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Adequately organized nutritional support allows avoiding the development of protein-energy malnutrition in patients with bronchopulmonary diseases and cystic fibrosis (CF). The satisfying of increased protein and energy needs of CF patients can only be implemented under the administration. The aim of the study is to analyze the tolerance and effectiveness of the use of domestic sterilized liquid specialized high-protein high-calorie mixtures «Nutrien Pulmo» and «Nutrien Energiya with Dietary Fibers» in children over three years of age with acute (pneumonia) and chronic (cystic fibrosis) forms of bronchopulmonary pathology. Patients and methods. Fifty-five children, including 41 patient suffered from CF, 14 cases with pneumonia, aged from 3 to 18years, were under observation. Of these, 23 (42%) children received Nutrien Pulmo, 32 (58%) children received Nutrien Energiya with Dietary Fibers. Nutritional status was assessed using the WHO-Anthro programs (for children from 3 to 5 years old) and WHO-Anthro Plus (for patients over five years) and clinical and biochemical blood test indices. The observation period was accounted for three weeks. Results. All patients highly appreciated the taste of the products, there were no refusals to take specialized mixtures, neither adverse events during the observation period. While taking specialized mixtures, there was a positive trend in anthropometric indices and a significant improvement in biochemical markers of nutritional status: an increase in prealbumin, total protein, transferrin level. Conclusion. The use of specialized domestic products «Nutrien Pulmo» and «Nutrien Energiya with Dietary Fibers» in the diet therapy of children with acute and chronic bronchopulmonary pathology has the safe and positive effect on the nutritional status of patients.

The prevalence of food allergy (FA) among children with atopic dermatitis (AD) ranges from 26 to 38%. The article presents an analysis of domestic and foreign publications devoted to the peculiarities of the AD flowing from the FA in children, in which the withdrawal diet plays a leading role in elimination diet. The complete or partial exclusion of one or several foods from the diet contributes to an insufficient intake of macro- and micronutrients, which can lead to a decrease not only in body weight, but also in a delay in the growth of children, as well as in decrease in parameters of bone mineral density. According to research results, the intake of calcium and vitamin D in children with AD and FA is below the recommended levels. The serum 25(OH)D level in these patients is lower than in the general population and is inversely proportional to the SCORAD index. Vitamin D supplementation improves the effectiveness of treatment, helps to reduce the clinical manifestations of AD, as evidenced by a decrease in indicators of both the SCORAD index and the EASI index. The timely and adequate correction of the diets of children with FA who follow strict elimination diets requires an interdisciplinary approach in close cooperation between the pediatrician, allergist and nutritionist.

Objective. To assess the efficacy of nocturnal hyperalimentation via a low-profile gastrostomy tube for in the improvement of nutritional status and lung function in children with severe cystic fibrosis (CF). Patients and methods. We used nocturnal hyperalimentation with a nutrient solution via a low-profile gastrostomy tube installed under endoscopic control to improve nutritional status of 16 CF children with severe protein-calorie malnutrition aged between 5.5 and 17.5 years. The mean duration of nocturnal hyperalimentation was 1.3 years (range: 7 months–54 months). The nutritional status was evaluated using the WHOAntho Plus software; pulmonary function was evaluated by assessing forced expiratory volume in 1 minute (FEV1) and the number of bronchopulmonary exacerbations per year. Results. All children demonstrated an improvement in their weight and height. After the first 12 months, the mean body weight gain was 5 kg; during the second and third years, children gained 4 kg and nearly 2 kg, respectively. The mean increase in height was 7 cm in the first year, 10 cm in the second year, and 4 cm in the third year. All patients except one had an increase in FEV1 and fewer exacerbations. Complications after gastrostomy were rare and easily addressed. Conclusion. Nocturnal hyperalimentation via a percutaneous endoscopic gastrostomy tube is an effective and safe method of improving nutritional status in children with CF, which delays the progression of bronchopulmonary lesions and lung function reduction, improves the prognosis and quality of life. Key words: cystic fibrosis, children, nutritional status, lung function, enteral nutrition, low-profile gastrostomy tube, nocturnal hyperalimentation

The incidence of functional gastrointestinal disorders (FGIDs) in infants is very high. They are not only a medical challenge, but also a social problem. The causes of FGIDs are still being discussed by researchers. Particular attention is paid to impairments in functioning of the brain-intestine axis, formation of the intestinal microbiota, as well as psychological factors. FGID is a diagnosis of exclusion; however, no clear criteria for this diagnosis have been developed so far. If a baby has regurgitation, colic and/or constipation, an active search and differential diagnosis with various diseases manifesting themselves with such symptoms are necessary. Nutrition diagnosis is an important step in the diagnosis of FGIDs, which allows timely identification or exclusion of this pathology. In this study, we have demonstrated high efficacy of Comfort baby formulas, adapted fermented milk formulas, and antireflux formulas in artificial feeding of infants with FGIDs. Key words: functional gastrointestinal disorders, regurgitation, colic, constipation, infants, diet therapy, Comfort formulas, functional components

A significant interest in the diagnosis and treatment of orphan diseases, among which inherited metabolic diseases (IMD) constitute a significant part, has been currently increased. For many of them, diet therapy with specialized food products remains the basis of pathogenetic therapy and complex treatment. The expansion of diagnostic capabilities of neonatal and selective screening requires timely guaranteed patients’ provision with specialized therapeutic food products. The article highlights the basic principles of diet therapy for the most common inherited metabolic diseases and the current rules for providing these products to disabled children and patients with IMD who do not have the status of “children with disabilities”. Key words: inherited metabolic disorders, diet therapy, specialized food products, phenylketonuria, galactosemia, cystic fibrosis, celiac disease

Background. Adequate nutritional support is known to help to avoid the protein-energy deficiency in patients with cystic fibrosis (CF) and to reduce the number of escalations of the bronchopulmonary process. The CF patients need for increased protein and energy in their diet so they need to use specialized high-calorie high-protein foods. Purpose. To estimate tolerance and clinical efficacy of specialized mixtures «Nutrien Standart» and «Nutrien Diabet» (dry and liquid forms) in CF patients over 1 year. Materials and methods. 87 children aged 1.2-17 years were observed at children’s clinics in Moscow, Tumen, Voronezh. In all cases, there was confirmed a diagnosis of CF and/or CA associated with diabetes mellitus (DM). All of them showed a nutritional deficiency of varying severity. 70% of children received liquid forms of products, 30% - dry mixtures prepared in isocaloric dilution. The WHO-Anthro and WHO-Anthro Plus programs were used for the determination of nutritional status. The duration of observation accounted for at least 2 months. Results. The taste of the products was rated by most (97.7%) patients as very good, only two (2.3%) patients refused to accept new products. No adverse events were noted during the observateon. 73 (83%) patients showed a positive dynamics of nutritional status. Among patients aged less than 6 years, the number of children with normal physical development significantly increased (p

The review analyses the available literature on the main principles of breastfeeding support in cases of confirmed/suspected novel coronavirus infection in breastfeeding mothers. Various approaches to management of mother and baby in the conditions of the COVID-19 pandemic have been studied that found reflection in the protocols of the World Health Organization, Chinese, American and European medical communities. The evolution of Russian recommendations is analysed. A rationale is offered for the current guidelines on temporary mother-child separation in the healthcare settings when maternal COVID-19 is suspected/confirmed and on the organization of infant feeding with expressed maternal milk. The literature on the nutritional and biological value and the safety of expressed breast milk stored in various conditions is reviewed. Practical advice is given on organization of an individual breast milk bank at home. Key words: breastfeeding, breast milk, individual milk bank, coronavirus infection, newborns, COVID-19 pandemic, breast milk expression

The article presents the results of clinical observation of cystic fibrosis (CF) patients received the enteral nutrition product Nutrient Standard (Russia) as nutritional support. The high efficiency of this product has been shown for the correction of malnutrition in СF children.