No 2 (2026)

The contemporary pharmaceutical market is characterized by a plethora of probiotic formulations with various microorganism combinations, dosages, and claimed indications for usage. Different probiotics show divergent evidence for efficacy and safety, and markedly different spectra of action. This diversity presents a significant challenge for practitioners in selecting the optimal probiotic for individual patients, necessitating consideration of evidence-based medicine principles and unique clinical characteristics. Strain specificity is the most critical attribute of probiotics, as it directly influences their functional potential. Recent advancements have identified a select group of probiotic strains with demonstrated efficacy for several common clinical conditions, particularly in relation to functional gastrointestinal disorders. This development facilitates a paradigm shift for pediatricians, moving from the empirical use of general probiotics to the targeted selection of specific strains or combinations designed to address well-defined clinical issues. Both Russian and international studies underscore the substantial impact of intestinal microbiota composition on the health of young children. In routine clinical practice, pediatricians frequently observe the consequences of imbalances in the qualitative and quantitative composition of the intestinal microbiota. In this context, combinations of Pediococcus pentosaceus CECT 8330/Bifidobacterium longum CECT 7894 (Bifistim^® Baby) and Lactobacillus plantarum CECT 7315/ CECT 7316 (Bifistim^® Immuno) strains are of particular interest. These strains and their respective combinations exhibit strain-specific effects that are beneficial for infants in their early months and years. This review analyzes the role of these strains in shaping microbiota, preventing and correcting functional gastrointestinal disorders, and supporting immune function.

The introduction of complementary foods is a crucial stage in the development of the intestinal microbiome, shaping the body's metabolic and immune programming. During this period, a transition occurs from the microbial community characteristic of dairy foods, predominantly represented by Bifidobacterium, to a more mature microbiota dominated by Firmicutes and Bacteroidetes. The characteristics of this process have a significant impact on subsequent health, including the risk of metabolic disorders, the development of immune tolerance, and the prevention of allergic diseases. Research shows that dietary fiber and prebiotics (inulin, fructooligosaccharides, and galactooligosaccharides) promote the growth of beneficial microflora and the synthesis of short-chain fatty acids, which play a crucial role in maintaining intestinal barrier function and the immune response. Fermented milk products, particularly yogurt, are also important, containing probiotic and prebiotic microorganisms and promoting microbial diversity. Modern industrial complementary foods are considered an effective tool for nutritional support in young children. Their advantages stem not only from a high level of safety and quality control, but also from the ability to specifically optimize their composition. The use of prebiotics and other functional components improves nutrient absorption while simultaneously maintaining a favorable intestinal microbiota.

Background. Teething in infants during the first year of life is frequently associated with both localized and systemic manifestations that may concern caregivers and complicate clinical evaluation. As a result, continuous observation of symptom changes and treatment approaches in pediatric practice is of significant value. This article presents practical experiences in managing infants aged 6 to 12 months exhibiting teething syndrome, focusing on clinical signs that hinder the differentiation between physiological teething and concurrent illnesses.

Aim. To assess the spectrum of signs and symptoms associated with teething in infants during their first year of life, followed by an analysis of their frequency and progression. Additionally, the study aims to compare the clinical efficacy of multicomponent medications for the treatment of teething-related conditions.

Materials and methods. The observational study included two in-person visits (on days 1 and 6) and a telephone consultation with the child's legal guardians on Day 3, enabling an assessment of the condition's change in the early stages following diagnosis. Diagnosis relied on a combination of local symptoms (such as hyperemia and edema of the gums, assessed using a scoring system; pain upon palpation; itching as reported by caregivers; presence of an eruption hematoma) and systemic manifestations (modifications in appetite, sleep patterns, activity levels, and irritability), recorded by parents on structured scales. To reduce subjectivity, the assessments of hyperemia and swelling by caregivers and the pediatrician were compared. Additionally, stool monitoring was conducted using the Bristol scale. Viburcol®, a multicomponent agent, was administered as a suppository based on fever levels as the basic treatment. Symptomatic therapy, including nasal irrigation with saline and antipyretic usage for fever, was permitted in the presence of respiratory symptoms.

Results. The mean age of participants was 8.6 months, with a relatively uniform distribution by sex: boys constituted 56% (n=10), while girls accounted for 44% (n=8). Data collected during Visit 1 revealed that 33% of the children experienced fever, with two exceeding 38.0°C. At Visit 2, normal body temperature was recorded for all patients. At the baseline visit, the distribution of local symptom severity indicated that 7 patients (38.9%) had mild or moderate hyperemia and swelling, and 4 (22%) had severe hyperemia. At Visit 3, only one patient displayed mild oral mucosal changes. Parent-reported data indicated that the percentage of children experiencing no negative impact on appetite increased from 39% at Visit 1 to 72% by Visit 3. At baseline, most children presented with sleep disturbances; however, by Visit 3, parents characterized sleep as normal or only mildly impaired in 83% of cases.

Conclusion. The observations indicate that the therapy was well-tolerated, with no reported allergic reactions. Clinical improvement was evident, as signified by the resolution of fever by Day 3, improvements in sleep and appetite, and a reduction in the severity of systemic symptoms.

Respiratory diseases are the most common reason for seeking medical care in pediatric practice. Interstitial lung diseases and other rare pulmonary conditions hold a distinct position within this group. Organizing pneumonia (OP) is a serious condition that can impair lung function and quality of life. Diagnosing OP can be challenging because symptoms may resemble those of other respiratory illnesses, such as bacterial pneumonia. The lack of timely diagnosis of the disease significantly worsens the patient's prognosis. The objective of this paper is to report a new clinical case and to consolidate and summarize the available data on the OP. The article presents the clinical case of a 4-year-old patient with progressive dyspnea and infiltrative changes in the lungs, which were initially interpreted as a manifestation of bilateral pneumonia. Chest computed tomography showed a characteristic pattern for OP. Significant clinical and radiological improvement was achieved with glucocorticosteroid therapy.

Neurogenic urinary disorders refer to bladder dysfunction that arises due to neurological and neurosurgical conditions, as well as malformations of the bladder and urethra. The treatment and medical rehabilitation of children with neurogenic urinary disorders are crucial from the point of diagnosis and continue throughout the child’s life until transitioning to public health organizations that provide healthcare services to the adult population. The primary rehabilitation objectives include preserving renal function, preventing and treating urinary tract infections, and addressing the significant concern of socialization and improving the quality of life for both the patient and their family. Pediatricians play a pivotal role in the medical rehabilitation of these children throughout their growth, serving as key coordinators of interdisciplinary collaboration. This paper presents two clinical cases of children diagnosed with neurogenic urinary disorders, highlighting the challenges healthcare providers encounter in diagnosis and treatment. Clinical case 1. A three-year-old girl diagnosed with caudal regression syndrome, neurogenic bladder, and recurrent grade 4 vesicoureteral reflux on the left side (after endoscopic correction) and a recurrent chronic secondary pyelonephritis. Clinical case 2. A two-year-old boy who presented with recurrent urinary tract infections following surgical treatment for a myelocele. The integration of urodynamic test methods into the diagnosis and evaluation of bladder function has enhanced treatment quality and enabled individualized medical rehabilitation strategies for children.

Helminthiasis is a significant part of infectious pathology in children. The spread of parasitic diseases is recorded in all regions of the world. In Russia, more than 20 million people fall ill with helminthiasis every year. The article sets out the basic ideas about epidemiology and clinical manifestations, treatment and prevention of the most common helminthiasis in children. The issue of the relationship between allergic diseases and parasitoses is considered, when under the mask of allergic diseases hides helminthprotozoal invasion. The growth of allergopathology and the widespread prevalence of parasitic diseases among children make this problem urgent. A clinical case of helminthiasis is presented in a 7-year-old child with bronchial asthma, in combination with mixed invasion: 2 helminths and protozoosis (ascariasis + toxocarosis + giardiasis).