Introduction. Acute respiratory infections cover majority of pediatric outpatient visits and hospitalizations, especially during the cold and flu epidemic season. Aim. To evaluate the effect of Baс-Set Cold/Flu probiotic on the clinical manifestations and severity of acute respiratory infections (ARI) along with standard symptomatic therapy during periods of increased morbidity (November 2023 – March 2024). Materials and methods. This study was an open-label, observational, multicenter study. The number of subjects was 234: 111 volunteers in the first group (experimental) and 123 volunteers in the second group (control) aged from 2 to 10 years inclusive (mean age 5.79) with a diagnosis of ARI. Patients of the first group took Bac-Set Cold/Flu probiotic along with standard symptomatic therapy in comparison with control group which took a standard symptomatic therapy only. Statistical analysis was performed using the R programming language. Results and discussion. The use of probiotic significantly reduced the number of complications and the prescription of antibiotic therapy by more than three times (5% in the probiotic group versus 17% in the control group). A significant difference was revealed in the total duration of the disease (the maximum period from the first symptom of fever to the fact of complete recovery, – absence of fever within last 48 hours) between groups (Mann- Whitney test, p-value = 0.017). In the experimental group, the average duration of illness was 6.2 ± 3.7 days, in the control group – 7.2 ± 3.1 days. A statistically significant difference in the duration of fever was also revealed (Mann-Whitney test, p-value = 0.006). In the control group, on average, fever lasted 1 day longer. The median maximum temperature in the probiotic group was 0.5 degrees lower at the 2nd visit compared to the control group. The use of the probiotic did not affect the symptoms of cough, nasal congestion and the color of nasal discharge, but a trend was recorded for the effect on the symptoms of sore throat. Conclusion. The use of a probiotic reduced the number of complications and the prescription of antibiotic therapy by more than three times, the duration of the disease and fever.

The aim of this paper was to assess vitamin D status in infants and young children in Moscow. 211 children aged 0 to 3 years were examined, of which 103 (48.8%) were under the age of 12 months, 64 (30.3%) children were 2 years old, 44 (20.9%) were 3 years old. The number of boys and girls was almost equal (52.6 and 47.4%). In the examined group of children, only 38.4% had the serum calcidiol level within the normal range (> 30 ng/ml). In other cases (61.6%), the children were diagnosed with one or another degree of vitamin D deficiency: severe deficiency in 2.4%; deficiency in 27.5%; insufficiency in 31.8% of patients. The frequency of registration of vitamin D insufficiency or deficiency increases significantly with the increase of years (R = -0.22, p = 0.0018). When comparing the obtained data with the results of study RODNICHOK, it was found that the vitamin D deficiency value in Moscow children was significantly lower than that in the regions located to the south (Kazan 65.0%; p <0.01; Stavropol 45 , 8%; p <0.05), and the Far East (Blagoveshchensk 42.6%; p <0.05; Khabarovsk 42.9%; p <0.05; Vladivostok 72.7%; p < 0.01). The absolute majority of the examined children (84.8%) received a prophylactic dose of vitamin D of 500 to 1500 IU/day. The 500 IU/day dose is insufficient, because 71.2% of patients in this subgroup had a low vitamin D status. A similar effect was obtained in patients taking vitamin D at a dose of 1000 and 1500 IU/day: the absolute values of cholecalciferol reliably increased by 1.8 and 1.9 times, the number of patients with normal vitamin values increased by 2.7 and 2.2 times as compared with intake of vitamin D at a dose of 500 IU; the deficiency level reduced by more than 8 times as compared to the control group and more than 2 times as compared to the patients receiving 500 IU. The seasonal factor does not have a significant effect on the serum calcidiol level (r = 0.06 at p = 0.3), which may be due to the peculiarities of the specific prevention of hypovitaminosis: a bit more than a third of children take vitamin D in summer (39.2%), whereas absolute majority (83.3%) take it in winter.

The article describes the clinical case of combined skin lesions in the form of generalized erythematous-urticarial dermatitis and the respiratory tract in the form of rhinoadenopharyngitis, simple bronchitis, in a child of 2 years. Caused by parvovirus B19 and Мycoplasma pneumoniae. The problems of diagnosis, treatment, variety of clinical manifestations of parvovirus B19 infection and Мycoplasma pneumoniae are discussed.

The article describes the clinical case of combined skin lesions in the form of generalized erythematous-urticarial dermatitis and the respiratory tract in the form of rhinoadenopharyngitis, simple bronchitis, in a child of 2 years. Caused by parvovirus B19 and Мycoplasma pneumoniae. The problems of diagnosis, treatment, variety of clinical manifestations of parvovirus B19 infection and Мycoplasma pneumoniae are discussed.

Acute obstructive laryngitis is a life-threatening upper respiratory tract disease of various aetiologies that is characterized by laryngostenosis and manifests itself by barking cough, dysphonia and inspiratory dyspnoea [8]. A child showing these clinical symptoms needs urgent medical care. Delay in emergency treatment of a child with acute obstructive laryngitis may lead to serious complications and even to an unfavourable outcome [1–15].

Medical examination of 360 children from four regions of Russia (Moscow, Astrakhan, Stavropol, Kazan) showed significant regional differences in the sufficiency and compensation of vitamin D deficiency at the baseline (Day 0) and established factors associated with vitamin D sufficiency on Day 0. The established interregional differences in vitamin D levels were not due to insolation, but primarily to adequate vitamin D supplementation received at the baseline. Vitamin D supplementation (an average of 894 ± 632.6 IU/day) significantly reduced the risk of vitamin D deficiency (RR 0.15, 95% CI 0.09–0.26, P = 5.7 x 10–14). The study included the analysis of factors associated with the increase in 25(OH)D levels during the administration of Aquadetrim, identification of predictors of patient’s response and the analysis of identified predictors. The most important factor determining the patient’s response was the dose of vitamin D taken by the patient: 25(OH)D levels increased by 1 ng/ml with an increase in the dose of vitamin D by 90 IU per day. As can be seen from the above, the study results indicate that the vitamin D deficiency requires a long-term preventive therapy (for at least several months) with adequate doses of vitamin D (1000–2000 IU/day).

The article discusses the problem of teething in babies, the related mechanisms and factors. The research findings demonstrate the importance of different clinical symptoms of teething in infants, the relationship of the process with the baby's body type. Questions of the current therapy of pathological teething are considered.

Background: Vitamin D insufficiency is a widespread phenomenon, having an adverse effect on human health. This problem is also actual in Russia, which most part of the territory is located above the 42nd latitude and is at risk for vitamin D insufficiency. Objective: Our aim was to evaluate the vitamin D sufficiency of the child population of a junior age group and the adequacy of a drug treatment/prevention of vitamin D insufficiency in various regions of the Russian Federation. Methods: Children of the first 3 years of life, who received in-patient treatment in medical institutions of Russia, were examined. When they were involved in the study, they took a blood test to determine a plasma 25(OH)D concentration. The study period: November, 2013 – October, 2014. Results: 1,230 children aged from 1 month to 3 years were examined. Vitamin D insufficiency (25(OH)D concentration in the blood plasma 21–29 ng/ml) is found in 300 (24.4%), deficiency (25(OH)D ≤ 20 ng/ml) — in 513 (41.7%) children. The prevalence of vitamin D insufficiency and deficiency did not depend on a geographical location and level of insolation of regions, where the surveyed lived. Conclusion: In the studied selection more than 2/3 of children of a junior age group have a vitamin D insufficiency or deficiency. In this regard, it is expedient to revise the current guidelines taking into account modern approaches to the prevention and treatment of a vitamin D insufficiency, to make the appropriate changes and to implement them in a clinical practice.

Background : Vitamin D insufficiency is a widespread phenomenon, having an adverse effect on human health. This problem is also actual in Russia, which most part of the territory is located above the 42nd latitude and is at risk for vitamin D insufficiency. Objective : Our aim was to evaluate the vitamin D sufficiency of the child population of a junior age group and the adequacy of a drug treatment/prevention of vitamin D insufficiency in various regions of the Russian Federation. Methods : Children of the first 3 years of life, who received in-patient treatment in medical institutions of Russia, were examined. When they were involved in the study, they took a blood test to determine a plasma 25(OH)D concentration. The study period: November, 2013 – October, 2014. Results : 1,230 children aged from 1 month to 3 years were examined. Vitamin D insufficiency (25(OH)D concentration in the blood plasma 21–29 ng/ml) is found in 300 (24.4%), deficiency (25(OH)D ≤ 20 ng/ml) — in 513 (41.7%) children. The prevalence of vitamin D insufficiency and deficiency did not depend on a geographical location and level of insolation of regions, where the surveyed lived. Conclusion : In the studied selection more than 2/3 of children of a junior age group have a vitamin D insufficiency or deficiency. In this regard, it is expedient to revise the current guidelines taking into account modern approaches to the prevention and treatment of a vitamin D insufficiency, to make the appropriate changes and to implement them in a clinical practice.

Iron deficiency still presents an urgent problem in pediatrics. The paper presents both foreign and domestic data on prevalence of iron deficiency anemia and latent iron deficiency and methods of laboratory diagnostics of these states. Authors also discuss clinical presentations, long-term effects and modern approaches to treatment of iron deficiency states in children.