The goal is to improve the prediction of the immune status state dynamics in children with HIV infection, taking into account the results of clinical and laboratory examination. Materials and methods. Clinical, immunological and molecular genetic examination was carried in 81 children with HIV infection at the age of median Me 22 months (interquartile interval of IQI 13—42 months). The duration of observation of patients was Me 10 months ( IQI 4—12 months). The time interval before the development of severe immunosuppression according to the WHO classification was determined. The criterion for severe immunosuppression was a decrease in the absolute number of CD4-lymphocytes less than 0.5 x 109/l, their relative number — less than 20%. To determine the factors influencing the rate of development of severe immunosuppression, mathematical models of the analysis of the time to the onset of the event (survival) and Cox proportional intensities were used. Results. Severe immunosuppression developed in 92.5% of children aged Me 32 months (IQI 17—54 months). Testing of clinical and laboratory parameters at the beginning of the study in mathematical models showed that statistical significance in the multifactorial model (P = 0.011) was demonstrated by the indicators «HIV blood viral load of 100 000 cop./ml or more» (odds ratio OR 3.1; 95% confidence interval 95% CI 1.9—10.2; P = 0.012), «Active form of cytomegalovirus infection» (OR 2.3; 95% CI 1.2—7.8; P = 0.026), «Active form of Epstein-Barr virus infection» (OR 2.0; 95% CI 1.1—4.6; P = 0.040). Conclusion. The vast majority of children with HIV infection (92.5%) at the age of Me 32 months ( IQI 17—54 months) developed severe immunosuppression. Independent factors that influenced the timing of severe immunosuppression development were the high rate of HIV replication and the presence of active forms of cytomegalovirus infection and Epstein-Barr virus infection. To prevent the progression of immunological disorders in children with HIV infection, it is necessary not only to prescribe antiretroviral therapy earlier, but also timely diagnosis and treatment of active forms of herpesvirus infections.

Timely diagnosis of Lyme-borreliosis (LB) is the key to its successful treatment. Outpatient monitoring of patients after tick bite based on the algorithm is able to optimize the early diagnosis of LB, shorten the start of treatment and improve the disease surveillance.Purpose. Creation of an algorithm for monitoring patients after tick bite for use in outpatient settings by primary care physicians. Material and methods. A retrospective, non-randomized, single-center cohort study was conducted based on the analysis of data from 660 outpatient records of patients consulted by an infectious disease specialist in the Infectious clinical hospital No.1 in Moscow. Patients were divided by age and the presence or absence of a diagnosis of LB. Confirmation of the diagnosis was carried out according to clinical and/or laboratory criteria using methods of enzyme-linked immunoassay and immune blot. Results. The analysis of the results of enzyme immunoassay of antibodies to borrelia in patients with LB was carried out. The optimal sampling time was 7 or more weeks from the moment of tick bite and 4 or more weeks from the moment of onset of symptoms. The specificity of immunological diagnostics in patients with excluded LB was evaluated. The proportion of doubtful and false positive results in such patients was high — 28.1%. False positive results were more common in adults (37.6%) compared with children (9.8%), which is associated with more frequent false positive results of IgM determination (34.1% in adults, 4.9% in children). Based on the data of our study, an algorithm for monitoring patients after tick bite has been developed, focused on use in outpatient settings by primary care physicians.

The analysis of obstetric anamnesis and indicators of heart rate variability in the neonatal period in prematurely born children who had deviations of somatometric parameters from reference values at the age of 12 months was carried out. Excessive due to various reasons, the level of adrenomimetics supplied with maternal blood caused an increase in the intensity of metabolism in the fetal body and inhibition of the activity of sympathoadrenal systems. The insufficient provision of the fetal and newborn organism with energy and plastic materials that arose under these conditions initiated perinatal metabolic programming of deviations in the physical development of prematurely born infants.

The long-term using of protective masks, linked with the COVID-19 pandemic, could has a significant impact on people from negativism to addiction to use them. Aim: to assess the frequency of mask use after the canceling of restrictions depending on gender and behavioral characteristics, to assess the possible impact of not wearing masks on the incidence of COVID-19. Materials and Methods: We conducted a prospective longitudinal cohort study on the Moscow Metro from 03/15/22 to 04/11/2022. Three cohorts of passengers were identified: K1 — using masks, K2 — wearing masks with defection from rules and K3 — not using masks. The shares of cohorts were determined depending on gender, travel area, time of day, occupation (use of paper information carriers, electronic devices). The proportions, their confidence intervals were determined; the comparison of the significance of differences was carried out using the Pearson chi-square method. Results: we made 28672 observations covering 225 out of 348 metro stations (67.5%). Within 5 weeks (11—15 weeks of 2022 year), the proportion of passengers not using masks (K3) increased from 74% to 94.6%. Starting from the 2nd day, significant differences between men and women were identified. The largest share of K3 passengers was among those using electronic devices. Among those using paper, the trend towards the elimination of masks was the least pronounced. The decrease in passengers using masks in Moscow did not lead to an increase in the incidence of COVID-19. Conclusion: in the absence of legal restrictions, the decision to use masks is influenced by the gender and behavioral characteristics of passengers.

The goal is to evaluate the tolerability and effectiveness of the domestic vector vaccine Gam-Covid-Vak-M in children aged 12—17 years, adherence to vaccination of adolescents and parents to improve work on the prevention of COVID-19. Materials and methods. A retrospective analysis of the medical records of 115 children aged 12—17 years who were vaccinated in 2022 with the Gam-COVID-Vac-M vaccine in two children's polyclinics in St. Petersburg was carried out. Additional information was collected through telephone interviews. A cross-sectional anonymous online survey of adolescents aged 15—17 was also conducted to study awareness of COVID-19 and adherence to vaccination. Results. Only 23.5% of those vaccinated were at risk for severe and complicated COVID-19. Parents showed low adherence to vaccination against COVID-19 — 71.3% vaccinated themselves and 73.1% considered it necessary to protect the child. Only in 14.1% of cases, a teenager aged 15—17 made the decision to be vaccinated. According to 76.9% of adolescents, COVID-19 is a dangerous disease, while 55.6% consider vaccination unnecessary, mainly due to ineffective protection and the possibility of complications. Nevertheless, side effects after the first and second components of Gam-COVID-Vac-M were observed in 24.3% and 24.2%, respectively, which is 4 times less than with foreign vaccines. Systemic and local reactions were observed on days 1—2 after immunization. All manifestations were mild or moderate and resolved within 1—2 days on average. Serious adverse events were not registered. The effectiveness of the vaccine was 97.4%. Conclusion. Preliminary results indicate good tolerance and efficacy of the domestic vaccine Gam-COVID-Vac-M.

Objective: to analyze the influence of medical and social factors on the attitude of parents to the specific prevention of infectious diseases in children during the pandemic of a new coronavirus infection. Material and methods. Anonymous questioning of parents on the attitude to vaccination was conducted. A specially designed questionnaire included questions about attitudes towards vaccines included in the National Immunization Schedule, as well as those not included in it, in particular, the desire of parents to vaccinate their children against COVID-19 was assessed. In total, 153 people aged 17 to 42 took part in the survey — parents of children aged 1 to 14 years. Results. All parents under 18 years of age support vaccination in accordance with the National Vaccination Calendar; 52.1% of parents aged 18—25 years (p < 0.001), 55.6% of parents aged 26—35 years (p < 0.001 compared to parents under 18 years old), and 66.7% of parents over 35 years old (p < 0.001 compared to parents under 18 years old and parents 18—35 years old). Conclusion. The main medical and social factors associated with the refusal to carry out preventive vaccinations for their children are: the age of parents under 35, incomplete higher education and trust in information received on the Internet. The results obtained indicate the need to determine the «risk group» among parents who express doubts about the need for vaccination. It is necessary to conduct educational programs for them in order to form a positive attitude towards the specific prevention of infectious diseases.

Ongoing research on SARS-CoV-2 showed the ability of a pathogen to affect cardio-vascular system in the form of myocarditis, dysrhythmia, cardiac failure, etc. According to an infectious diseases hospital in Omsk, changes in the heart were recorded in 3.3% of children hospitalized with COVID-19. Authors conducted a retrospective study of 24 children aged 1—17 years 11 months with a new coronavirus infection who recieved treatment in an infectious diseases hospital at the Budgetary Healthcare Institution of Omsk Oblast City Children's Clinical Hospital №3 in Omsk from October 2020 to December 2021. It was found that heart lesions were more often recorded in children over 10 years old, all males. In most patients, cardiac lesions developed in presence of concomitant pathology and were combined with lung damage. Clinical manifestations indicating involvement in the pathological process of the cardiovascular system appeared in addition to respiratory infection. They were mild and nonspecific.

Congenital tuberculosis is a rare disease that occurs during intrauterine infection transmission from a mother with an active tuberculosis process to a child. Symptoms and signs may be minimal and non-specific. Unfortunately, it is not always possible to find evidence to confirm congenital children tuberculosis. Early diagnosis and adequate treatment have a significant positive effect on the disease course and outcome. An analysis of 9 articles, published in the domestic literature, describing clinical cases of 11 patients, diagnosed with congenital tuberculosis, the criteria and validity of such a diagnosis were made and considered.

The most common viral infections causing gastroenteritis in children include rotavirus, norovirus, and the SARS-CoV-2. A typical clinical picture includes fever, vomiting, diarrhea, toxicosis and exicosis of varying severity. However, in 30—35% of cases, acute intestinal infections of viral etiology complicate of acute kidney injury (AKI), which significantly aggravates the course of the disease and affects the outcome of the disease. Currently used markers for the diagnosis of AKI are poor informative due to late detection of typical laboratory changes during the clinical picture's change. Currently, there are non-invasive biomarkers of AKI detected before changes in routine biochemical tests and can be used for early diagnosis of kidney damage. Using of these biomarkers in practice will develop of clinical and laboratory differential diagnostic criteria for early diagnosis, risk factors for the development of AKI in children with viral diarrhea of various agents, in order to start timely effective pathogenetic treatment and prevent serious complications.

Botulism is a serious infectious disease that has not lost its relevance today. Due to the widespread popularity of home canning, botulism is widespread everywhere, more often recorded in the form of sporadic cases and small (local) outbreaks. The paper presents a clinical case of a severe form of food botulism with the development of bulbar disorders and respiratory disorders in one of three patients united by one epidanamnesis. The complexity of differential diagnosis of botulism and the importance of timely diagnosis is emphasized.

The relevance of the problem of visceral leishmaniasis is due to the severity of clinical manifestations, as well as the need for immediate etiotropic therapy. The aim of the work is to summarize the data available in the literature regarding the epidemiological situation of visceral leishmaniasis in the Republic of Armenia, taking into account the possibility of imported cases in the territory of the Russian Federation. Materials and methods: a review of domestic and foreign literature over the past 10 years, including Internet resources, was carried out and our own clinical observation of a child with relapsed visceral leishmaniasis imported from Armenia was presented. Conclusion. Visceral leishmaniasis is endemic for Transcaucasia, incl. for the Republic of Armenia, disease. Persons who have visited areas of high risk of infection with developed characteristic symptom complex, including fever, hepatosplenomegaly, pancytopenia, are subject to examination for visceral leishmaniasis. After the treatment, it is necessary to carry out dynamic monitoring.