Modern principles of allergic rhinitis therapy in childrenAllergic diseases, the prevalence rate of which continues to grow, constitute a global issue for the world healthcare. Allergic rhinitis (AR) is a disease widespread among the children and adolescents, causing extensive socio-economic load as well as negative influence on the quality of life of both the patients and the members of their families [1−5]. Moreover, according to the results of the epidemiological studies, 10-40% of AR patients also suffer from bronchial asthma (BA). At the same time, almost 100% of BA patients, at least among the children, complain of AR manifestations. Constant sneezing, itching, rhinorrhea, nasal obstruction, cough and snoring, sleep disorders and fatigue negatively influence physical and psychological condition and social wellbeing, causing downslide in school performance [6]. Despite the presence of excruciating symptoms, the proven interconnection with and the influence on bronchial asthma, the issue of AR is often paid very little attention to, sometimes no more than a usual cold [5]. As a result, most of the pediatric patients either do not receive any adequate therapy they require, or are treated sporadically, taking palliative medications, falling out of modern treatment regimens. One of the reasons of this situation, which is not exclusively typical for our country, is the absence of guidelines on allergic rhinitis in children and its differences from the rhinitis in adults. The acute problem of choosing the correct treatment aiming at controlling the AR

Acute respiratory infections (ARI) still represent a big challenge for paediatricians, especially in those children defined as "ailed" as they are more susceptible to such kinds of disease. In this paediatric population, the immune system is still under-developed with an evident alteration in cytokine levels. A clinical study was carried out in 5 sites in Russia with the intention to enroll children particularly susceptible to contract respiratory infections (defined as "ailing"), assigning them to a treatment group with pidotimod in comparison with a control group, treating them for 30 days and observing the reduction in the number of ARI episodes throughout the follow-up period (6 months). Moreover, changes in serum immunological markers were evaluated at baseline and 30 days after treatment discontinuation. One hundred and fifty-seven ailing children were enrolled and assigned to two arms: a main pidotimod treatment group or a control group. The percentage of incidence of ARIs in the observation period at three different time points was statistically significant (p < 0.05). At the end of the follow-up period (after 6 months), ARIs had developed in 72 children (92.3%) in the main group and in 79 patients (100%) in the control group. Concerning changes of the immunological markers, the treatment group showed a better profile of normalization compared to the control group. The 30-day pidotimod therapy course led to improvement/reduction in the rate of acute respiratory infection recurrence in ailing children within a 3-month period, with a quick elimination of symptoms and signs of infection and, as a result, a faster recovery. The normalisation of the content of the pro-inflammatory cytokine interleukin-8 confirmed the immune-modulatory effect of the investigational drug, underlying its prophylactic effect.

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Urban phytocenoses preserving under the warming climate becomes especially urgent problem in the arid areas, including the steppe zone of Ukraine. Expected elimination of the susceptible woody plants defines necessity of species composition enrichment by introduction. In order to estimate Tilia platyphyllos adaptive capacity, leaves growth and metabolic features were determined for both shaded and lighted trees grew at the plots polluted with transport exhausts in Dnipro city. Reducing leaf surface area by 29 -60% compared to conventional control (the Botanical Garden) was associated with level of pollution and lighting as well. Leaf weight (per cm2) exceeded the control (4 -25%) at the most contaminated plots, but diminished with increasing distance from the pollution source. Compared to control, stomata density increased in all leaves, especially at the most polluted and shaded plots (50% above control).Total chlorophyll content was below the control value (maximum 16%) at almost all polluted plots, while Chl a/Chl b ratio exceeded the control. Redox state of glutathione reached the maximum in leaves at the Botanical Garden, decreasing notably at contaminated plots, whereas the total accumulation of glutathione was enhanced.Activity of glutathione-S-transferase was the highest in the most lighted leaf even on contaminated plot, while was inhibited (11-32% below control) by pollutants in shaded leaves. Results showed variability of morphometric characteristics and metabolic properties of large-leaved linden, depending on local environmental conditions. Phenotypic plasticity of urban T. platyphyllos trees is quite capable play a key role in adaptation to climate change allowing survival of the species.

1 Научный центр здоровья детей РАМН, Москва, Российская Федерация 2 Первый Московский государственный медицинский университет им. И.М. Сеченова, Российская Федерация 3 Российский национальный исследовательский медицинский университет имени Н.И. Пирогова, Москва, Российская Федерация Статья посвящена проблеме бронхиальной астмы у детей. Незрелость дыхательной и иммунной систем, особенности течения болезни, трудности при постановке диагноза и выборе средств доставки лекарственных средств, а также небольшое количество доказательных рекомендаций по лечению астмы у детей обусловливают тот факт, что немногие руководства касаются вопроса ведения детской астмы. Несмотря на то, что астма является наиболее распространенным хроническим заболеванием у детей, значительное количество пациентов не получают адекватного лечения, в связи с чем по-прежнему не могут контролировать свою болезнь. Авторами статьи в целях увеличения доступности, распространения и внедрения стандартной терапии детской астмы были проанализированы наиболее современные документы (ICON, GINA, PRACTALL, NAEPP, SIGN), касающиеся данного вопроса, и кратко изложены основные ключевые принципы достижения контроля над астмой. Ключевые слова: бронхиальная астма, классификация, патогенез, клиническое течение, лечение, контроль болезни, дети. (Педиатрическая фармакология. 2013; 10 (4): [60][61][62][63][64][65][66][67][68][69][70][71][72] The article is dedicated to the issue of bronchial asthma in children. Immaturity of respiratory and immune systems, peculiarities of the disease course, difficulty in establishing diagnosis and selecting delivery agents for drugs and a limited amount of evidence-based recommendations determine the current situation: only few guides touch upon the subject of child asthma management. Although asthma is the most widespread chronic disease in children, a significant number of patients do not receive adequate treatment, which is why they cannot control asthma. The authors of this article analyzed the most up-to-date documents (ICON, GINA, PRACTALL, NAEPP, SIGN) that touch upon this subject and briefly stated the key principles of attaining control over this nosology in order to increase availability, spread and introduction of standard therapy of infant asthma.