Though there is a specific national program, guidelines, and international consensus paper, diagnosis of bronchial asthma (BA) in preschoolers is still a challenge for practitioners. The main disease to be distinguished from BA is acute bronchitis (AB). Aim. To determine the age of diagnosis of bronchial asthma for children with known episodes of acute bronchitis at an early age and to find out clinical/laboratory features of bronchial asthma in such patients. Materials and Methods. The research involved 72 children with a history of AB who were divided into 2 groups. The average age of children was 3.2 +/- 1.3, the number of known episodes of obstructive bronchitis in past medical history was - 2.0 [1.0-3.0] (Me; 25-75 %). Results. Out of 72 children with a history of AB, BA was diagnosed in 32 (44.4 %); 25 of them (78 %) were diagnosed with asthma at the age of 5 or earlier. The analysis of the inflammatory phenotype of induced sputum in children with BA revealed paucigranulocytic type in 4 children (13 %), mixed type in 2 (6 %), and eosinophilic type in 26 (81 %). It was found that children with a history of AB who had a dynamic increase of eosinophil levels in induced sputum by 5% or more, irrespective of the baseline levels of eosinophils in induced sputum, developed bronchial asthma in 95.2 % of cases.

Федоров И.А., доктор медицинских наук, Заслуженный врач Российской Федерации, заведующий кафедрой факультетской педиатрии, Челябинская государственная медицинская академия. Fedorov I.A., Doctor of Medical Sciences (Grand MD), Honored Doctor of the Russian Federation, Head of the Department of Pediatrics Faculty of Chelyabinsk State Medical Academy. Степанов О.Г., доктор медицинских наук, профессор кафедры факультетской педиатрии, Челябинская государственная медицинская академия. Stepanov O.G., Doctor of Medical Sciences (Grand MD), Professor, of Pediatrics Faculty Chelyabinsk State Medical Academy. Пушкарева Ю.Э., кандидат медицинских наук, ассистент кафедры факультетской педиатрии, Челябинская государственная медицинская академия. Pushkarev Y.E., Candidate of Medical Sciences (PhD), Assistant Professor of Pediatrics Faculty, Chelyabinsk State Medical Academy.

This article describes the pathogenetic significance of hypoxia in the development of the combined diseases of the central nervous system and cardiorespiratory and urogenital tract in infants.

The purpose of the given work was studying of infringements of element balance of chemical elements in fabrics among children with a syndrome of angry intestines (SAI) for definition of ways of their medicinal correction. 590 children of the large metallurgical industrial centre of Southern Ural Mountains are surveyed: 488 healthy children of 5-17 years; 102 children with SAI. The maintenance of 22 elements in hair on atomic absorbtion spectrometer (P, Pb, Cu, Mn, Fe, Zn, Sr, Ba, Ca, Mg, Ni, Cr, Cd, Co, Al, Li, Be, Hg, As, Mo, W, Se) has been defined. An essential change of element balance in fabrics among children with SAI is established. The obtained data give the basis for application of methods of correction of the revealed infringements by means of the preparations possessing ion-exchange properties (Litovit) and the preparations containing medical doses Ca and Mg.

65 children with the severe course of bronchial asthma (BA) were examined. The character of respiratory tract microflora, humoral immunity characteristics, mediators, of inflammation and pathomorphological features of the bronchial tree during the severe course of BA in children at the period of remission were studied. The specific features of the colonization of the bronchial tree by microflora in the severe form of BA were established. The severe course of BA in children at the period of remission was characterized by a higher content of tumor necrosis factor and an increase in the lysozyme activity of bronchoalveolar fluid. Disturbances in the proportion of cAMP and cGMP in smooth muscles and an increase in the number of apudocytes containing adrenalin and serotonin may probably be one of the mechanisms of bronchial hyperreactivity.