[ORGANIZATION OF MEDICAL CARE FOR CHILDREN WITH A NEW CORONAVIRUS INFECTION IN PATIENT CONDITIONS ON THE EXAMPLE OF THE CHILDREN'S CITY CLINICAL HOSPITAL NAMED AFTER Z. A. BASHLYAEVA].

The article presents an analysis of the work of the largest children's COVID-19 center in Moscow, organized on the basis of the Children's City Clinical Hospital named after Z. A. Bashlyaeva of the Moscow City Health Department. From March to November 2020 at the COVID-19 Center were hospitalized 2,837 patients with suspected/confirmed diagnosis of COVID-19, in total in 2020 1,876 children with a confirmed diagnosis of COVID-19 were treated, 58 (3%) children were in serious condition in the intensive care unit, of which children 11-18 years old were 25%. At the 2020 neonatal COVID-19 center, 215 newborns were observed with suspected COVID-19 diagnosis. The diagnosis of COVID-19 was confirmed in 18 children, while 8 newborns came from the home of COVID-19. In the Center for rehabilitation, where children aged 0 to 3 years old who were born with very low and extremely low body weight are observed, dispensary observation for children who have undergone COVID-19 is organized. 45 children who were observed fell ill with the new coronavirus infection. There were no deaths among children with COVID-19.

[Neurological complications and outcomes of bacterial meningitis in children]. / Nevrologicheskie oslozhneniya i iskhody bakterial'nykh meningitov u detei.

AIM: To analyze neurological complications and outcomes of bacterial meningitis (BM) in children. MATERIAL AND METHODS: Fifty-five patients with BM, aged from 2 months to 12 years, were examined. Bacteriological study, clinical and biochemical blood tests and blood serology and cerebrospinal fluid (CSF) tests as well as serum molecular-genetic study were performed. Neuroimaging methods (neurosonography, computed (X-ray) tomography and brain magnetic resonance imaging) were used. RESULTS AND СONCLUSION: A key role of generalized meningococcal infection in the development of BM in children was confirmed. Brain edema was an early and life-threatening complication of BM. It was found in 9% of the patients with meningococcal infection, 7.3% with pneumococcal meningitis and 3.6% with haemophilus meningitis. Changes in the brain structure were not found in 80% of the patients, in 20%, the residual stage of BM was characterized by cerebral destructive/proliferative or atrophic changes of different severity. The dissociation between clinical and neuroimaging parameters and poor outcomes of BM, related to the complicated premorbid state, concomitant somatic/neurological pathology, BM severity, late laboratory diagnosis and untimely etiotropic antibacterial treatment, were identified in 65.5%.

[Neurological presentations of bacterial meningitis in children: current possibilities of diagnosis and treatment]. / Nevrologicheskie proyavleniya bakterial'nykh meningitov u detei: sovremennye vozmozhnosti diagnostiki i lecheniya.

AIM: To improve clinical/laboratory diagnosis of bacterial meningitis (BM) in children. MATERIAL AND METHODS: Fifty-seven patients, aged from 4 months to 12 years, with BM were examined. Bacteriological study of the mucus from the nasopharynx, sterility tests of blood and cerebrospinal fluid (CNF), clinical and biochemical tests, serological study of paired samples of plasma - indirect hemagglutination test, latex agglutination assay, immunological study of plasma and CNF with the determination of interferon -α, -ß and -γ, interferon procalcitonin and neopterin with ELISA were performed at admission and after CNF remediation. Molecular-genetic study of the blood serum and CNF using PCR, neurosonography, computed tomography and MRI of the brain were done as well. RESULTS AND CONCLUSION: Most of the patients had generalized meningococcus infection (64,9%). Hib-meningitis, pneumococcus meningitis and other forms were less frequent. Characteristics of neurological presentations of BM depending on the etiology, somatic complications and time from the manifestation of symptoms were described. Clinical/biochemical criteria of BM and correlations between procalcitonin, neopterin and interleukin-8 in the CNF and blood of the patients and disease severity as well as between the level of inflammatory reactions in the CNF and the BM form were established. These results are important for the development of informative biomarkers for the prognosis of BM course and outcome.

[Detection of sapoviruses in children with acute gastroenteritis in Moscow in 2002-2003].

Sapoviruses were found, for the first time, to be circulating in children with acute gastroenteritis in the city of Moscow. On the basis of a genetic analysis, they were classified as belonging to genotypes 1 and 2. Two groups of sapoviruses that are essentially different from the strains presented now at the GenBank NCBI were described within the case study.

[The proteolytic activity of the contents of the normal large intestine and in microecological disorders]. / Proteoliticheskaia aktivnost' soderzhimogo tolstoi kishki v norme i pri mikroékologicheskikh narusheniiakh.

The proteolytic (caseinolytic) activity of fecal supernatants obtained from 52 practically healthy children and 220 children with the etiologically undetermined (unclear) diagnosis of gastrointestinal tract dysfunction has been studied. As revealed in this study, in cases of bacteriologically confirmed microecological disturbances in the intestine, accompanied by the activation of opportunistic microflora, the caseinolytic activity of fecal supernatants increases. The determination of the level of the caseinolytic activity of fecal supernatants on solid culture media as a rapid method, specially intended for the diagnosis of dysbiotic states of the gastrointestinal tract, is proposed.

[The Amben regulation of the intestinal microflora and macrophage functional activity in an experiment]. / Reguliatsiia ambenom kishechnoi mikroflory i funktsional'noi aktivnosti makrofagov v éksperimente.

The possibility of the correction of intestinal microflora disorders and the functional activity of macrophages in dysbiosis, caused by the intragastric administration of ampiox, with the use of amben (PAMBA), an inhibitor of proteolytic enzymes, was studied. Quantitative and qualitative changes in the main representatives of automicroflora, the functional activity of macrophages in the phagocytosis of 51Cr-labeled sheep red blood cells, the intensity of protein synthesis, the content of cathepsin D, acidic phosphatase and nitro blue tetrazolium activity were determined. The combined administration of ampiox and amben normalized quantitative and qualitative ratios of the main representatives of intestinal microflora, as well as the characteristics of macrophage functional activity, studied in this investigation. The administration of amben to intact animals was found to stimulate bifido- and lactoflora.

[The role of food hypersensitivity in the pathogenesis of protracted forms of intestinal infections in infants]. / Rol' pishchevoi sensibilizatsii v patogeneze zatiazhnykh form kishechnykh infektsii u detei rannego vozrasta.

Sensitization with food antigens and the status of the general and local immunological systems were examined in 31 children suffering from lingering intestinal infections which may be related to body sensitization with food antigens. The children of the first year of live manifested sensitization to cow's milk proteins most frequently, particularly to alpha-lactablumin and beta-lactoglobulin. The main criteria for laboratory diagnosis of food sensitization were blood eosinophilia, the presence of eosinophils in the feces, the presence of antibodies to food antigens, blood hypo- and dysimmunoglobulinemia. The treatment of lingering intestinal infections requires the use of etiotropic drug therapy, hypoallergenic dietetic management bearing in mind individual food intolerance, and the use of antihistaminic drugs.

[Experience in the use of the coagglutination reaction in diagnosing rotavirus infections in children]. / Opyt primeneniia reaktsii koaggliutinatsii dlia diagnostiki rotavirusnoi infektsii u detei.

To improve the etiologic diagnosis of acute intestinal infections in children and to identify a rotaviral infection, a solid-phase coagglutination test for the detection of a rotaviral antigen has been introduced into the complex of diagnostic tests. This method is available and simple, highly sensitive and specific. The authors describe the technique of the test and give their recommendations on how to introduce this test into practice at hospitals for infectious diseases.