Aim. To detect the most informative ultrasonic signs of cerebral haemodynamics distress in various degrees of severity asphyxia of newborn for the timely correction of cerebral haemodynamics and normal morphofunctional maturation of brain structures in the early neonatal period and childhood.

Materials and methods. 78 newborns were examined, including: 25 newborns who had a satisfactory condition at birth and 53 newborns with a mild, moderate and severe condition at birth due to neonatal asphyxia. Ultrasonic examination of brain and Doppler sonography of cerebral blood flow were carried out for all newborns in the first 7 days of life.

Results. Echographic and Doppler sonographic criteria of changes in cerebral haemodynamics of full-term newborn with mild, moderate and severe asphyxia were obtained.

Conclusion. Cranial ultrasound demonstrates dopplerographic signs of cerebral hemodynamics formation disorders such as hypoperfusion in neonates who have had chronic intrauterine hypoxia in the early neonatal period, and signs of cerebral hyperperfusion in neonates who suffered from acute asphyxia. In neonates who have suffered from acute asphyxia against a background of chronic intrauterine hypoxia, signs of hypoperfusion persisted for a longer period as compared to neonates with chronic intrauterine hypoxia. 

Aim. The aim of the work was evaluation of physical development of preschool children of rural area of Krasnodar Krai.

 Materials and methods. Research was conducted on the base of six municipal preschool establishments of rural area of Krasnodar Krai. 538 preschool children (282 boys and 256 girls) aged from 3 to 7 years took part in it. Their physical development was estimated by means of sigma deviation method on the basis of height and bodyweight, a result was compared to the evaluation tables of physical development of preschool children ofKrasnodar.

 Results. It was shown that the majority of children evaluated are normally physically developed (76,02±1,84%, of which there were 196 girls (out of the total number of the evaluated girls 76,56±2,09%) and 213 boys (75,53±2,13% out of the total number of the evaluated boys), but the percent of children with disorders of physical development was rather high (23,98±1,84%). It has also been discovered, that a small percent of preschool children has a general physical developmental delay.

Conclusion. The results of research demonstrated gender distinctions in the indexes of physical development of preschool children of rural area. A compromised physical development is observed in girls more often than in boys, that testifies that girls are in a high-risk group of health status deviations.

Aim. The aim of the study was to study the clinical and epidemiological features of visceral forms of toxocariasis in children.

Materials and methods. The study involved 34 children (17 boys and 17 girls from 1 to 17 years old) with a diagnosis of toxocariasis. The diagnosis was confirmed by the method of immunoenzymatic analysis (ELISA) of blood, which allows to determine the level of specific antibodies of JgG to antigens of toxocar in children. In all patients, antibodies to toxocaram were found in a titer of 1: 800 and above, which was considered a diagnostic criterion. To exclude mixed infections, antibodies to lamblia antigens, ascarids, trichinelles and opistarchs were determined using the ELISA method of blood. Feces were studied for eggs of helminths threefold in all children.

Results. Toxocarosis in children is characterized by a polymorphism of clinical manifestations. In 85.3% of patients the gastrobiliary system was damaged, dyspepsia, unstable stool, hepatosplenomegaly, which was confirmed by instrumental research methods (ultrasound examination of the abdominal cavity organs, esophagogastroduodenoscopy). In addition to lesions of the gastrointestinal tract, 44.1% of patients showed lung damage, and 63.3% of patients had skin manifestations. Eye damage was noted in 10.2% of sick children, a kind of strabismus and reduced vision.

Conclusion. Analysis of clinical and epidemiological data of children with toxocarosis showed that all observed had signs of impairment from the gastrointestinal tract, bronchopulmonary system and skin. In the epidemic process, preschool children are primarily involved. The decisive role in the prevention of toxocarias is played by public health education and early education of children with health skills.

Aim. The aim of the study: to compare the effectiveness of traditional laparoscopic myomectomy to the one with an additional stage based on the analysis of echographic scar monitoring among fertile-interested patients.

Materials and methods. A prospective analysis of 96 surgical interventions was performed (laparoscopic myomectomy among reproductive-aged patients with uterine fibroids (UF).

Results. Echographic scar monitoring showed a lower incidence of adverse sonographic stigma after laparoscopic occlusion of the ascending branches of the uterine artery (UA AB LSO) during three months’ time observation and a leveling of differences – during half a year.

Conclusions. UA AB LSO improves the quality of myomectomy and the probability of morphologically substantiated scar formation on the uterus.

Aim. Assessment of the state of lipid peroxidation, antioxidant defense and oxidative stress indicators on the model of functional activity of neutrophil granulocytes of blood in children with type 1 diabetes mellitus depending on the stage of endocrinopathy compensation.

Materials and methods. The material of laboratory-diagnostic and clinical studies was the results of a survey of 38 children without endocrine pathology and 89 children with type 1 diabetes mellitus at various stages of disease compensation. The state of antioxidant protection was assessed taking into account the overall antioxidant activity, superoxide dismutase activity, retinol level, α-tocopherol, the content of reduced and oxidized glutathione. The intensity of lipoperoxidation processes was studied by the level of substrates with conjugated double bonds, diene conjugates, ketodienes, conjugated trienes, malonic dialdehyde, common lipids. Functional activity of neutrophil granulocytes was investigated by means of luminol-dependent chemiluminescence.

Results. In children with type 1 diabetes mellitus, the intensification of lipid peroxidation processes and the activation of the antioxidant defense system, including variously directed changes in non-enzymatic mechanisms, are noted against the negative effect of active oxygen species. In children with decompensated type 1 diabetes mellitus, severe lipid metabolism disorders combined with oxidative stress indices increase the course of endocrine pathology, significantly increasing the likelihood of intravascular complications.

Conclusion. The coordinated generation of active forms of oxygen and the processes of oxygen-dependent metabolism of blood cells in children with compensated type 1 diabetes mellitus indicates the development of the second stage (resistance) of oxidative stress. Reduction of reactive oxygen species production, reduced activation rate оxygendependent metabolism phagocytes incompleteness phagocytosis mechanisms, correlating with an increase in lesion area (destruction of insulin-producing β-cells) of the pancreas in children with decompensated type 1 diabetes, indicating the occurrence of the third step (debilitation) oxidative stress. Violations of metabolic pathways in children with type 1 diabetes are determined by the intensity of «respiratory burst» of neutrophil granulocytes in the «Lipid peroxidation – antioxidant protection».

Aim. To assess the dynamics of the level of proinflammatory cytokines and their receptors in mixed saliva in patients with autoimmune diabetes mellitus during the period of the occlusal occlusion at various stages of disease compensation and to determine the possibility of applying these values in the early diagnosis and control of the effectiveness of endocrinopathy.

Materials and methods. The material of laboratory-diagnostic and clinical studies was the results of examination of 93 children during the period of the change of occlusion, which were divided into two groups. The comparison group consisted of children without endocrine pathology. The main group consisted of children diagnosed with type 1 diabetes mellitus, which were divided into two subgroups depending on the degree of endocrinopathy compensation. The level of pro-inflammatory cytokines and their receptors in the unstimulated oral liquid was carried out by the solid-phase enzyme-linked immunosorbent assay using the «Vector-Best»» and «Cytokine» reagent kits.

Results. With the compensated form of autoimmune diabetes mellitus, there is an overregulation of regulatory mechanisms with an imbalance in the level of soluble receptors initiating the realization of the proinflammatory properties of these cytokines. The decompensated form of autoimmune diabetes is caused by an absolute increase in virtually all pro-inflammatory cytokines in the oral fluid, with an even more pronounced imbalance in their soluble receptors.

Conclusion. In parallel with the therapeutic measures concerning the underlying disease in children with autoimmune diabetes mellitus the expediency of conducting a comprehensive dental examination with subsequent medical observation of doctors of a stomatology profile. In connection with a direct correlation be-tween the degree of activity of caries process and increase the severity of endocrinopathy, treatment and preventive measures in children with autoimmune diabetes should be regularly monitored and conducted with utmost care.

Aim. To observe a regulatory system adaptive status (regulative adaptive ability) of patients with acne (acne vulgaris), depending on the severity of the disease: mild, moderate or severe.

Materials and methods. Observations were made on 85 boys and girls aged 13-18 years suffering from acne (acne vulgaris). Along with the clinical methods of examination, the observed gave their informed consent to conduction of a trial of cardio-respiratory synchronism, which was performed on a certified device "VNS-Micro" (manufactured by Neurosoft LLC,Ivanovo) by means of a system for detection of cardio-respiratory synchronism in humans. The regulatory adaptive ability was evaluated by index. Statistical analysis of the results of the study was conducted using programmes “Statistika 6.0 for Windows”. To determine significance of differences in mean values in paired comparisons, the Student's t-test was used for p <0.05.

Results. Patients with mild acne demonstrated the regulatory system adaptive status index (M±m) being 68.5±0.3, SD=1.6, their regulative adaptive ability was good. Patients with moderate acne demonstrated the regulatory system adaptive status index being 37.4±0.4, SD=2.1, their regulative adaptive ability was satisfactory. Patients with severe acne – 16.6±0.4, SD=2.1, their regulative adaptive ability was low.

Conclusion. The harder for acne, the lower the regulative adaptive features of observed individuals.

Aim. To study the dimensional and topographic characteristics of the temporomandibular joint elements in mesial occlusion, depending on the topography and the extent of dentition defects.

Materials and methods. The materials of the studies were 17 certified human skulls with mesial occlusion of dentition, which were divided into two subgroups, depending on the topography and extent of dentition defects. Craniometric measurements on human skulls were carried out on the main points of Martin, and the anthropometric parameters of the elements of the temporomandibular joint were studied on sagittal incisions of joint blocks.

Results. Dimensional characteristics of the bone elements of the temporomandibular joint in mesial occlusion are approximated to similar sizes of bone elements in the physiological occlusion of the dentition. Statistically significant gender differences (sexual dimorphism) in the anatomical and topographic structure of the temporomandibular joint are absent in the mesial occlusion of the dentition. Mesial occlusion with intact dentition and included dentition defects of short length is characterized by the absence of pronounced structural changes in the elements of the temporomandibular joint. Mesial occlusion complicated by terminal and included dentition defects of considerable length, in comparison with physiological occlusion and mesial occlusion with included dentition defects of small length, is accompanied by topographic and anatomical changes of the constrictive disk and the head of the lower jaw in the mandibular temporal fossa of the temporal bone.

Conclusion. Achievement of an optimal functional and aesthetic result in the treatment of adult patients with gnathic mesial occlusion is possible only with careful diagnosis, compiling a comprehensive treatment plan, taking into account the individual anatomical and topographic features of the dentoalveolar system and the dynamic observation by physicians of related specialties at all stages of treatment.

Aim. The aim of this study was to determine parallel between clinical manifestations of adenomyosis and imaging methods data.

Materials and methods. 247 patients were examined, from which is formed clinical groups: 1st group included 26 patients (35,1%), and 2nd group – 23 patients (31,1%) with adenomyosis-related infertility, 3rd group (control) – 25 patients (33,8%). It has been clarified reproductive anamnesis, estimated clinical course of adenomyosis and performed hysteroscopy, and ultrasound assessment of resistance indexes in uterus vessels, Hatle index, thickness of «transition area» on MRI.

Results. The intensity of algomenorrhea, dyspareunia, and pelvic pain outside of menses is correlated with US data: the resistance indexes (RI) of uterus vessels as Hatle index and thickness of «transition area» were significantly higher in groups 1 and 2 than in control (р<0,0001); hypervascularization and the presence of the dark red areas showed high sensitivity and specificity; the correlation coefficient between hysteroscopically signs and visual evaluation scale of pain came to R=0,637.

Conclusion. The severity of the adenomyosis clinical intensity is correlated with US, MRI, and hysteroscopy data.

Aim. To reveal the quantity changes of the regulatory system adaptive status of patients after different approaches for myomectomy.

Materials and methods. Myomectomy was performed in the 2ndRegionalClinicalHospital by three different approaches: laparotomic, laparoscopic and hysteroresectoscopic. The heart rate variability was evaluated by time and spectral parameters.

Results. There was revealed that the decrease of heart rate variability is more significantly expressed after laparotomic myomectomy than after laparoscopic myomectomy. The least expressed change of the regulatory system adaptive status was observed in patients after hysteroresectoscopy.

Conclusion. The parameters of heart rate variability allow estimating the functional adaptive status in patients with myoma of uterus who underwent different surgical treatment.

Aim. The purpose of this study was for identify the main orerall symptoms. Typilal for teething of children first year of life, including prematures, because uncontrolled using of medicines car lead of to advers and negative reactions.

Materials and methods. The results of random survey of it children from 1 month to 1 year. 42 boys (55,3 %) and girls (44,7%) full-term Group included 40 children (63%), 36 children (47%) were included in preterm infants group.

Results. The appearance of the first teeth is move common in 6-8 months оf babies life, painful teething was noted in 30 children (39,5 %). The most often symptoms were irritability, drooling, desire to bite. For relief of symptoms of 64 children, there was using medical funds. Of them prevailed gels (92,1% ).

Conclusion. There is no specific symptoms of teething. To relive symptoms it is advisable to use safe medicines, pretembly of plant origin.

Aim. The objective of this study was detecting of neurological pathology among first grade students.

Materials and methods. We examined 2507 students (1414 male and 1093 female) in the age from 16 to18 in the process of deep medical examination. We collected neurological complains, neurostatus, analyses of medical documentation. This data was statistically handled.

Results. Therefore 80% of students had neurological pathology. The most frequent cases were vegetative-vascular dystonia, vertebrogenic pathology and essential headache.

Conclusions. The gained data means the very high level of neurological disease among students, which shows not only importance of rehabilitation activities, but modernization of preventive activities among adolescences.

Aim. Estimate the efficiency of improved complex therapy of premature with surgical pathology.

Materials and methods. 374 medical histories of premature infants were studied. The number of medical histories for 2011 was 169, and the number of medical histories for 2016 was 205.

Results. There is an increase in the number of premature with surgical pathology. The number of premature infants increased with a gestation period of less than 28 weeks and decreased among children with a gestation period of 32-34 weeks. The percentage of deceased children with a gestation period of 32-37 weeks has significantly decreased. Decrease in lethality of premature with surgical pathology in 2 times.

Conclusion. Results of this study confirmed effectiveness of the improvement of complex therapy of premature with surgical pathology.

Aim. The study was to evaluate the effect of cytokine dysfunctions on the endometrial implantation potential in patients with adenomyosis and unsuccessful IVF attempts and the possibility of hormone-mediated regulation of the cytokine balance at the pre-gravitational stage.

Materials and methods. The study included 90 patients with infertility, an unsuccessful attempt of IVF in the history and diffuse adenomyosis of 1 or 2 degrees. Patients were randomized into two groups: the 1st group consisted of 44 patients (group 1) − no pre-education training was conducted. The second group − 46 patients − pregravid preparation of dienogest (2 mg daily for 3 months before the IVF cycle). Control group (group 3) − 30 healthy fertile women. To assess the implantation potential of the endometrium, initially, and after pre-gravity training, the concentration of LIF, IL1в, IL-6, IL-10, RAIL in cervical mucus was determined.

Results. Analysis of the indices in patients with adenomyosis showed a decrease in their implantation potential of the endometrium. It has been revealed that hormone-modulating therapy with dienogest partially neutralizes cytokine regulation defects and leads to a certain increase in the effectiveness of IVF programs.

Conclusion. Shows expediency of including dienogest in the pregravide preparation plan for patients with adenomyosis, but for full immunocorrection in pregravidual training in women with adenomyosis 1 and 2 The degree of additional directional immunotropic therapy is probably necessary.

Aim. Evaluation of the efficiency of magnetic therapy application using the apparatus of RIKTA-02 as a part of a complex therapy of placental insufficiency in pregnant women with bacterial vaginosis.

Materials and methods. The study included 122 women with bacterial vaginosis and detected fetoplacental insufficiency in III trimester. All the patients underwent general clinical, obstetric-gynecologic, microbiological, microscopic, immunological and instrumental methods of investigation (ultrasound fetal Doppler FPC, cardiotocography of the fetus). Pregnant women of the main group (72 patients) underwent treatment of fetoplacental insufficiency on the background of basic therapy, which was supplemented by magneto-laser therapy using the apparatus of RIKTA-02 performed as a course of 10 treatments. The comparison group consisted of 50 patients who underwent traditional medical therapy of the fetoplacental system disorders. Pregnant women of both groups were prescribed a complex treatment with 2% cream Dalacin and immunomodulatory drug Kipferon for the treatment of bacterial vaginosis. Vaginal suppositories atsilakt were used to restore the vaginal biocenosis.

Results. A course of magnetic laser therapy in pregnant women with fetoplacental insufficiency contributed to the normalization of fetoplacental complex, which was confirmed by pathomorphological studies of the placenta.

Conclusion. The inclusion of magnetic-laser therapy in complex therapy of placental insufficiency in pregnant women with bacterial vaginosis significantly reduces the frequency of manifestations of fetoplacental violations, decrease of gestation complications, which reduces maternal and perinatal morbidity.

Aim. To study the prevalence and structure of dysfunctional disorders of the biliary tract (DRBT) in children and adolescents of theKrasnodarTerritory.

Materials and methods. To achieve this goal, an analysis was made of the prevalence and incidence of DRBT in children and adolescents who turned to treatment and prophylactic institutions in theKrasnodarTerritory. Data on the health status of children and adolescents were obtained from the annual reports of children's medical and preventive institutions, annual reports of the Department of Medical Statistics of the Ministry of Health of theKrasnodarTerritory. The main group included 3,065 children and 2,415 adolescents who were examined in schools and pre-school establishments in theKrasnodarTerritory.

Results. Against the background of an increase in the overall frequency of pathology of the digestive organs, a significant change in their structure was observed in 2028 (37.0%) children. Thus, diseases of the liver, gallbladder and pancreas were diagnosed in 1480 (27.0%) of the number of patients examined, of them 843 (5.5%) were diagnosed with DRBT. In the early age and preschool age, there were 72 (8.5%), primary school age 225 (26.6%), and senior school age 546 (64.8%). The number of boys was 632 (75.0%), girls – 211 (25.0%).

Conclusion. Dependence of the structure of DRBT on the age of the child population, the functional state of the biliary tract was established. Primary hyperfunction of HP and biliary type of CO disorder prevail in children of early and preschool age. At school age, the incidence of hypothyroidism increases, and biliary and pancreatic types of CO dysfunction are equally recorded. In children puberty, secondary dysfunctions of the biliary tract are predominant in the form of hypofunction of HP and pancreatic type of CO disorder.

Aim. Was the analysis prospective follow-up data of children undergoing long conjugational jaundice at an early age.

Materials and methods. The analysis of medical documentation data (the form-112) outpatient care, 87 children, 41 of them a boy and 46 girls. All patients in the first three months of life had a clinical and laboratory-confirmed indicators of long conjugational jaundice. All the examinees were divided into 4 main clinical groups according to the periods of childhood: group 1 (1 to 3 years) – 21 children; group 2 (from 4 to 6 years) – 23 of the child; 3 group (7 to 11 years) – 21 children; 4 group (12 to 17 years) – 22 subject. All patients underwent clinical, laboratory and instrumental examinations, sonographic examination of the abdominal cavity in dynamic monitoring, esophagogastroduodenoscopy (EFGDS).

Results. Patients who had at an early age the signs of impaired conjugation of bilirubin, are at risk for the development of the pathology of the gastro-biliary system. The presence of anatomical peculiarities of structure of gall bladder and biliary tract lead to the appearance of clinical manifestations at the age of 4 years and older. Special attention pediatricians and gastroenterologists should be focused on patients of school age where there is a pain syndrome characterized by persistent, regular presence, amid signs violations of the outflow of bile, presence of possible infection with H. pylori, and provoked by defects in the supply. In this period you can observe the appearance and progression of neurological symptoms, often accompanied by pathology of the gastro-biliary system.

 Conclusion. When analysing follow-up data of children who had a protracted conjugational jaundice in the first months of life, it is revealed that everything observed in the different age periods had evidence of violations of the gastrointestinal tract, require continuous long-term dynamic monitoring of a gastroenterologist and pediatrician. 

Aim. To explore some regularities of the immune system and resistance in children with ulcer duodenum. On the basis of systemic pathogenetic approach to develop a system of integrated assessment of the immunity of the child with the ulcer duodenum.

Materials and methods. A clinical and immunological study of 114 children aged 5-14 years, suffering from an ulcer duodenum. The control group consisted of 30 healthy children of similar age. Investigation of venous blood were performed on the day after admission and after a course of appropriate treatment before discharge. By mathematical analysis of unsubstantiated "factor" structure of the immune system in normal and ulcer duodenum.

Results. At different stages of the disease varies the amount and structure of relations between the components within the immune system and its relationship with other systems. Conclusion. These peculiarities – a normal physiological response of the immune system to develop an immunological process in the mucosa of duodenum. 

Modern options of uterine fibroids pharmacotherapy allow for individual selection of therapy.

 Aim. To compare the effectiveness of uterine fibroids treatment with administration of mifepristone (Gynestril) on the basis of a differentiated approach to the assignment of two treatment schedules in various dosages: 25 mg or 50 mg per day for three months.

Materials and methods. A prospective comparative study was conducted at the clinical bases of Department of Obstetrics and Gynecology with the Course of Perinatology of the Peoples’ Friendship University of Russia (Moscow) and the Department of Obstetrics, Gynecology and Perinatology of the Kuban State Medical University (Krasnodar). 160 women with uterine myoma were enrolled in the clinical groups. Randomization was carried out by a double-blind method using envelopes.

Results. Administration of mifepristone (Gynestril) at a dosage of 50 mg per day for 12 weeks and 25 mg per day for 24 weeks has comparable efficacy.

Conclusion. Due to the assessment of subjective and objective criteria of drug tolerance, an individual dose selection of mifepristone is possible without compromising the achievement of the therapeutic effect. 

Aim. To determine the clinical, morphological and microbiological efficacy of treatment of gastric ulcer associated with Helicobacter pylori, using recombinant interleukin-2 "Roncoleukin" without antibiotics.

Materials and methods. 108 patients suffering from HP-associated gastric ulcer disease were randomly divided into two groups. The I group of patients was cured with standard three or four component methods of therapy included proton pomp inhibitors and two antibiotics (usually Klaritromycin and Amoxicillin). Patients of the second group were treated with the same therapy, but instead of antibiotics they received 0,1 mg rIL-2 – Roncoleukin into four – six points submucously using gastroscope techniques and 0,4 mg was dissolved in 400 ml 0,9% NaCl and infused intravenously. This procedure was performed three times with the interval of 72 hours.

Results. One month after the end of treatment it was found that in the group treated with rIL-2 the HP eradication achieved in 95,4% in comparison to 81,5% in control patients. In Roncoleukin treated group ulcer epithelization period was 10,79±0,46 days and in traditionally treated group – 35,23±1,58 days. In third month of monitoring in gastric mucosae bioptates of basic group patients in 93,5% there were no morphological inflammatory signs and in 81,4% of patients intestinal metaplasia disappiered. Conclusion. The proposed method of complex treatment of gastric ulcer associated with Helicobacter pylori is clinically and pathogenetically justified. 

Aim. Optimization of recovery treatment at often painful children.

Materials and methods. The analysis of the combined application of a rehabilitation and recovery complex is carry out with use physical treatment techniques and herbal medicine Tonzingon H (althea root, chamomile flower, bottlebrush, dandelion, milfoil, nut leaves, oak bark) in the conditions of sanatorium treatment for 35 children with chronic tonsillitis. Clinical and Immunological efficiency and the safety of medicine are also evaluated.

Results. Anti-inflammatory and immune-modulating effect is registered due to increase level of immunoglobulin in nasal secretion. Recovery morphofunctional condition of epithelium mucous membrane cells (cytoprotective impact) is noted at children with chronic tonsillitis.

Conclusion. Combined use of physical factor and phytotherapy Tonzingon H at children with chronic tonsillitis at the stage of rehabilitation in a therapeutic treatment center promotes full implementation of individual programs of recovery treatment. 

Aim. The purpose of this article is to study the dynamics of neurological morbidity in the Krasnodar Region.

ulated over 9 years, and reflecting the overall and neurological incidence of children in the Krasnodar Region. This material does not require in-depth development, but at the same time it has practical application and facilitates the organization of work, and also provides an opportunity to comprehend and analyze it. On the basis of the obtained data the estimation of dynamics of index of morbidity and the proportion of neurological pathology in the structure of children's disability are conducted.

Results. Based on the results of the analysis, a stable trend towards a decrease in the incidence of children 0-14 and 15-17 years old was detected and a negative rate of increase in general and neurological morbidity was determined. However, this trend was traced only in 2012, when the peak of neurological morbidity increased. Every fourth case of childhood disability is caused by diseases of the nervous system.

Conclusion. Since 2012, there has been a stable positive evolution of the incidence rate, which found a negative growth rate by 2016 in all age groups. Summarizing the section on children's disability, it is established that almost every fourth case of disability is caused by a disease of the nervous system. 

Aim. Study aspects of preventive treatment for infections in children with hereditary HA and analyze haemogram changes in immunization context.

Materials and methods. There are 19 children with HA registered in Krasnodar, 26,31% of them are girls and 73,69% are boys. In 2015 – 2016 three children (two girls and one boy) with hereditary spherocytosis and ovalocytosis have been immunized in the Pediatric Child Care Department in Krasnodar Infectious Diseases Hospital.

Results. Each child had scheduled immunizations. First day two children had fever at a febrile rate, headaches, apathy, decreased appetite. Hematologic tests showed increased symptoms of anemia and reticulocytosis. Billirubin chemistry value increased, mostly unconjugated. Fluid therapy, glucocorticosteroids, hepatoprotectors, spasmolytics, sorbents were prescribed to children, and it showed clinical improvement in patients condition, as well as laboratory test values normalization.

Conclusion. Taking into consideration frequent infectious diseases in children with hereditary HA, it is reasonable to immunize them after splenectomy. Two children with hereditary HA were immunized while being in hospital and during the period of monitoring there were noticed deviations in hematological tests, but in a few days after immunization children’s condition was normal.Therefore it is reasonable to immunize children with hereditary HA in hospital, despite the possibilities of complications in the post immunization period. 

Aim. To substantiate the possibility of using modern drug-free technologies in the treatment of chronic inflammatory diseases of uterine appendages.

Materials and methods. During the study, 65 patients with chronic inflammatory diseases of uterine appendages were divided into study and control groups. 30 patients of the main group following a traditional medical treatment in the first phase of rehabilitation received a course of quantum therapy. Laser therapy was carried out using the apparatus of RIKTA-02 percutaneous method to the area of the womb. The course of treatment ranged from 5 to 10 procedures. In the second phase of rehabilitation therapy the following treatment course using teraklitau clay was carried out after 3-4 weeks. The control group consisted of 35 patients who underwent the treatment of inflammatory diseases of the uterine appendages according to the standard scheme. Women in both groups underwent clinical, laboratory, immunological, hormonal, and instrumental methods of examination.

Results. Stage integrated non-pharmacological treatment of chronic inflammatory processes of uterine appendages had anti-inflammatory, immunocorrective and vasoactive effect.

Conclusion. The use of clays of teraklitau and laser therapy in the treatment of inflammation of the uterine appendages has led to persistent therapeutic effect and significantly improved the quality of life in 85% of patients. 

Aim. Assess the significance of anamnestic data and complications of gestation in I-II trimesters in predicting PL depending on the gestational age.

Materials and methods. A prospective comparative study was carried out at the clinical bases of the Department of Obstetrics, Gynecology and Perinatology of postgraduate education of the Kuban State Medical University (Krasnodar): in the Perinatal Centers of the Children's Regional Clinical Hospital (DKKB) and the Regional Clinical Hospital No. 2 (KKB No. 2). The perinatal center of theRegionalClinicalHospital "DKKB" (Krasnodar) is specialized in premature birth in theKrasnodarTerritory. Women with preterm labor (ICD code-O60) included in the study were divided into four groups included depending on the gestational age: very early premature births (22-276days, n = 37 women), early premature births (28-306 days) weeks, n = 40 women), premature birth (30-336 days, n = 38 women), late premature birth (33-366 days, n = 35 women). The control group consisted of conditionally healthy women with a full term of pregnancy and with physiological births (37- 403 days of weeks, n = 50).

Results. The importance of pregnancy complications in I-II trimesters as risk factors for premature birth was established. Prophylaxis, timely diagnosis and treatment of these complications may be a measure of a decrease in the frequency of PL, or an increase in the duration of pregnancy with PL.

Conclusion. Prophylaxis, timely diagnosis and treatment of these complications may be a measure of a reduction in the frequency of preterm labor or an increase in the duration of pregnancy in preterm labor. 

Aim. To assess the effectiveness of the intentional teaching and efficiency of treatment of children with obesity.

Materials and methods. The research includes children aged 7 to 18 years old with overweight and obesity gaining the required knowledge of principles of eutrophy and methods of weight loss. The training had a structured program. All the necessary investigations were made: laboratory assessment, anthropometric measurements, bioimpedance body scanning at the beginning and in six months of training.

Results. 49 children completed training: 25 boys and 24 girls. The medium swing of weight loss was 0,48 kg per week and 1,23 kg per month. 82% of children had favourable results in the program of weight loss.

Conclusion. 12% of boys normalized their body weight and 25% of girls moved from obesity to overweight. The number of children with obesity degree III and II fell nearly by one half. 

Aim. The study is to establish causally significant epidemiological risk factors for the occurrence of iron deficiency disorders (WDS) in children and adolescents in the Krasnodar Territory.

Materials and methods. The absolute and relative risks of the formation of GVD in 605 children and adolescents aged from birth to 18 years, living in the territories of the Krasnodar Territory with various ecological conditions, were studied. The ecological situation in the province was assessed according to the method previously proposed by V.A. Shashel et al. (2000). The following characteristics of the general blood test performed on an automatic analyzer with the determination of hemoglobin (Hb), the number of red blood cells (RBC), hematocrit (Ht), erythrocyte indices (mean erythrocyte volume- MCHC, width of red blood cell distribution by volume-RDW, reflecting The degree of anisocytosis), the number of reticulocytes (Ret), and the hemoglobin content in the reticulocytes (CHr). The serum iron (SJ), serum ferritin (SF) and total iron binding capacity of serum (BFW) were determined. The saturation coefficient of ferric iron was calculated by the formula: NTZ=SZ/OZSS.100%. The relative risk (RR) was calculated using the formula: R=d.a/b.c.

Results. The study of the influence of various endogenous and exogenous epidemiological risk factors on the occurrence of GVD in children allowed the identification of 25 most significant factors. Of the medical and biological antenatal and intranatal reasons, the main ones were placental insufficiency, multiple pregnancy, diseases of pregnant women, including anemia. Of the postnatal factors, the leading ones were insufficient intake of iron with food in the form of early artificial feeding, the use of unadapted milk mixtures of cow or goat milk. Increased need for iron occurs in children with accelerated growth rates in early, prepubertal and pubertal age, and increased losses of this macroelement were due to intestinal absorption, bleeding of various etiologies, including a part of girls during the period of menstrual cycle. The main risk factors for social and hygienic reasons can be attributed to an unbalanced diet with a rare intake of meat products, a strict vegetarian, flour, milk, sweet rations, a rare intake of fruits and vegetables, leading to a qualitative and quantitative deficiency of macro- and micronutrients. The majority of children had a disturbance of the regime of the day and nutrition, the use of fast food, inactivity. The majority of these risk factors for the development of LVS have occurred in the upbringing of children by parents, smokers and mothers in families with low material incomes and low medical activity in the family. The detected risk factors for the emergence of GVH in children exacerbate its effect against the background of air pollutants, water basins and agricultural lands.

Conclusion. The detected risk factors make it possible to form children in risk groups for the occurrence of their WDN, to timely appoint a diagnosis for diagnosis, treatment and develop targeted programs for primary prevention and rehabilitation of these diseases.

Aim. Of the study is to assess the vegetative status of children with vegetative dystonia syndrome.

Materials and methods. The vegetative status was studied in 811 children and adolescents under the age of 17 years with a syndrome of vegetative dystonia who applied for medical assistance in the consultative and diagnostic department of the Children's Regional Clinical Hospital of the Ministry of Healthcare of Krasnodar Krai during 2016. To study the functioning of the autonomic nervous system, the сardiointervalography (CIG) was used. When assessing the state of the autonomic nervous system, the initial vegetative tonus (IVT), vegetative reactivity (VR), stability of vegetative processes regulation and activity of subcortical nerve centers (ASNC) were taken into account.

Results. In 37.6% of the patients examined, the predominance of the parasympathetic nervous system tone was noted, in 28.9% of children the sympathetic department dominated, in 33.5% of the cases the eutonium was recorded. Hypersympathicotonic autonomic reactivity was registered in 50% of children, asymptaticotonic – in 22.9% of cases, within the normal limits – 27.1%. Stable regulation of vegetative processes was observed in 42.3% of patients, dysregulation with prevalence of parasympathetic nervous system was identified in 21.8% of cases, dysregulation with prevalence of sympathetic nervous system – in 13.5% of patients, a central type of dysregulation was observed in 11.8% of patients and a transient process – in 10.6% of cases. An increase in subcortical nerve centers activity was detected in 47% of the children and adolescents examined, an activity decrease was registered in 25.9% of the examined, normal activity was detected in 27.1% of cases. The evaluation of autonomic reactivity in children with clinical manifestations of autonomic dystonia syndrome according to the CIG was characterized as follows: initially, vegetative reactivity was increased in 66.2% of girls aged 5 to 9 years, in 33.8% it was decreased. In the age range from 10 to 14 years, the schoolchildren are strongly dominated by the increase in vegetative reactivity – 85.0%, the indicator is decreased in 15.0% of patients. 15-17 years old girls with hypersympaticotonic reactivity prevail – 88.0% of patients, while there were only 12.0% of patients with registered asympathicotonic reactivity. 5-9 years old boys of with defined hypersympathicotonic reactivity make 73.7%, with asymptoticotonic reactivity – 26.3%. Age from 10 to 14 years is represented by the following results: 91.5% of boys are characterized by increased vegetative reactivity and only 8.5% by decreased vegetative reactivity. In young men aged 15- 17 years, the prevalence of hypersympathicotonic dystonia is expressed, the incidence of increased vegetative reactivity increases significantly.

Conclusion. With the increase of years of children suffering from vegetative dystonia syndrome without considering gender factors, the parasympathetic orientation of the vegetative tonus increases. The regulation of vegetative processes in most children is stable when the activity of the subcortical nerve centers is increased. 

Aim. To study the allergic reactions in children with minimal brain dysfunctions and features their treatment.

Materials and methods. Eighty two children with allergic reactions and minimal brain dysfunctions include on research.

Results. The article presents data on the pathogenesis of allergic reactions in children with minimal brain dysfunction. The authors share their own experience with hydroxyzine having anxiolytic and antihistamine action in children with allergic reactions at the minimal brain dysfunction.

Conclusion. Hydroxyzine has the high efficiency and safety for treatment allergic and neurotic symptoms in children. 

Aim. The objective of this study was to establish structural changes in the brain of preterm neonates born with low and extremely low body weight, with perinatal brain damage of moderate severity by neurotractography.

 Materials and methods. 48 children born with very low and extremely low body weight were examined. Structural changes according to neurosonography were revealed in all. Neurotractography was performed before discharge from the nursing department.

Results. A significant difference in the neurological status before discharge was not detected in children. The area of interest was the crus posterius capsulae internae during neurotractography. Reduction of FA and increase of ADC was detected in three cases. These children had a motormental retardation at the adjusted age of 12 months.

Conclusions. Neuropathography results can increase the accuracy of later neurologic prognosis. If significant changes in the neurotractography are not recorded, then a favorable neurological prognosis is predicted 

Aim. The purpose of the work is the study of the impact of bronchopulmonary dysplasia on the prognosis of perinatal brain injury in premature newborns with low and extremely low body weight considering the results of neurotractography.

Materials and methods. 61 children born with low and extremely low body weight took part in our study. The first group included 22 newborns with manifesting bronchopulmonary dysplasia; the second group included 39 newborns without bronchopulmonary dysplasia. Perinatal brain injury of hypoxic-ischemic genesis of moderate severity was diagnosed in all cases.

Results. Significant differences in groups during the antenatal and intrapartum periods were not detected. Period of respiratory support was significantly different in groups. Damage оf corticospinal tract was not detected by MRI.

Conclusion. Rehabilitation of newborns without bronchopulmonary dysplasia was faster in the first months. 

Aim. Evaluation of clinico-laboratorial and sonographic signs of adnexal torsion.

Materials and methods. Follow-up of the patient in the Perinatal Center of the Regional Clinical Hospital No. 2; ultrasound performed on Medison and Voluson E6; laparoscopy performed with the use of endoscopic devices KARL STORZ.

Results. Left adnexal torsion was seen on ultrasound while the patient with a gestation period of 7-8 weeks was in the hospital. The main sonographic criteria for dynamic examination were: ovarian displacement and enlargement, changes in its echostructure, paraovarian cyst adherent to it, lack of blood flow in the ovary, and increasing hydroperitoneum. The  192 diagnosis was verified with laparoscopy and histological examination. Laparoscopic adnexectomy was performed. The postoperative period was unremarkable. Pregnancy progresses without complications.

 Conclusion. In the absence of convincing clinico-laboratorial, instrumental data indicative of adnexal torsion and an absolute indication for laparoscopy, ultrasound is necessary in dynamics. The above signs make possible to diagnose the adnexal torsion. Laparoscopy carried out in early pregnancy does not cause any complications in carrying of a pregnancy now.

Aim. The purpose of the study: to pay attention to the urgency of the problem for further deeper study of diseases in children, which is based on the violation of histamine metabolism in the body, namely, increase in the level of extracellular histamine. To study the syndrome of intolerance to histamine (CIS), the diagnosis and treatment of diaminoxidase deficiency (DAO).

Results. Understanding the etiology and pathogenesis of the CIS, studying the diagnosis and treatment of DAO deficiency gives new opportunities in successful treatment, and most importantly prevention of food hypersensitivity in children.