Background. The high prevalence of acute respiratory infections in children, recurrent episodes of acute bronchitis remain to be one of the hot topics of pediatrics. The causes of recurrent exacerbations of bronchitis in children, despite the numerous research works on this issue, are not completely clear. Aim: to study the features of the clinic in children with recurrent bronchitis. Methods. There were 58 patients aged 3 to 12 years with recurrent bronchitis. A study demonstrated the close relationship between recurrent episodes of acute bronchitis not only with pre-preschool and preschool age (when bronchopulmonary tissue is not completely differentiated), with the influence of negative environmental factors, with bacterial, viral infection, but also with signs of connective tissue disorders (CTD) in them. Results. Revealing connective tissue insufficiency explains the causes of disorders of bronchial cartilage and connective tissue, that lead to the development of bronchial dyskinesia thus exacerbating the vulnerability of immature bronchopulmonary tissue along with autonomic dysfunction, typical for CTD. Involvement of several organs and systems in the CTD process changes the course of clinical symptoms of recurrent bronchitis. Probably by the main differentiation of tissues of organs at this age, including connective tissue, can be explained the fact that in 2/3 of the children observed by the age of 7 the manifestations of exacerbations of the disease ceased. In the half of the patients with recurrent episodes, who had bronchial obstruction in the first year of life, a allergy history, paroxysms of respiratory dyspnoea after an additional examination, – asthma was diagnosed; in one patient an aneurysm of the lung vessels was revealed. Conclusions. Basing on the conducted study, the use of the term “recurrent bronchitis” is advisable in children of the first seven years of life. In patients with continuing episodes of bronchitis bronchopulmonary pathology should be excluded; in patients with allergy history and symptoms of bronchial obstruction, spasmodic cough in previous episodes of bronchitis asthma should be excluded. The presence of symptoms of connective tissue disorders in children with recurrent bronchitis requires a careful examination of patients for the detection of comorbid diseases.

The article presents a review of publications in in Russian and foreign literature devoted to modern views on the role of intestinal microbial metabolites as risk factors for cardiovascular diseases. The technical capabilities of the last decade made it possible to accurately characterize the intestinal microbiota, which contributed to a deeper understanding of the processes occurring during the development of a number of diseases and to establish that the outcome of their treatment is aff ected by pronounced changes in the composition, diversity and metabolic activity of the human intestinal microbiota. A number of questions on the interaction of the intestinal microbiota and the host organism remain open. Further research on the relationship of the intestinal microbiota, its metabolic products with risk factors for cardiovascular diseases opens up unique opportunities in the treatment and prevention of diseases of the cardiovascular system using manipulative technologies with the composition of the microbiota and its function.

Table of contentsWORKSHOP 4: Challenging clinical scenarios (CS01–CS06)CS01 Bullous lesions in two children: solitary mastocytomaS. Tolga Yavuz, Ozan Koc, Ali Gungor, Faysal GokCS02 Multi-System Allergy (MSA) of cystic fibrosis: our institutional experienceJessica Hawley, Christopher O’Brien, Matthew Thomas, Malcolm Brodlie, Louise MichaelisCS03 Cold urticaria in pediatric age: an invisible cause for severe reactionsInês Mota, Ângela Gaspar, Susana Piedade, Graça Sampaio, José Geraldo Dias, Miguel Paiva, Mário Morais-AlmeidaCS04 Angioedema with C1 inhibitor deficiency in a girl: a challenge diagnosisCristina Madureira, Tânia Lopes, Susana Lopes, Filipa Almeida, Alexandra Sequeira, Fernanda Carvalho, José OliveiraCS05 A child with unusual multiple organ allergy disease: what is the primer?Fabienne Gay-CrosierCS06 A case of uncontrolled asthma in a 6-year-old patientIoana-Valentina Nenciu, Andreia Florina Nita, Alexandru Ulmeanu, Dumitru Oraseanu, Carmen ZapucioiuORAL ABSTRACT SESSION 1: Food allergy (OP01–OP06)OP01 Food protein-induced enterocolitis syndrome: oral food challenge outcomes for tolerance evaluation in a Pediatric HospitalAdrianna Machinena, Olga Domínguez Sánchez, Montserrat Alvaro Lozano, Rosa Jimenez Feijoo, Jaime Lozano Blasco, Mònica Piquer Gibert, Mª Teresa Giner Muñoz, Marcia Dias da Costa, Ana Maria Plaza MartínOP02 Characteristics of infants with food protein-induced enterocolitis syndrome and allergic proctocolitisEbru Arik Yilmaz, Özlem Cavkaytar, Betul Buyuktiryaki, Ozge Soyer, Cansin SackesenOP03 The clinical and immunological outcomes after consumption of baked egg by 1–5 year old egg allergic children: results of a randomised controlled trialMerrynNetting, Adaweyah El-Merhibi, Michael Gold, PatrickQuinn, IrmeliPenttila, Maria MakridesOP04 Oral immunotherapy for treatment of egg allergy using low allergenic, hydrolysed eggStavroula Giavi, Antonella Muraro, Roger Lauener, Annick Mercenier, Eugen Bersuch, Isabella M. Montagner, Maria Passioti, Nicolò Celegato, Selina Summermatter, Sophie Nutten, Tristan Bourdeau, Yvonne M. Vissers, Nikolaos G. PapadopoulosOP05 Chemical modification of a peanut extract results in an increased safety profile while maintaining efficacyHanneke van der Kleij, Hans Warmenhoven, Ronald van Ree, Raymond Pieters, Dirk Jan Opstelten, Hans van Schijndel, Joost SmitOP06 Administration of the yellow fever vaccine in egg allergic childrenRoisin Fitzsimons, Victoria Timms, George Du ToitORAL ABSTRACT SESSION 2: Asthma (OP07–OP12)OP07 Previous exacerbation is the most important risk factor for future exacerbations in school-age children with asthmaS. Tolga Yavuz, Guven Kaya, Mustafa Gulec, Mehmet Saldir, Osman Sener, Faysal GokOP08 Comparative study of degree of severity and laboratory changes between asthmatic children using different acupuncture modalitiesNagwa Hassan, Hala Shaaban, Hazem El-Hariri, Ahmed Kamel Inas E. MahfouzOP09 The concentration of exhaled carbon monoxide in asthmatic children with different controlled stadiumPapp Gabor, Biro Gabor, Kovacs CsabaOP10 ...

A review of recent publications devoted to the study of risk factors for the onset of the disease, mechanisms, diagnosis and treatment of asthma from the point of view of molecular allergology is presented. New concepts and problems in the implementation of the exposome paradigm and its practical application are considered, including genetic and epigenetic factors, environmental impact. The most relevant experimental studies are noted that contribute to further understanding of molecular and immune mechanisms with potential new targets for the development of therapeutic agents. Reliable diagnosis of asthma, endotyping of the disease and monitoring of its severity are of great importance in the treatment of asthma. The heterogeneity of asthma is due to individual genetic and epigenetic variability, exposure to individual environmental factors (depending on regional characteristics, changing climatic conditions and population distribution), which explains the occurrence of asthma is not associated only with allergies. The modern assessment and treatment of comorbid/multimorbid asthma is described, including interaction with asthma phenotypes, which is important for the formation of a new therapeutic personalized approach to precision medicine and testing of prognostic biomarkers. The results of clinical trials, multicenter international studies on the use of new approaches in the diagnosis of asthma (candidate biomarkers) based on molecular allergology and treatment in adults and children using biological preparations are given.

The basis of the modern industrial revolution is digitalization and artificial intelligence due to the influence of the digitalization process on all aspects of the economy, public life, including healthcare and education. The creation of a modernized healthcare system that would meet world standards implies an increase in both the quality and accessibility of medical care, which requires new technological solutions. The development of any new technology relies on digitalization, which has led to the creation of the Internet, robots, and artificial intelligence. Digital health is a new format for the medical industry to improve the efficiency and quality of medical care. The training of modern specialists provides for a significant change in teaching methods. The dependence of the quality of medical education on the multicomponent and increasingly digital nature of social reality is obvious. Additional special training of doctors for remote work is needed, the development of curricula taking into account the digitalization of healthcare. The relevance of the problem of digitalization of higher medical education involves an analysis of the state of modernization processes in medical universities, regulations on the electronic information educational environment of the university, including electronic information and educational resources, a set of information, telecommunication technologies and technological tools. The necessity of systematizing the social effects of the digitalization of higher education and conducting appropriate prolonged studies is substantiated.