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MODERN STRATEGY AND TACTICS OF MANAGEMENT OF CHILDREN WITH INFANTILE HEMANGIOMAS
N.P. Kotlukova, N.K. Konstantinova, I.I. Trunina, N.D. Telezhnikova, T.R. Lavrova, A.N. Grishkin, E.V. Karelina

Summary. The article is devoted to the actual problem of modern treatment of infant hemangiomas. The accumulated 10-year experience of using propranolol to 512 patients has shown its effectiveness and safety. The team of authors developed a protocol for managing patients with infantile hemangiomas of various localization at all stages of treatment. Special attention was paid to the cardiological aspect of patient monitoring using modern methods of instrumental diagnostics. Due to the clear application of the created protocol with the use of ultrasound control, in most cases, it was possible to achieve complete cure of this pathology, minimize the occurrence of undesirable effects and avoid the formation of relapses (rebound syndrome). The effectiveness of the developed algorithm of diagnosis and treatment is confirmed by both clinical results and the results of instrumental examinations .
Keywords: infantile hemangioma, propranolol, treatment, β-blockers, cardiovascular system, rebound syndrome

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SELECTIVE IMMUNOGLOBULIN A DEFICIENCY IN THE PRACTICE OF A PEDIATRICIAN
A.P. Prodeus, I.A. Korsunsky, L.A. Fedorova

Summary. Selective immunoglobulin A deficiency is the most common primary immunodeficiency. It is associated with a number of clinically significant complications: infectious and autoimmune diseases, cancer, atopy. The article describes the structure and functions of immunoglobulin A, which makes it possible to understand and analyze the clinical manifestations of the disease, describes the possible genetic nature, associative relationships with many diseases and possible prerequisites for this. The importance of timely detection of patients with selective immunoglobulin A deficiency is indicated and ways for further study of this immunodeficiency are outlined .
Keywords: primary immunodeficiency, immunoglobulin A, selective immunoglobulin A deficiency, common variable immunodeficiency, infectious diseases, autoimmune diseases

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ENTEROVIRUS INFECTION IN CHILDREN: CURRENT STATE OF THE PROBLEM
O.N. Solodovnikova, L.A. Kharitonova

Summary. Enteroviruses are one of the most common human pathogens. Worldwide, they cause almost a billion infections in people every year. Enterovirus infection (EVI) is mostly asymptomatic and is limited to viral symptoms, but can also cause severe diseases with fatal outcomes. Clinical polymorphism, the prevalence of asymptomatic forms of EVI, accounting for up to 75% of all cases of the disease, and high contagiousness are factors that make it possible to classify this disease as a "high risk" group. The ubiquity of EVI and the lack of specific treatment and prevention tools constantly maintain a high level of infection in the world's population. In the Russian Federation, in addition to the World Health Organization programmes, there is ongoing epidemiological surveillance of the circulation of enteroviruses and the incidence of enterovirus infections. High susceptibility of people to EVI with the possibility of long-term viral transmission in the absence of visible manifestations contributes to the formation of mechanisms of autoimmune processes, which is a trigger for the development of recommendations for its rehabilitation .
Keywords: enterovirus infection, enteroviruses, carriage of viruses, asymptomatic forms, poliomyelitis-like forms, serous meningitis, energotropic therapy, L-carnitine, Elkar®

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URINARY TRACT INFECTION IN PREMATURE NEWBORNS
M.V. Kushnareva, G.M. Dementyeva, E.I. Shabelnikova, E.D. Balashov, A.Yu. Gerasimov, Kh.M. Markhoulia

Summary. The study objective is to assess the incidence of urinary tract infections (UTIs) and asymptomatic bacteriuria in premature infants and to identify the microorganisms responsible for their development. Materials and methods. Five hundred and eighty (580) preterm infants (112 conditionally healthy infants and 468 infants with infectious and inflammatory diseases) were examined. The etiological structure of UTIs was studied in 51 preterm infants, and the etiology of asymptomatic bacteriuria was tested in 66 preterm infants with positive microbiological cultures. Birthweight was from 780 to 3000 g, and gestational age was from 27 to 37 weeks. Urine culture was researched by the quantitative. Results. Asymptomatic bacteriuria was 1.8 and 3 times more common in newborns with a non-urological infection and among conditionally healthy extremely preterm infants than in more mature babies, respectively. Most of pathogens of UTIs was represented by gram-negative microorganisms. Enterobacteriaceae were found more often (in 53%). Gram-positive cocci (Staphylococcus epidermidis, Staphylococcus aureus, Enterococcus faecalis) were found in 2-20% of infants. Candida spp. was found in 4-32% of infants. Asymptomatic bacteriuria was represented by the same spectrum of microorganisms as UTIs pathogens .
Keywords: preterm infants, infection, urinary tract, microorganisms, antibiotics

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SOCIAL SIGNIFICANCE OF AUDIOLOGICAL EXAMINATION OF CHILDREN WITH SPEECH RETARDATION
M.R. Bogomilsky, I.V. Rakhmanova, A.G. Matroskin, A.V. Kuznetsova

Summary. This article is devoted to the problem of violation of speech development in children of various ages. Materials and methods. Over the past 2 years, 153 children under the age of 9 with diagnoses of "delayed speech development", "delayed psychomotor and speech development", "autism spectrum disorder", "childhood autism", "alalia" have been examined in the polyclinic department of the Morozov Children's City Clinical Hospital advisory center. All children were examined for auditory function with auditory evoked potentials analysis. Results. The study showed that in 53 (34.8%) of the 153 examined children, neurosensory hearing loss or deafness was diagnosed, and in the 1 was two-sided mixed hearing loss. Bilateral sensory hearing loss of varying degrees was revealed in 37 children, 15 children had unilateral sensory hearing loss of varying degrees of severity and 1 bilateral mixed hearing loss (right – III degree, left II degree). In 100 children, the pathology of the auditory analyzer was not detected. Conclusion. Analyzing the obtained data, we can talk about the insufficiency of applying an interdisciplinary approach in identifying etiological factors of child development disorder. Speech, behavioral and intellectual disorders are more often the result of various diseases than an independent process. Thus, the timely detected and corrected insufficiency of auditory function will significantly increase the quality of medical care provided, the level of social adaptation of the child in the future .
Keywords: children, auditory function, audiological examination, speech, autism spectrum disorders

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ANTIVIRAL THERAPY OF ACUTE RESPIRATORY DISEASES IN CHILDREN
O.L. Chugunova

Summary. According to World Health Organization, respiratory diseases occupy the first place in the structure of child morbidity. Acute viral respiratory infections (AVRI) are most frequent current diseases of respiratory tract. AVRI are thought to spread mainly through airborne transmission, and immunocompromised children are primarily predisposed to these infections. The change in the classical clinical presentations of acute respiratory infections in dependence on the type of pathogen, as well as the increasing proportion of mixed infections (viral-bacterial and viral-viral associations) dictates the need for etiological interpretation of pediatric AVRI. Main methods of AVRI etiological diagnosis are presented. Actual current problem is frequent association of AVRI and Herpes infection. Clinical presentation of acute pediatric Herpes infection is nonspecific and similar to AVRI manifestation. Features of the interaction of Herpes viruses with host cells, the long course of the infectious process and changes in immunological reactivity as a result determine the feasibility of antiviral therapy to patients with clinical manifestations of ARVI and active forms of herpesvirus infections. Article discusses actual problems of AVRI treatment. Meglumini acridonacetas has antiviral activity against a number of respiratory viruses, herpesviruses, and hepatitis viruses. Its studies proved that its antiviral activity is mediated by both direct antiviral effect – formation of defective viral particles in the presence of the preparation that are not capable of further invasion of host cells, and by induction of interferon-а production starting from the first hours of taking the drug. Complex treatment of pediatric acute respiratory infections including preparations with direct antiviral effect against both respiratory viruses and herpesviruses contributes to faster recovery, reduces the number of severe forms of infection and prevents the development of complications.
Keywords: acute diseases of respiratory tract, AVRI, meglumini acridonacetas, children

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LEGAL BASIS FOR PROTECTING THE BUSINESS REPUTATION OF A HEALTHCARE INSTITUTION
A.N. Makarova

Summary. The article considers a narrow and broad interpretation of the term "business reputation", describes various ways to protect the business reputation of a legal entity (in an out-of-court and judicial procedure), defines information that discredits the honor and dignity of citizens or the business reputation of citizens and legal entities. The circumstances that must be determined in the course of the trial for the protection of business reputation are listed: the fact that the defendant disseminated information about the plaintiff, the defamatory nature of this information and its inconsistency with reality.
Keywords: business reputation, defamatory information, court, judicial protection, plaintiff, defendant, civil code, evidence