Ground: Newborn lacto trophy consists of own digestion by digestive enzymes of gastrointestinal tract and autolytic digestion by breast milk enzymes. Newborn digestive hydrolase are the initial digestive potential. Its determination can be predict the lacto trophy efficacy, but doesn’t be done now. Aim of the study: Revealing the ability of determination the newborn digestive potential according to digestive gland hydrolase content in the amniotic fluid and comparison it with the same enzymatic activities of the funic and venous blood serum, newborn gastric content. Materials and methods: According to parents agreement the amniotic fluid, funic blood samples, newborn gastric content, mother’s venous blood were taken from 76 parturient women (40 had complete and 36 had incomplete pregnancy). The following data were obtained by means of routine methods: lipase, a-amylase, alkaline phosphatase, pepsinogen I and pepsinogen II. The results were processed by methods of non-parametric statistics. Results: The assessment of digestive enzymatic potential of newborn digestive system may be done by hydrolytic enzymes determination. The analysis should be performed in amniotic fluid as its hydrolase and zymogens have fetal origination in the end of gestation. If the pregnancy is incomplete or intrauterine growth retardation is taken place the hydrolase and pepsinogen content in amniotic fluid is decreased. The probability of newborn dyspepsia is great. It required the earlier digestive correction and breast feeding technology. Conclusion: The content of hydrolytic enzymes in amniotic fluid, gastric content and funic blood serum, their alteration in incomplete pregnancy have diagnostic value in assessment of newborn digestive potential.

Aim: to investigate of fecal microbiota composition and to specify the features of intestinal dysbiosis in patients with ulcerative colitis (UC) and celiac disease (CD). Methods: Fresh fecal samples were collected from 40 mild-to-moderate active UC patients on mesalazine treatment, 43 CD patients on a gluten-free diet and 42 healthy controls (HC). The quantitative real-time polymerase chain reaction (qRT-PCR) was used for fecal microbiota assessment. Results: UC and CD patients had lower Faecalibacterium prausnitzii counts than HC (p = 0.043 and p = 0.036, respectively). Butyrate-producing bacteria (primers for Butyryl-CoA: acetate CoA transferase gene were used) were depleted in UC patients compared to HC (p = 0.048). Surprisingly, Bacteroides thetaiotaomicron was detected less frequently in UC patients than in HC (p = 0.016). The absence of Bacteroides thetaiotaomicron in feces or its levels below the limit of detection were significantly associated with ulcerative colitis (OR = 6.30; 95% CI: 1.33 - 29.95). CD patients had lower Bifidobacterium spp. counts than HC or UC (p = 0.022 and p = 0.046, respectively). Taxonomic dysbiosis in both UC and CD was characterized by a higher Bacteroides fragilis/Faecalibacterium prausnitzii ratio compared to HC (p < 0.05 in both cases). Conclusions: An increased B. fragilis/F. prausnitzii ratio can serve as available biomarker for intestinal proinflammatory dysbiosis in both UC and CD. Low counts of Faecalibacterium prausnitzii (in both UC and CD) and total butyrate-producing bacteria (in UC) suggest the desirability of co-treatment with oral butyrate or butyrate-enhancing agents (probiotics, prebiotics, metabiotics) in both UC and CD. Not only butyrate-producing bacteria but possibly also Bacteroides thetaiotaomicron protects against ulcerative colitis. Treatment that increases colonic bifidobacteria (e. g. some Bifidobacterium probiotics or inulin-type prebiotics) can be considered in CD.

We conducted a study to assess the impact on growth and development of infants the levels of certain microelements, particularly the relationship of different groups of microelements in children. Outlines the most common causes of deficiency and excess of macro- and microelements, allocated for the development of risk microelementoses. Bioelements deficiency is a common cause of serious violations of the functioning of organs and systems, intrauterine growth retardation, anemia, which leads to low birth weight and an increased incidence in the neonatal period

Study Aim. To study clinical, endoscopic and morphological patterns in children with GERD suspected Barrett’s esophagus according endoscopy. Methods. The study involved 87 children with GERD. According to the results of endoscopy and histological examination of biopsy specimens of esophageal mucosa in 13 of 87 patients were identified signs of metaplasia. Results. In 13 of 87 patients with GERD (14.9%) were detected metaplasia of the esophagus (Barrett’s esophagus): in 10 cases (11,5%) - gastric, in 3 (3,4%) - intestinal type. According to EGD, 6 children with Barrett's esophagus had erosive GERD, and 7 - non-erosive GERD. Intestinal metaplasia was detected only in children with erosions in the esophagus. Clinical manifestations of GERD in patients with metaplasia did not differ from that in children without metaplasia. According to the 24-hour intragastric acidity, 53.8% of children with Barrett's esophagus had physiological GER, 38.5% of pathological acidic GER and one child (7,7%) - abnormal non-acid GER. All children with intestinal metaplasia had pathologic acidic GER. Conclusions. Not revealed any clinical features of Barrett's esophagus in children with GERD. Long term GERD, erosive esophagitis, pathological acid GER - predisposing factors of Barrett's esophagus.

The article presents the clinical and medical history especially in children with the syndrome of bacterial overgrowth (SIBO), diagnosed by breath test with lactulose. It was found that among children with SIBO significantly more frequent functional dyspepsia, lactase deficiency. In this clinical picture in children ARIS was not specific, but probiotic therapy has a pronounced therapeutic effect.

The study provided a method for predicting the development of severe rotavirus infection (RVI) in out-patient infants using conventional laboratory examination on the first day of hospitalization. The index positivity as a prognostic criterion is proposed, which is calculated during the enzyme immunoassay (EIA) test system «Rotavirus antigen-ELISA-Best» (Novosibirsk).The probability of development of severe forms of RVI in infants was determine in 3.5 times the sensitivity of clinical indicators. If by ELISA (test system «Rotavirus-antigen-ELISA-BEST») defines the meaning of a positivity rate of ≥ 13, and we assume the prior probability of severe disease is equal to 0.24, the probability of development of severe forms tear in children of early age is of 0.84 (i. e. 84%), 3.5 times higher than established clinically. Taking into account a response is received IFA from the feces of the child on the first day of hospitalization the forecast probability of severe forms tear, can justify early therapy with intravenous immunoglobulins. Conclusions. In hospitalized infants with confirmed rotavirus infection at 24.0% of cases diagnosed with severe forms of the disease. The positivity rate of the optical density, calculated when conducting a ELISA test-system «Rotavirus-antigen-ELISA-BEST», Novosibirsk, may serve as a measure of the probability of development of severe forms of rotavirus infection in children of early age - its value in severe forms is higher than for moderate 16,7 >9,2 (t=0,97, p=0.00).For small values of positivity rate of more than 13, the probability of developing severe forms of the disease is 84%

Objective: To study the intestinal microbiota in children with viral gastroenteritis (VG) and the role of dysbiosis in the genesis of functional pathology of the digestive system (FPDS). Materials and methods. 143 patients aged 1 to 7 years, without a history of gastroenterological diseases with moderate rotavirus, norovirus and the mixed company of norovirus-intestinal infections, verified by PCR in the feces were observed. Intestinal microbiota was evaluated using bacteriological method, real-time PCR and by the hydrogen breath test (study on the presence of bacterial overgrowth syndrome). Within 1 year of follow-up was carried out surveillance for the detection of functional disorders of the digestive system Results. During the acute period of RVI we revealed a significant decrease in Bacteroides thetaiataomicron and increase of Bacteroides fragilis comparing to the NVI. Proliferation of OP was observed in a quarter of patients with VG and accompanied by inflammatory changes in feces (more often for RNVI). FPDS diagnosed in 22.7% of convalescents VG, which rate was at RNVI 26.9%, RVI - 25.9%, NVI - 17.3%. Children who have formed FPDS showed in intestinal microbiota a trend toward reduction of Bifidobacterium spp., F. prausnitzii and increase B. fragilis. BOS diagnosed at all VI, with a maximum frequency at RNVI (54.5%). Revealed a connection BOS with the manifestation FPDS. Conclusion. Intestinal dysbiosis and bacterial overgrowth syndrome at VII pathogenically associated with the development of postinfectious FPDS in children.

Introduction: tyrosinemia type I - is a rare genetic disease that leads to cirrhosis of the liver, liver failure, and tubulopathy. In this connection, great importance is early diagnosis and timely initiation of pathogenetic treatment of the disease. Goal. Based on multivariate statistical analysis of clinical diagnostic indicators and their changes over time to develop an algorithm stepwise diagnosis of hereditary tyrosinemia type I in children and to evaluate the effectiveness of pathogenetic therapy. The scope and methods. The study included 17 children (8 boys and 9 girls) with tyrosinemia type I: 5 patients (29.4%) with type IA and 12 patients (70.6%) with the IB type. All children received pathogenetic therapy of NTBC. Conducted the study of history and the life of the patients of the disease, we evaluated the clinical and laboratory data at the onset of the disease and on the background of a six-month course of pathogenetic therapy. Results. Using multivariate statistical analysis revealed clinical and laboratory criteria for diagnosis of tyrosinemia type 1 in young children, followed by incremental compilation disease diagnostic algorithm. The estimation of the severity of liver dysfunction before and 6 months after initiation of specific therapy, which has proven its improvement.

The purpose of the study was the levels of blood serum gastrin in children with a mild form of viral hepatitis B and their importance in clinical manifestations of the disease. Materials and Methods of the Research. 48 children aged between 3 and 15 years old have been examined as per viral hepatitis standard testing with additional measuring of morning gastrin level. The first group included 33 children suffering from a mild form of hepatitis B. The control group (norm) consisted of 15 healthy children. Results of the Research. The majority of children (69,7%) suffering from a mild form of hepatitis B had a higher gastrin level in the blood serum as compared to the healthy children (norm). It was proved by the findings of esophagogastroduodenoscopy (EGDS) as functional dyspepsia. Conclusions 1. Icteric hepatitis B in children starting with mild forms of the disease is in most cases accompanied by functional dyspepsia. 2. Icteric hepatitis B in children starting with mild forms of the disease should be treated as hepatic pathology accompanied by functional dyspepsia. It will enable to raise effectiveness of their therapy. 3. An infection disease doctor should carry out the clinical supervision and rehabilitation of children who have had icteric hepatitis B starting with mild forms of the disease together with a gastroenterologist; it will ensure the timely detection of their gastroduodenal pathology and will have a positive effect for increasing a number of healthy children.

Wolman disease or lysosomal acid lipase deficiency (LAL - D) is a rare autosomal recessive lysosomal storage disease caused by deleterious mutations in the LIPA gene. The age at onset and rate of progression vary greatly and this may relate to the nature of the underlying mutations. The disease in infants is characterized by rapidly progressive course, and signs and symptoms in the first weeks of life and even in utero. These patients rarely live up to 6 months. In older children the disease is characterized by a combination of dyslipidaemia, hepatomegaly, increased transaminase levels and microvesicular steatosis in biopsy material. Patients with liver damage observed in the outcome of fibrosis, cirrhosis, increased levels of cholesterol and low-density lipoprotein cholesterol and decreased high-density lipoprotein cholesterol levels. During childhood and may manifest symptoms of lesions of the cardiovascular system. The review presents data on the prospects of enzyme replacement therapy with sebelipase alfa is a recombinant human lysosomal acid lipase.

Background: Anaphylaxis is a potentially fatal allergic reaction. Food allergy is one of the main causes of anaphylaxis in children. Anaphylaxis research in different populations across Europe is one of the unmet needs. The aim of this study is to evaluate typical clinical features of anaphylaxis to fish in Russian Federation children admitted to the allergy department. Materials and methods: Allergy history of 80 children with food anaphylaxis was investigated and specific IgE concentration in serum was tested. Results: Among the causes of food anaphylaxis in children fish was the cause of anaphylactic reactions in 33,7% of patients. Single episode of anaphylaxis to fish was diagnosed in 77,8% of children, more than one episode in 22,2% of patients. 3 children had anaphylaxis after the first in a life of eating fish. Specific IgE levels ≥ 0,35 кUA/l to fish associated with anaphylaxis episodes were revealed in all children. 38,5% of children had anaphylaxis episodes after inhalation contact with fish. In patients with fish anaphylaxis and sIgE < 100 кUA/l, anaphylaxis episodes due to inhalation contact was twice less often (25% of cases) than in children with fish anaphylaxis and sIgE level ≥ 100 кUA/l (54,5% of cases). Clinical manifestations with skin/mucosa and respiratory system involvement were the most frequent (97,5% and 92% respectively), 44,4% of patients presented with cardiovascular symptoms. 22% of children had severe anaphylaxis to fish. Conclusion: Among the causes of food anaphylaxis in children fish is the cause of anaphylactic reactions in more than 1/3 of patients. Anaphylaxis to fish may occur during the first in the life eating fish. Level of specific IgE to fish is useful for the diagnosis of fish anaphylaxis and for the selection of a subgroup of children with high risk of anaphylactic reactions after inhalation of allergen of fish.

This article describes a clinical case of celiac disease in child. The features of which was associated with allergic enteropathy, making it difficult to distinguish, and protein losing enteropathy secondary to celiac disease. The patient’s dynamics on a nine-month diet was considered also. This case is particularly interesting to note the growing frequency of allergic disease and gluten related diseases

We report a case of allergic enterocolitis secondary to cow’s-milk protein allergy in a preterm infant. This syndrome is less common among preterm neonates and is characterized by abdominal distension, vomiting, bloody stools, anxiety, eosinophilia, pneumatosis on abdominal X-rays in severe cases. Differential diagnosis with necrotizing enterocolitis is essential in order to start appropriate treatment.