Objective: based on the production of cytokines, to identify the immunological features of the chronic course of cytomegalovirus infection in children of the first year of life against the background of hypoxic-ischemic CNS damage.Research methods:108 newborns with cytomegalovirus infection occurring against the background of perinatal hypoxic-ischemic lesions of the central unequal system were examined. All observed patients immediately after the diagnosis of cytomegalovirus infection underwent an immunological examination, including the determination of the levels of interferon-alpha (IFN-α) and interferon-gamma (IFN-γ), the level of interleukins — 2 and 4 (IL -2 and IL-4) necrosis factor human alpha tumors (TNF-α in blood serum was determined by enzyme immunoassay using a set of reagents ProCon IF2 plus, ProCon Ifgamma, ProCon TNFα (Protein contour LLC, Russia, St. Petersburg). At 1 and 6 months of life .The observation groups consisted of 78 children (72.2%) with an acute course of the disease (Group 1) and 30 children (27.3%) with a chronic course (Group 2). The control group consisted of 15 newborns without herpes virus infection.Results. Of the totality of the studied cytokines, statistically significant for the chronic course of cytomegalovirus infection in children of the first year of life against the background of hypoxic-ischemic CNS damage were found: IL-2, IFN-γ. It was found that in children with a persistent low level of IFN-γ and an increased level of IL-4 in the blood serum at the age of 6 months, there was a chronic course of cytomegalovirus infection against the background of perinatal hypoxic-ischemic CNS damage.A decrease in IFN-γ production indicates a congenital or acquired deficiency of the interferon system and can be considered as an indication for long-term interferon replacement therapy.

Very preterm infants (VPI) are exposed to atypical and intense light levels in the Neonatal Intensive Care Unit. We conducted this prospective observational study to better understand very preterm infants' responses to light level variations in their incubator and to evaluate the determinants of their reactivity. Methods A total of 27 VPI were studied in their incubator during 10 h. We analysed their physiological responses: Heart rate (HR), respiratory rate (RR), systemic saturation (SaO 2 ), regional cerebral saturation (rSO 2 ) and fractional oxygen extraction (FOE) following variations (10 to 50 lux, > 50 lux above baseline) of their light level environment, measured concomitantly on the same time scale. Results A total of 332 light level changes were identified and analysed. An increase in HR (+3.8 [-2.6;12.6] bpm), RR (+6 [-1.5;26] cycles/min) and rSO 2 (+1.1 [-0.5;3.9]%) and a decrease of FOE (-1.4 [-4;-0.2]%) were observed when the light level increase more than 50 lux above the background light level (all p < 0.05). Below 50 lux variation, only RR (-8.4 cycles per minute [-28;-0.4]) and FOE (-0.7% [-0.6;0.2]) decreased (p < 0.05). Characteristics of the population did not seem to interfere with the VPI's responses in contrast to the initial degree of illumination (the higher the ambient baseline light level, the higher the reactivity). Conclusion VPI react to small variations of their environment's illumination suggesting that they are able to detect light levels changes in the range recommended by the American Association of Paediatrics. The ambient baseline illumination can alter their responses. Anatomical tracing in animal models has shown that the thalamus projects to regions in the temporal lobe around primary auditory cortex, and many regions anterior to this. During development, post-mortem studies in humans have shown that myelination in the temporal lobes follows a posterior-to-anterior progression. Our aim was to investigate auditory development, and specifically the thalamo-temporal white matter connexions, in infants during the first postnatal year. We hypothesised that the connectivity will strengthen from birth through the first year, particularly in anterior temporal areas. PO-0436We recruited 4 healthy controls (1 month, 3 months, 9 months and 11 months). We assessed white matter tracts using diffusion-weighted MRI with probabilistic tractography. A highly accelerated multiband EPI sequence (monopolar acquisition, acceleration factor=4, iPAT=0) with 128 non-collinear diffusion weighting directions was acquired (TR/TE=1980/71, voxel size 2 Â 2 Â 2 mm 3 , b=1500 s/mm 2 ). We found an increment in the strength of connectivity from 1 to 11 months between the thalamus and cortex (thalamo-temporal 60% and temporo-thalamic 37%). Moreover, the pathway's fractional anisotropy increased by 26% and its mean diffusivity dropped by 90%. Furthermore, the pattern of development followed a posterior-to-anterior progression, with an extension of connections to more anterior temporal regions at 9-11 mon...

Objective. To develop prognostic criteria for the chronic course of cytomegalovirus infection by studying disorders of the regulation of the immune response in children of the first year of life against the background of hypoxic-ischemic CNS damage.Materials and methods. 108 newborns with cytomegalovirus infection occurring against the background of perinatal hypoxicischemic lesions of the central unequal system were examined. All observed patients at 1 and 3 months of life conducted an immunological examination, including the determination of T and B-lymphocytes. Determination of the population and subpopulation composition of peripheral blood lymphocytes, activation markers was carried out by the method of one- and twoparameter phenotyping using reagents from Immunotex (France), FITC (fluorescein isothiocynate) — labeled with CD3+, CD4+, CD8+, CD20+ and PE (phycoerythrin) — labeled CD28+, CD40+. The results were recorded on a BECKMAN COULTER EPICSXL-II flow cytometer (USA) using standard protocols. The observation groups consisted of 78 children (72.2%) with an acute course of the disease (Group 1) and 30 children (27.3%) with a chronic course (Group 2).Results. Of the totality of the studied parameters of the cellular and humoral parts of the immune system, statistically significant for the prognosis of the chronic course of cytomegalovirus infection in children of the first year of life against the background of hypoxic-ischemic CNS damage were found: CD8, CD40, CD3+CD28+, CD20+CD40+. Using the PolyAnalist 3.5 Pro CNS package, systems of inequalities were obtained and a formula for predicting the chronic course of cytomegalovirus infection in children in the first year against the background of perinatal hypoxic-ischemic CNS damage was calculated.Conclusion. A statistically significant relationship was found between the prognosis of the chronic course of cytomegalovirus infection against the background of perinatal hypoxic-ischemic CNS damage and the level of CD20, CD4, costimulatory molecules CD3+CD28–, CD20+CD40+. The proposed diagnostic rules can be considered screening markers for the prognosis of the chronic course of cytomegalovirus infection against the background of perinatal hypoxic-ischemic CNS damage in newborns, which makes it possible to start specific therapy in a timely manner.

The problem of intrauterine growth retardation is currently relevant, as it is one of the causes of neonatal morbidity and mortality. Purpose. To study the course of the neonatal period and evaluate the content of arginine and glutamic acid in full-term newborns depending on the severity of intrauterine growth retardation.Material and methods. 78 full-term newborns with intrauterine growth retardation according to hypotrophic type were examined. The content of glutamic acid and arginine in blood serum was determined in the early neonatal period by capillary electrophoresis using an unmodified quartz capillary (Kapel-105, Lumeks, St. Petersburg, Russia).Results. Markers of the formation of a severe degree of intrauterine growth retardation were identified: increased levels of glutamic acid and arginine, taking into account impaired cerebral blood flow in the early neonatal period. A model is proposed for predicting the persistence of a severe degree of intrauterine growth retardation in newborns by the end of the neonatal period.Conclusion. The proposed diagnostic criteria make it possible to start specific therapy in a timely manner in order to prevent the formation of a severe degree of intrauterine growth retardation.

A clinical case of a familial form of peroxisomal D-bifunctional protein (DBP) deficiency (OMIM 261515) with an unfavorable (fatal) outcome caused by a mutation in type 4 17ß-hydroxysteroid dehydrogenase (HSD17B4) with a nucleotide replacement of chr5:118788316G>A in the homozygous state is presented. (D-bifunctional protein deficiency or 17-beta-hydroxysteroid dehydrogenase IV deficiency). Bifunctional protein deficiency is an autosomal recessive birth defect of peroxisomal fatty acid oxidation. The total incidence of morbidity is one case per 50,000 newborns. Most peroxisomal disorders manifest in the early neonatal period with an extremely severe course and phenotypic features, which facilitates their diagnosis. This is the difference between them and diseases with a milder and prolonged course, which debuted at different age periods, often had no neonatal or infantile symptoms and were accompanied, in some cases, by satisfactory cognitive functions. The purpose of the report was to highlight the clinical manifestations, variants of the course and complexity of the diagnosis of peroxisomal disorders to a wide range of doctors of different specialization: in the field of perinatology, pediatrics, neurology, genetics, endocrinology.