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This comparative clinical and immunological trial investigated clinical efficacy of Seleksen combined with ascorbic acid as a part of complex rehabilitation of children with recurrent respiratory diseases in sanatorium pre-school child care settings. We assessed serum levels of IgA, IgG, IgM, IgE, and interleukin-8, leucocyte luminol-induced chemiluminescence, secretory IgA level in saliva, erythrocyte glutathione peroxidase activity, serum superoxide dismutase activity, serum concentrations of malone dialdehyde and diene conjugates. The follow-up period was 12 months. The complex rehabilitation with Seleksen and ascorbic acid led to clear improvement in clinical, immunological, and metabolic parameters. It allows significant reduction in rate of upper and particularly lower respiratory infections in children attending pre-school child care facilities. This therapy was the most effective in children with allergic respiratory diseases and recurrent tracheobronchitis.

Objective. To determine the trends in the structure and assess medical, social and clinical aspects of the consumption of tobacco and nicotine-containing products among adolescents aged 1417. Material and methods. During the study, 352 adolescents aged 14 to 18 years studying in urban (n = 202) and rural (n = 150) schools of Yaroslavl region were surveyed in 20202021. Statistical processing of the data was carried out using computer programs "Statistica" v.10.0. Results. The survey of teenagers revealed a fairly high prevalence not only of active tobacco smoking (tried 37 %, actively smoked 30 % of adolescents), but also the use of "new" nicotine-containing products (vape, hookah, electronic cigarettes, snus, snuff) (tried 38 %, actively used 7 % of teenagers). The structure of active tobacco use and NRTI use was found to differ by the place of residence. Active tobacco use accounted for 46.7 % of rural adolescents and 19.8 % of urban residents (p 0,01). Conclusions. In modern adolescents, along with tobacco smoking, a negative trend has been detected to increase the use of nicotine-containing products, especially hookah. This substantiates the need to improve educational anti-nicotine programs, to introduce a system of regular regional monitoring of the prevalence of traditional and new nicotine-containing products use among children and adolescents in order to make quick and effective decisions.

Respiratory diseases persistently lead in the structure of general morbidity in both children and adolescents. Acute respiratory infections are the most common among them. Interest of pediatricians to phytotherapy is not accidental and is due to the fact that it has a mild therapeutic effect, enhances the effectiveness of complex therapy, has few side effects. Of particular interest are herbal remedies containing ivy extract (Hedera helix), the active ingredients are mainly found in ivy leaves, they are biologically active substances: Triterpene saponins, glycosides, also contain carbohydrates, essential oils, steroids, phenolcarboxylic acids, coumarins, flavonoids, carotenoids, tocopherols (vitamin E), B and C vitamins, tannins, phytoncides. Ivy preparations are prescribed as an expectorant in the treatment of infectious and inflammatory diseases of the upper and lower respiratory tract due to their proven multidirectional effects: secretolytic, mucolytic, bronchospasmolytic. They also have anti-inflammatory, reparative, antioxidant effects.This article presents a clinical example of an officinal ivy-based preparation used in the treatment of a 3.5 year old patient diagnosed with acute respiratory viral infection. Temperature increased to 38 °C, runny nose; on the second day of illness the temperature remained subfebrile and a dry cough appeared. Nasal vasoconstrictor drops and oral acetylcysteine were prescribed, but there was no relief. On the third day of the illness, against the background of subfebrile temperature, the cough persisted, single dry rales were heard in the lungs, wheezing appeared during physical exertion. Acetylcysteine was withdrawn and replaced by ivy-based drops (16 drops 3 times a day orally after meals in a small amount of water). After 2 days the cough was moist, the sputum was easily expectorated, the wheezing in the lungs was almost gone, there was no more wheezing and the temperature was normal. By the sixth day of treatment the cough was gone and the girl had almost recovered. Nevertheless, Gedelix was continued for another 4 days. Prospective results and detailed study of the effects of herbal preparations on the basis of ivy extracts served as the basis for their recommendation as a complex therapy of cough in children.