the data obtained by the authors.

The authors sum up literature data concerning clinical effectiveness of antiviral and immunomodulating drug Inosine Pranobex in therapy of respiratory infections in children. The manifold effect of the drug allows preventing polypharmacy and render effective aid.

152 cases of enteroviral meningitis in children aged 3 to 17 years were analyzed. All the patients were treated in the Municipal Health Care Institution «Clinical Hospital for Infectious Diseases No1» in Yaroslavl. The predominance of moderate forms of the disease with hypertensive syndrome was determined. An imbalance of the cytokine profile in the acute phase of the disease was registered. This was due to the increased production of pro-inflammatory cytokines and a decrease of protective role of anti-inflammatory cytokines. Despite relatively favorable course, there remained a high risk of formation of functional and organic disorders on the part of the nervous system in the period of convalescence, which creates ground for review and amendment of the standard protocols of treatment programs and including preparations of etiotropic direction. The authors tested therapeutic schemes and defined clinical and immunological efficacy of antiviral drugs Amixin and Arbidol with antiviral and interferonogenic effects as a part of complex basic therapy for enteroviral meningitis in children. In addition, the authors analyzed the results of follow-monitoring of 87 convalescents 3 months after their discharge from hospital. The results confirm the necessity and appropriateness of inclusion of preparations of etiotropic direction, in particular the antiviral preparations Arbidol and Amixin in standards of basic therapy of enteroviral meningitis in children.

One of the challenges faced by pediatricians is to improve the rehabilitation of children with frequent episodes of acute respiratory infections. This is caused by high prevalence of respiratory diseases, risk of complications and exacerbations of chronic diseases, decreased quality of life, high social and economic costs. [1-5] According to expert approximations, the economic burden of acute upper respiratory tract infections in 2014 totalled more than 376 billion rubles. At the same time, for about a decade ARVI consistently maintained a high rank in the list of the most economically damaging communicable diseases (excluding tuberculosis and HIV infection). In 2014, about 20% of the population got sick with ARVI, with the incidence of the disease varying from 5 to 40 thousand cases per 100 thousand of population. [6]

The diagnostic significance of bronchophonography (BPG) for early detection of bronchial asthma (BA) in children from 2 to 5 years old is estimated. BPG was used to examine 210 children, including 110 children with often acute respiratory infections (ARIs), 35 children with the mild case of BA in the remission period, and 65 practically healthy children. In patients with BA compared to the group of practically healthy children, the indices of acoustic work of respiration in the high-frequency range (the so-called zone of obstructive changes) were increased, and this increase was reversible after pharmacological test with a bronchial spasmolytic. Similar changes of BPG were observed in 20% of patients with often ARIs, and two years later these children had typical clinical signs of BA. Indices of diagnostic sensitivity and specificity of BPG were equal to respectively 95.2 and 95.0%. Taking into account the relative simplicity and noninvasive character of BPG, this allows us to recommend the wide use of this method as a screening one for early diagnostics of BA in children of early and preschool age under hospital conditions.