Background and aims Congenital and hereditary diseases of respiratory system are often accompanied by nonspecific symptoms, that result in late diagnosis and time-lag therapy. In some cases, such diseases have symptoms, similar to asthma, so children are wrong diagnosed and do not receive appropriate treatment for a long time. Aim: to define the informative value of measurement of exhaled nitric oxide (FeNO) as a non-invasive screening method for patients with pathology of pulmonary system. Methods 598 children (from 4 to 17 y.o.) were examined at Scientific Centre of Children’s Health from 01.01.2012 to 11.06.2016. The level of FeNO was determined by portable hand held monitor using, unit ppb (parts per billion). Results 557 patients (93.14%) were diagnosed with asthma of different severity. Variation of level of FeNO depended on asthma severity and control. FeNO was normal or elevated (from 5 to 233 ppb). In 41 (6.8%) patients the level of FeNO was low (<5 ppb): 25 children (61%) with cystic fibrosis (CF), 5 (12%) with congenital lung malformations (CLM) and 11 (27%) with primary ciliary dyskinesia (PCD). The mean of FeNO level in children with CLM was 2,616±1,804, with CF: 3,27±3,07, with PCD: 0,88±0,53. FeNO level in children with PCD was lower than in children with CF (p<0.05). Conclusions The finding data indicate the possibility of using of FeNO level evaluation as a non-invasive screening method in the complex differential diagnostics of pulmonary system pathology in children.

The article is concerned with the issue of a standardized approach to determining the effectiveness of allergen-specific therapy (AST) in children. AST has a special role in treating allergy: only this method can induce clinical and immunological tolerance to the cause-significant allergen; is safe enough and highly effective; reduces the duration of acute conditions; reduces the necessity for both basic therapy medicines and additional symptomatic therapy; is capable of preventing the progression of allergic diseases by reducing the sensibility spectre and the formation of bronchial asthma in those suffering from allegic rhinitis; improves the control over the disease and has a positive effect on the patient’s and his family quality of life. At the moment evaluating the effectiveness of medical technologies is one of the most important tasks in medicine while the effectiveness and safety of any medical intervention should be obtained in accordance with the requirements of evidence-based medicine. In order to determine the effectiveness of AST in children, a combined clinical and pharmaceutical evaluation should be performed and as a secons point — determine the patient’s life quality and also evaluate the gravity of symptoms according to the visual analogue scale, and to count the number of days with the symptoms and without them.

Relevance. Allergic pathology in particular, a hay fever, can lead to decrease in cognitive functions at children. Earlier it was established that antihistamine preparations of I generation influence cognitive functions of patients. Т he patients with this nosology receive for a longtime courses of antihistamine preparations of II generation, so the analysis of influence of different AH preparations of II generation on cognitive activity of children with a hay fever is necessary. P urpose . Studying of influence of II generation antihistamine preparations in a complex with the specific allergen immunotherapy on cognitive functions at children with a hay fever. Patients and methods. Using the psychophysiological computer complex «Psihomat» the condition of cognitive functions was established. In total the 81 child with a hey fever were investigated. The persons under consideration were divided on subgroups depending on antihistamine which they received. For the patients in the main group of investigation the cognitive functions have been studied in 3 points. Results. The patients had changes in the attention and psychomotor activity more often, than in other conitive activity. It is not obtained distinct data on characteristic contribution of antihistamine preparations of a second generation in improvement of cognitive activity as a whole at complex treatment of hay fever with specific allergen immunotherapy. Antihistamine preparations (desloratidine and cetirizine) are improved by indexes of visual and space perception at children with a hay fever. From the 3 antihistamine preparations the cetirizine has the most carried out positive effect concerning the psiho-motoric activity in the combined ASIT. Conclusion. Padding express researches in the field are necessary for receiving the definite answers to problem questions.

Relevance. Allergic pathology in particular, a hay fever, can lead to decrease in cognitive functions at children. Earlier it was established that antihistamine preparations of I generation influence cognitive functions of patients. Тhe patients with this nosology receive for a longtime courses of antihistamine preparations of II generation, so the analysis of influence of different AH preparations of II generation on cognitive activity of children with a hay fever is necessary. Purpose. Studying of influence of II generation antihistamine preparations in a complex with the specific allergen immunotherapy on cognitive functions at children with a hay fever. Patients and methods. Using the psychophysiological computer complex «Psihomat» the condition of cognitive functions was established. In total the 81 child with a hey fever were investigated. The persons under consideration were divided on subgroups depending on antihistamine which they received. For the patients in the main group of investigation the cognitive functions have been studied in 3 points. Results. The patients had changes in the attention and psychomotor activity more often, than in other conitive activity. It is not obtained distinct data on characteristic contribution of antihistamine preparations of a second generation in improvement of cognitive activity as a whole at complex treatment of hay fever with specific allergen immunotherapy. Antihistamine preparations (desloratidine and cetirizine) are improved by indexes of visual and space perception at children with a hay fever. From the 3 antihistamine preparations the cetirizine has the most carried out positive effect concerning the psiho-motoric activity in the combined ASIT. Conclusion. Padding express researches in the field are necessary for receiving the definite answers to problem questions.

The article is dedicated to allergic rhinitis (AR) in children. AR is widespread among children and adolescents; it negatively affects physical and psychological condition, social life and school performance and reduces life quality of both patients and members of their families. The authors consider the most modern approaches to diagnostics and control over the disease and present evidence-based recommendations. The authors offer the relevant classification; describe classic and additional disease symptoms and list the key nosological forms of differential diagnostic search. The complex of therapeutic measures to be taken at AR is aimed at relieving devastating symptoms of the disease and involves limitation of contacts with pathogenetically significant allergens, drug therapy, specific immunotherapy and education. Preventive measures are aimed at preventing development of sensitization/manifestation/aggravation of the AR course. The information given in the article is aimed at spreading the main principles of AR therapy and increasing accessibility of the modern methods of control over allergic diseases. Key words: allergic rhinitis; children; control; therapy

Author affiliation: Vishneva Elena Aleksandrovna, MD, leading research scientist of the Department of Standardization and Clinical Pharmacology, allergist-immunologist at the Department of Medical Rehabilitation for Children with Allergic and Respiratory Diseases of the Research Institute of Preventive Pediatrics and Medical Rehabilitation of SCCH. Address: 2/2 Lomonosovskii Av., Moscow, 119991, tel.: +7 (495) 967-14-12.

Relevance. Allergic pathology, particularly, pollinosis, may reduce cognitive functions in children. Objective: study effect of allergen-specific immunotherapy on cognitive functions in children with pollinosis and relation of cognitive functions dynamics to repeated ASIT courses. Patients and methods. We determined condition of cognitive functions in 97 children of 8‑17 years of age with pollinosis in comparison with their healthy peers using a psychophysiological computer complex “Psychomath”. Results. We revealed reduction in cognitive activity parameters in most children with pollinosis during remission. Concurrent persisting allergic rhinitis aggravated reducing in cognitive functions parameters. Conclusion. We confirmed positive effect of allergen-specific immunotherapy: cognitive functions improve significantly in children with pollinosis; the effect becomes more pronounced after repeated courses.

Cough is the main symptom of respiratory tract lesion. It is commonly caused by viral, mixed (viral-bacterial) and bacterial respiratory infections. Upon that it may be both a sign of respiratory system pathology and a reflex response to other organs and systems disorders. In spite of expert’s close attention to the cough problem it is still urgent as ever. The studies of its causes are currently in progress, diagnostic patterns and treatment methods are improved. In the article potential causes of cough in children due to their age are analyzed, principal lines for diagnostic search and approaches to therapy of cough syndrome in children are presented. Special attention is paid to medication of cough symptomatic treatment. It is shown that selection of drugs depends on cough characteristics, its strength and other features.

Aim: to compare clinical efficacy and safety of sublingual and parenteral allergen-specific immunotherapy in children with pollinosis. Patients and methods: 143 patients with pollinosis aged from 5 to 16 years old were included into the study. They were divided into 4 groups and received allergen-specific immunotherapy. Patients of the groups I and III were administered water-salt mixtures of extracts of tree pollen allergens. Patients from the II group received standardized adjuvant mixture of extracts of tree pollen allergens. Patients from the IV group were administered standardized extract of birch pollen allergens. Prophylaxis with water-salt solutions was performed before seasons of increased allergy risk during 3 years in autumns and winters. Prophylaxis with standardized extracts of allergens was performed uninterruptedly for 3 years. Results: allergen-specific immunotherapy prevents increase of sensitization and enlargement of allergen spectrum of elevated organism perceptibility, as well as prevents aggravation of disease course and conversion to more severe forms. It also decreases requirements of anti-allergic drugs and therefore elongates the duration of remission. Conclusions: allergen-specific immunotherapy with the use of standardized allergens is the most effective method of treatment of pollen sensitization in children. In order to increase its efficacy not less than 3 courses of immunotherapy are needed.

Constant skin care in children with atopic dermatitis is one of the main aspects of treatment, which demands special attention and much time. Taking bath regularly, usage of emollient remedies and preparations improving blood circulation and skin trophy allow to significantly decrease intensity of such pathological symptoms as dryness, pruritus, cutaneous desquamation and thickness, and consequently — to reduce the speed of disease progression and prevent development of infectious complications.

The comparative characteristics of emotional condition of healthy schoolchildren and children with pollinosis at the age of 11–17 years old was performed with Spielberg-Hanin questionnaire on the basis of computer psychophysiological complex CPPC-99 «Psichomat».One hundred seventy-five healthy schoolchildren and 46 children with pollinosis at the age of 11–17 years old were included to the study. No significant difference in reactive anxiety between children with pollinosis and healthy children was found. It was shown, that pollinosis (in 35% significantly) and concomitant diseases, such as bronchial asthma (in 57 significant) influence on personality anxiety, in comparison with healthy children (significant personality anxiety was found in 3% of cases). It was revealed, that all children from control group with high anxiety rate (3%) were 17-year-old adolescents.

The article gives scientific data on the development of cognitive brain functions in children in relation to their clinical significance and application: variants and regularities of development in normal state, pathology and at their boundary; pathological development of cognitive performance; origination and transformation of main symptoms and syndromes of cognitive disorders. Prospective and applied in the Center scientific approaches to diagnostics and treatment of cognitive disorders taking into consideration their development in age dynamics are given in detail. A complex of measures on the improvement of cognitive health in children and adolescents in the Russian Federation is suggested on the analysis results.

The results of studies of cognitive functions, their age dynamics and gender differences revealed by computer psychophysiological complex KPFK-99 «Psychomat» in healthy school children of various age groups. The study included 241 children aged 8 to 17 years (52% girls and 49% boys). The average age of the observed schoolchildren was 11.8 years. We received cognitive norms of healthy schoolchildren with one year interval, which allows to estimate cognitive activity objectively quantified. We proved the impossibility to join children into the age group teams (such as a junior, middle and senior school age), according to the standards of cognitive functions. A model of cognitive functions evaluation according to the parameters of the psycho-physiological computer complex (KPFK) has been worked out. We proved a steady increase in performance assignments with the forwardness of the children, indicating a smooth improvement of cognitive functions of the child throughout the school-age period. The absence of reliable gender differences in cognitive activity in children of the identical age (as used in the methods), suggests the possibility of co-education of boys and girls in school.