176 research outputs found
ΠΠΠ’ΠΠΠΠΠΠ ΠΠΠΠ ΠΠΠΠΠΠΠ’ΠΠΠΠΠΠ Π ΠΠΠΠΠ’ΠΠ― ΠΠΠ’ΠΠ Π ΠΠΠΠ ΠΠ‘Π’ΠΠΠ
The article represents the results of neurocognitive development study in progress. Clinical methods of investigation are supplemented with examination of children with Russian computer psychophysiological complex βPsichomatβ, which allows to examine a number of cognitive functions β perception, attention, memory, visual-motor coordination, processes of analysis and synthesis β in mathematical function expression: milliseconds and percentage of mistakes. A childβs intrauterine and postnatal development is determined by various factors. Cognitive processes, which are ascending accordingly to a childβs age, play significant role in social development. The standard charts of children psychoneurological development, worked out by the authors, must become key factors both for pediatricians of different subspecialities and for parents and psychologists, in order not to miss the beginning of some pathology condition β from development delay to retardation. During the analysis of cognitive status of a child, speech development, behavior and emotions should be assessed. The deficiency of cognitive functions causes difficulties in education and contact with a child, which in some cases leads to formation of syndromal pathological conditions and disease entities (from mild development delays to different stages of oligophrenia). It is necessary to educate pediatricians of various subspecialities and pediatric neurologists the methods of children examination in order to determine the βcognitive profileβ according to the age, health condition, presence of somatic and/or psychoneurological diseases and influence of the drug therapy both on a childβs organism and cognitive processes.Β Π ΡΠ°Π±ΠΎΡΠ΅ ΠΏΡΠ΅Π΄ΡΡΠ°Π²Π»Π΅Π½Ρ ΡΠ΅Π·ΡΠ»ΡΡΠ°ΡΡ ΠΈΠ·ΡΡΠ΅Π½ΠΈΡ Π½Π΅ΠΉΡΠΎΠΊΠΎΠ³Π½ΠΈΡΠΈΠ²Π½ΠΎΠ³ΠΎ ΡΠ°Π·Π²ΠΈΡΠΈΡ Π΄Π΅ΡΠ΅ΠΉ Π² ΠΏΡΠΎΡΠ΅ΡΡΠ΅ ΡΠ°Π·Π²ΠΈΡΠΈΡ. ΠΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΈΠ΅ ΠΌΠ΅ΡΠΎΠ΄Ρ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΡ Π΄ΠΎΠΏΠΎΠ»Π½Π΅Π½Ρ ΠΎΠ±ΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠ΅ΠΌ Π΄Π΅ΡΠ΅ΠΉ Π½Π° ΠΎΡΠ΅ΡΠ΅ΡΡΠ²Π΅Π½Π½ΠΎΠΌ ΠΊΠΎΠΌΠΏΡΡΡΠ΅ΡΠ½ΠΎΠΌ ΠΏΡΠΈΡ
ΠΎΡΠΈΠ·ΠΈΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΎΠΌ ΠΊΠΎΠΌΠΏΠ»Π΅ΠΊΡΠ΅ Β«ΠΡΠΈΡ
ΠΎΠΌΠ°ΡΒ», ΠΊΠΎΡΠΎΡΡΠΉ ΠΏΠΎΠ·Π²ΠΎΠ»ΡΠ΅Ρ ΠΎΠΏΡΠ΅Π΄Π΅Π»ΠΈΡΡ ΡΡΠ΄ ΠΊΠΎΠ³Π½ΠΈΡΠΈΠ²Π½ΡΡ
(ΠΏΠΎΠ·Π½Π°Π²Π°ΡΠ΅Π»ΡΠ½ΡΡ
) ΡΡΠ½ΠΊΡΠΈΠΉ β Π²ΠΎΡΠΏΡΠΈΡΡΠΈΠ΅, Π²Π½ΠΈΠΌΠ°Π½ΠΈΠ΅, ΠΏΠ°ΠΌΡΡΡ, Π·ΡΠΈΡΠ΅Π»ΡΠ½ΠΎ-ΠΌΠΎΡΠΎΡΠ½ΡΡ ΠΊΠΎΠΎΡΠ΄ΠΈΠ½Π°ΡΠΈΡ, Π°Π½Π°Π»ΠΈΡΠΈΠΊΠΎ-ΡΠΈΠ½ΡΠ΅ΡΠΈΡΠ΅ΡΠΊΠΈΠ΅ ΠΏΡΠΎΡΠ΅ΡΡΡ Π² ΠΌΠ°ΡΠ΅ΠΌΠ°ΡΠΈΡΠ΅ΡΠΊΠΎΠΌ Π²ΡΡΠ°ΠΆΠ΅Π½ΠΈΠΈ ΡΡΠ½ΠΊΡΠΈΠΈ: ΠΌΠΈΠ»Π»ΠΈΡΠ΅ΠΊΡΠ½Π΄Π°Ρ
ΠΈ ΠΏΡΠΎΡΠ΅Π½ΡΠ΅ ΠΎΡΠΈΠ±ΠΎΠΊ. Π Π°Π·Π²ΠΈΡΠΈΠ΅ ΡΠ΅Π±Π΅Π½ΠΊΠ° ΠΎΡ Π²Π½ΡΡΡΠΈΡΡΡΠΎΠ±Π½ΠΎΠ³ΠΎ ΠΏΠ΅ΡΠΈΠΎΠ΄Π°, ΠΈ Π² ΠΏΠΎΡΠ»Π΅Π΄ΡΡΡΠ΅ΠΉ ΠΏΠΎΡΡΠ½Π°ΡΠ°Π»ΡΠ½ΠΎΠΉ ΠΆΠΈΠ·Π½ΠΈ, ΠΎΠΏΡΠ΅Π΄Π΅Π»ΡΠ΅ΡΡΡ ΠΌΠ½ΠΎΠ³ΠΈΠΌΠΈ ΡΠ°ΠΊΡΠΎΡΠ°ΠΌΠΈ. ΠΠΎΠ»ΡΡΠΎΠ΅ Π·Π½Π°ΡΠ΅Π½ΠΈΠ΅ Π΄Π»Ρ ΡΠΎΡΠΈΠ°Π»ΡΠ½ΠΎΠ³ΠΎ ΡΠ°Π·Π²ΠΈΡΠΈΡ ΠΈΠΌΠ΅ΡΡ ΠΏΠΎΠ·Π½Π°Π²Π°ΡΠ΅Π»ΡΠ½ΡΠ΅ ΠΏΡΠΎΡΠ΅ΡΡΡ, ΠΈΠΌΠ΅ΡΡΠΈΠ΅ Π²ΠΎΡΡ
ΠΎΠ΄ΡΡΠ΅Π΅ Π΄Π²ΠΈΠΆΠ΅Π½ΠΈΠ΅ ΡΠΎΠΎΡΠ²Π΅ΡΡΡΠ²Π΅Π½Π½ΠΎ Π²ΠΎΠ·ΡΠ°ΡΡΡ ΡΠ΅Π±Π΅Π½ΠΊΠ°. Π Π°Π·ΡΠ°Π±ΠΎΡΠ°Π½Π½ΡΠ΅ Π½ΠΎΡΠΌΠ°ΡΠΈΠ²Π½ΡΠ΅ ΡΠ°Π±Π»ΠΈΡΡ ΠΏΡΠΈΡ
ΠΎΠ½Π΅Π²ΡΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ ΡΠ°Π·Π²ΠΈΡΠΈΡ ΡΠ΅Π±Π΅Π½ΠΊΠ° Π΄ΠΎΠ»ΠΆΠ½Ρ Π±ΡΡΡ ΠΎΠΏΡΠ΅Π΄Π΅Π»ΡΡΡΠΈΠΌΠΈ ΠΈ Π΄Π»Ρ ΠΏΠ΅Π΄ΠΈΠ°ΡΡΠΎΠ² ΡΠ°Π·Π»ΠΈΡΠ½ΠΎΠ³ΠΎ ΠΏΡΠΎΡΠΈΠ»Ρ, ΠΈ Π΄Π»Ρ ΡΠΎΠ΄ΠΈΡΠ΅Π»Π΅ΠΉ ΠΈ Π΄Π»Ρ ΠΏΡΠΈΡ
ΠΎΠ»ΠΎΠ³ΠΎΠ², ΡΡΠΎΠ±Ρ Π½Π΅ ΠΏΡΠΎΠΏΡΡΡΠΈΡΡ Π½Π°ΡΠ°Π»ΠΎ ΠΏΠ°ΡΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΎΠΉ ΡΠΈΠΌΠΏΡΠΎΠΌΠ°ΡΠΈΠΊΠΈ β ΠΎΡ Π·Π°Π΄Π΅ΡΠΆΠΊΠΈ Π΄ΠΎ ΠΎΡΡΡΠ°Π²Π°Π½ΠΈΡ ΡΠ°Π·Π²ΠΈΡΠΈΡ. Π‘ Π°Π½Π°Π»ΠΈΠ·ΠΎΠΌ ΠΊΠΎΠ³Π½ΠΈΡΠΈΠ²Π½ΠΎΠ³ΠΎ ΡΡΠ°ΡΡΡΠ° ΡΠ΅Π±Π΅Π½ΠΊΠ° Π½Π΅ΠΎΠ±Ρ
ΠΎΠ΄ΠΈΠΌΠΎ ΠΎΡΠ΅Π½ΠΈΠ²Π°ΡΡ ΡΠ΅ΡΠ΅Π²ΠΎΠ΅ ΡΠ°Π·Π²ΠΈΡΠΈΠ΅, ΠΏΠΎΠ²Π΅Π΄Π΅Π½ΠΈΠ΅ ΠΈ ΡΠΌΠΎΡΠΈΠΈ. ΠΠ΅ΡΠΈΡΠΈΡ ΠΊΠΎΠ³Π½ΠΈΡΠΈΠ²Π½ΡΡ
ΡΡΠ½ΠΊΡΠΈΠΉ ΡΠΎΠ·Π΄Π°Π΅Ρ ΡΠ»ΠΎΠΆΠ½ΠΎΡΡΠΈ ΠΎΠ±ΡΡΠ΅Π½ΠΈΡ, ΠΊΠΎΠ½ΡΠ°ΠΊΡΠ°, ΡΠΎΡΠΌΠΈΡΡΡ Π² ΡΡΠ΄Π΅ ΡΠ»ΡΡΠ°Π΅Π² ΡΠΈΠ½Π΄ΡΠΎΠΌΠ°Π»ΡΠ½ΡΠ΅ ΠΏΠ°ΡΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΈΠ΅ ΡΠΎΡΡΠΎΡΠ½ΠΈΡ ΠΈΠ»ΠΈ Π½ΠΎΠ·ΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΈΠ΅ Π·Π°Π±ΠΎΠ»Π΅Π²Π°Π½ΠΈΡ (ΠΎΡ Π»Π΅Π³ΠΊΠΈΡ
Π·Π°Π΄Π΅ΡΠΆΠ΅ΠΊ ΡΠ΅ΠΌΠΏΠΎΠ² ΡΠ°Π·Π²ΠΈΡΠΈΡ, Π΄ΠΎ ΠΎΠ»ΠΈΠ³ΠΎΡΡΠ΅Π½ΠΈΠΈ ΡΠ°Π·Π»ΠΈΡΠ½ΠΎΠΉ ΡΡΠ΅ΠΏΠ΅Π½ΠΈ ΡΡΠΆΠ΅ΡΡΠΈ). ΠΠ΅ΠΎΠ±Ρ
ΠΎΠ΄ΠΈΠΌΠΎ ΠΎΠ±ΡΡΠ΅Π½ΠΈΠ΅ ΠΏΠ΅Π΄ΠΈΠ°ΡΡΠΎΠ² ΡΠ°Π·Π»ΠΈΡΠ½ΠΎΠ³ΠΎ ΠΏΡΠΎΡΠΈΠ»Ρ, Π΄Π΅ΡΡΠΊΠΈΡ
Π½Π΅Π²ΡΠΎΠ»ΠΎΠ³ΠΎΠ² ΡΠ°ΠΊΡΠΈΠΊΠ΅ ΠΎΠ±ΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΡ Π΄Π΅ΡΠ΅ΠΉ Π΄Π»Ρ ΠΎΠΏΡΠ΅Π΄Π΅Π»Π΅Π½ΠΈΡ Β«ΠΊΠΎΠ³Π½ΠΈΡΠΈΠ²Π½ΠΎΠ³ΠΎ ΠΏΠΎΡΡΡΠ΅ΡΠ°Β» Π² Π²ΠΎΠ·ΡΠ°ΡΡΠ½ΠΎΠΌ Π°ΡΠΏΠ΅ΠΊΡΠ΅, Ρ ΡΡΠ΅ΡΠΎΠΌ ΡΠΎΡΡΠΎΡΠ½ΠΈΡ Π·Π΄ΠΎΡΠΎΠ²ΡΡ, Π½Π°Π»ΠΈΡΠΈΡ Π·Π°Π±ΠΎΠ»Π΅Π²Π°Π½ΠΈΠΉ ΡΠΎΠΌΠ°ΡΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ ΠΈ/ΠΈΠ»ΠΈ ΠΏΡΠΈΡ
ΠΎΠ½Π΅Π²ΡΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ Π³Π΅Π½Π΅Π·Π°, Π° ΡΠ°ΠΊΠΆΠ΅ Π²Π»ΠΈΡΠ½ΠΈΡ Π»Π΅ΠΊΠ°ΡΡΡΠ²Π΅Π½Π½ΠΎΠΉ ΡΠ΅ΡΠ°ΠΏΠΈΠΈ ΠΊΠ°ΠΊ Π½Π° ΠΎΡΠ³Π°Π½ΠΈΠ·ΠΌ ΡΠ΅Π±Π΅Π½ΠΊΠ°, ΡΠ°ΠΊ ΠΈ Π½Π° ΠΏΡΠΎΡΠ΅ΡΡΡ ΠΏΠΎΠ·Π½Π°Π½ΠΈΡ ΠΎΠΊΡΡΠΆΠ°ΡΡΠ΅Π³ΠΎ ΠΌΠΈΡΠ°.
ΠΠ‘ΠΠΠΠΠΠΠ‘Π’Π ΠΠΠΠΠΠΠ‘Π’ΠΠ§ΠΠ‘ΠΠΠΠ ΠΠΠ‘ΠΠΠΠΠΠΠΠΠ― ΠΠΠ¦ΠΠΠΠ’ΠΠ Π‘ ΠΠΠΠΠΠΠΠΠΠ’ΠΠΠ Π‘ΠΠΠ‘ΠΠΠΠΠΠΠΠ¦ΠΠΠ ΠΠΠ ΠΠ ΠΠ ΠΠΠΠΠΠΠΠΠ ΠΠΠΠΠ ΠΠΠΠ‘ΠΠΠ¦ΠΠ€ΠΠ§ΠΠ‘ΠΠΠ ΠΠΠΠ£ΠΠΠ’ΠΠ ΠΠΠΠ Π ΠΠ¦ΠΠΠΠ ΠΠ Π ΠΠΠ£ΠΠ¬Π’ΠΠ’ΠΠ ΠΠΠΠΠ ΠΠ’ΠΠ Π. ΠΠΠ’ΠΠΠΠΠ
Background: Due to the wide expansion of atopy, its early beginning, variety of forms, difficulty of specific pathogenetic treatment, and also highcost of in vitro researches there is a need of diagnostic test systems development and optimization. Aim: To make the assessment of atopy diagnostics efficiency in children with a multiple allergy and the analysis of specific immunotherapy (ASIT) influence on immune markers level in serum for a choice of the most significant predictive indicator. Patients and methods: 457 children (mean age 8,9Β±4,3 years) with pollinosis symptoms that prevalence in spring period were tested with birch pollen allergens extract by detecting allergen-specific immunoglobulin E (sIgE) levels. Than patient witch showed positive sIgE level (243 children) were tested with expanded set of plant allergens (birch, alder, hazel, oak pollen, allergens of Rosaceae family and carrot) and set of birch pollen allergocomponents (Bet v1, Bet v2, Bet v4, Bet v6). From them 32 patients were treated with allergenspecific immunotherapy. Immunological assays were performed by indirect immunofluorescent method on ImmunoCAP250 (Sweden). Results: It was shown that birch allergens sIgE antibodies detection in patients with pollinosis allows to estimate sensitization degree to allergens of related trees and could predict their quantitative values. The oak allergens sIgE level is a good predictive marker of sIgE level to food plant derived allergens. And apple allergens sIgE concentration is closely assotiated with sIgE to fruit allergens of Rosacea family. Detection of sensitization to minor allergens in patient influences on therapy efficacy prognosis. Conclusion: sIgE detection to limited number of allergens (birch-oak-apple) is effective to sIgE value assessment in patient with allergy to plant causing allergens cross reactivity. Component-divided in vitro diagnostics directed on reveal of sensitization caused by minor allergens, is actual at the answer a question about ASIT validity and its efficiency. Component-divided in vitro diagnostics directed on reveal of sensitization caused by minor allergens, is actual at the answer a question about ASIT validity and its efficiency. Significant results of the therapy are shown after double course ASIT that also allows to reduce considerably production of sIgE antibodies to significant allergens, and cross reacting plant food allergens.Π ΡΠ²ΡΠ·ΠΈ Ρ ΡΠΈΡΠΎΠΊΠΈΠΌ ΡΠ°ΡΠΏΡΠΎΡΡΡΠ°Π½Π΅Π½ΠΈΠ΅ΠΌ Π°ΡΠΎΠΏΠΈΠΈ, ΡΠ°Π½Π½ΠΈΠΌ Π½Π°ΡΠ°Π»ΠΎΠΌ Π·Π°Π±ΠΎΠ»Π΅Π²Π°Π½ΠΈΡ, ΠΌΠ½ΠΎΠ³ΠΎΠΎΠ±ΡΠ°Π·ΠΈΠ΅ΠΌ ΡΠΎΡΠΌ, ΡΠ»ΠΎΠΆΠ½ΠΎΡΡΡΡ ΠΏΠ°ΡΠΎΠ³Π΅Π½Π΅ΡΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ Π»Π΅ΡΠ΅Π½ΠΈΡ, Π° ΡΠ°ΠΊΠΆΠ΅ Π²ΡΡΠΎΠΊΠΎΠΉ ΡΡΠΎΠΈΠΌΠΎΡΡΡΡ in vitro ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠΉ Π²ΠΎΠ·Π½ΠΈΠΊΠ»Π° Π½Π΅ΠΎΠ±Ρ
ΠΎΠ΄ΠΈΠΌΠΎΡΡΡ ΡΠ°Π·Π²ΠΈΡΠΈΡ ΠΈ ΠΎΠΏΡΠΈΠΌΠΈΠ·Π°ΡΠΈΠΈ Π΄ΠΈΠ°Π³Π½ΠΎΡΡΠΈΡΠ΅ΡΠΊΠΈΡ
ΡΠ΅ΡΡ-ΡΠΈΡΡΠ΅ΠΌ. Π¦Π΅Π»Ρ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΡ: ΠΎΡΠ΅Π½ΠΈΡΡ ΡΡΡΠ΅ΠΊΡΠΈΠ²Π½ΠΎΡΡΡ Π΄ΠΈΠ°Π³Π½ΠΎΡΡΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ ΠΎΠ±ΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΡ Π΄Π΅ΡΠ΅ΠΉ Ρ ΠΏΠΎΠ»ΠΈΠ²Π°Π»Π΅Π½ΡΠ½ΠΎΠΉ Π°Π»Π»Π΅ΡΠ³ΠΈΠ΅ΠΉ ΠΈ ΠΏΡΠΎΠ°Π½Π°Π»ΠΈΠ·ΠΈΡΠΎΠ²Π°ΡΡ Π²Π»ΠΈΡΠ½ΠΈΠ΅ Π°Π»Π»Π΅ΡΠ³Π΅Π½ΡΠΏΠ΅ΡΠΈΡΠΈΡΠ΅ΡΠΊΠΎΠΉ ΠΈΠΌΠΌΡΠ½ΠΎΡΠ΅ΡΠ°ΠΏΠΈΠΈ (ΠΠ‘ΠΠ’) Π½Π° ΠΈΠ·ΠΌΠ΅Π½Π΅Π½ΠΈΠ΅ ΡΠΎΠ΄Π΅ΡΠΆΠ°Π½ΠΈΡ ΠΈΠΌΠΌΡΠ½Π½ΡΡ
ΠΌΠ°ΡΠΊΠ΅ΡΠΎΠ² Π΄Π»Ρ Π²ΡΠ±ΠΎΡΠ° Π½Π°ΠΈΠ±ΠΎΠ»Π΅Π΅ Π·Π½Π°ΡΠΈΠΌΠΎΠ³ΠΎ ΠΏΡΠΎΠ³Π½ΠΎΡΡΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ ΠΏΠΎΠΊΠ°Π·Π°ΡΠ΅Π»Ρ. ΠΠ°ΡΠΈΠ΅Π½ΡΡ ΠΈ ΠΌΠ΅ΡΠΎΠ΄Ρ: 457 Π΄Π΅ΡΠ΅ΠΉ (ΡΡΠ΅Π΄Π½ΠΈΠΉ Π²ΠΎΠ·ΡΠ°ΡΡ 8,9Β±4,3 Π»Π΅Ρ) Ρ ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΈΠΌΠΈ ΡΠΈΠΌΠΏΡΠΎΠΌΠ°ΠΌΠΈ ΠΏΠΎΠ»Π»ΠΈΠ½ΠΎΠ·Π°, ΠΏΡΠ΅ΠΎΠ±Π»Π°Π΄Π°ΡΡΠΈΠΌΠΈ Π² Π²Π΅ΡΠ΅Π½Π½ΠΈΠΉ ΠΏΠ΅ΡΠΈΠΎΠ΄, Π±ΡΠ»ΠΈ ΠΏΡΠΎΡΠ΅ΡΡΠΈΡΠΎΠ²Π°Π½Ρ Π½Π° Π½Π°Π»ΠΈΡΠΈΠ΅ Π°Π»Π»Π΅ΡΠ³Π΅Π½ΡΠΏΠ΅ΡΠΈΡΠΈΡΠ΅ΡΠΊΠΈΡ
ΠΈΠΌΠΌΡΠ½ΠΎΠ³Π»ΠΎΠ±ΡΠ»ΠΈΠ½ΠΎΠ² ΠΊΠ»Π°ΡΡΠ° Π (sIgE) ΠΊ ΡΠΊΡΡΡΠ°ΠΊΡΡ Π°Π»Π»Π΅ΡΠ³Π΅Π½ΠΎΠ² ΠΏΡΠ»ΡΡΡ Π±Π΅ΡΠ΅Π·Ρ. ΠΠ°ΡΠΈΠ΅Π½ΡΡ, Ρ ΠΊΠΎΡΠΎΡΡΡ
Π±ΡΠ» Π²ΡΡΠ²Π»Π΅Π½ Π·Π½Π°ΡΠΈΠΌΡΠΉ ΡΡΠΎΠ²Π΅Π½Ρ sIgE (n =243), Π±ΡΠ»ΠΈ Π·Π°ΡΠ΅ΠΌ ΠΏΡΠΎΡΠ΅ΡΡΠΈΡΠΎΠ²Π°Π½Ρ Ρ ΡΠ°ΡΡΠΈΡΠ΅Π½Π½ΠΎΠΉ ΠΏΠ°Π½Π΅Π»ΡΡ ΡΠ°ΡΡΠΈΡΠ΅Π»ΡΠ½ΡΡ
Π°Π»Π»Π΅ΡΠ³Π΅Π½ΠΎΠ² (ΠΏΡΠ»ΡΡΠ° Π±Π΅ΡΠ΅Π·Ρ, ΠΎΠ»ΡΡ
ΠΈ, Π»Π΅ΡΠΈΠ½Ρ, Π΄ΡΠ±Π°, Π°Π»Π»Π΅ΡΠ³Π΅Π½Ρ ΡΡΡΠΊΡΠΎΠ² ΡΠ΅ΠΌΠ΅ΠΉΡΡΠ²Π° ΡΠΎΠ·ΠΎΡΠ²Π΅ΡΠ½ΡΡ
ΠΈ ΠΌΠΎΡΠΊΠΎΠ²ΠΈ) ΠΈ ΠΏΠ°Π½Π΅Π»ΡΡ Π°Π»Π»Π΅ΡΠ³ΠΎ-ΠΊΠΎΠΌΠΏΠΎΠ½Π΅Π½ΡΠΎΠ² ΠΏΡΠ»ΡΡΡ Π±Π΅ΡΠ΅Π·Ρ (Bet v1, Bet v2, Bet v4, Bet v6). ΠΠ· Π½ΠΈΡ
32 ΠΏΠ°ΡΠΈΠ΅Π½ΡΠ° ΠΏΠΎΠ»ΡΡΠΈΠ»ΠΈ 2 ΠΊΡΡΡΠ° Π°Π»Π»Π΅ΡΠ³Π΅Π½ΡΠΏΠ΅ΡΠΈΡΠΈΡΠ΅ΡΠΊΠΎΠΉ ΠΈΠΌΠΌΡΠ½ΠΎΡΠ΅ΡΠ°ΠΏΠΈΠΈ. ΠΠΌΠΌΡΠ½ΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΈΠ΅ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΡ Π±ΡΠ»ΠΈ Π²ΡΠΏΠΎΠ»Π½Π΅Π½Ρ ΠΌΠ΅ΡΠΎΠ΄ΠΎΠΌ Π½Π΅ΠΏΡΡΠΌΠΎΠΉ ΠΈΠΌΠΌΡΠ½ΠΎΡΠ»ΡΠΎΡΠ΅ΡΡΠ΅Π½ΡΠΈΠΈ Π½Π° Π°Π½Π°Π»ΠΈΠ·Π°ΡΠΎΡΠ΅ ImmunoCAP 250 (Π¨Π²Π΅ΡΠΈΡ). Π Π΅Π·ΡΠ»ΡΡΠ°ΡΡ: Π±ΡΠ»ΠΎ ΠΏΠΎΠΊΠ°Π·Π°Π½ΠΎ, ΡΡΠΎ ΠΎΠΏΡΠ΅Π΄Π΅Π»Π΅Π½ΠΈΠ΅ ΡΠΎΠ΄Π΅ΡΠΆΠ°Π½ΠΈΡ sIgE ΠΊ Π°Π»Π»Π΅ΡΠ³Π΅Π½Π°ΠΌ Π±Π΅ΡΠ΅Π·Ρ ΠΏΠΎΠ·Π²ΠΎΠ»ΡΠ΅Ρ ΠΎΡΠ΅Π½ΠΈΡΡ ΡΡΠ΅ΠΏΠ΅Π½Ρ ΡΠ΅Π½ΡΠΈΠ±ΠΈΠ»ΠΈΠ·Π°ΡΠΈΠΈ ΠΊ Π°Π»Π»Π΅ΡΠ³Π΅Π½Π°ΠΌ ΡΠΎΠ΄ΡΡΠ²Π΅Π½Π½ΡΡ
Π΄Π΅ΡΠ΅Π²ΡΠ΅Π² ΠΈ ΠΏΡΠΎΠ³Π½ΠΎΠ·ΠΈΡΠΎΠ²Π°ΡΡ ΠΈΡ
ΠΊΠΎΠ»ΠΈΡΠ΅ΡΡΠ²Π΅Π½Π½ΡΠ΅ Π·Π½Π°ΡΠ΅Π½ΠΈΡ. Π£ΡΠΎΠ²Π΅Π½Ρ sIgE ΠΊ Π°Π»Π»Π΅ΡΠ³Π΅Π½Π°ΠΌ Π΄ΡΠ±Π° ΡΠ²Π»ΡΠ΅ΡΡΡ Ρ
ΠΎΡΠΎΡΠΈΠΌ ΠΏΡΠΎΠ³Π½ΠΎΡΡΠΈΡΠ΅ΡΠΊΠΈΠΌ ΠΏΠ°ΡΠ°ΠΌΠ΅ΡΡΠΎΠΌ ΡΠΎΠ΄Π΅ΡΠΆΠ°Π½ΠΈΡ sIgE ΠΊ ΠΏΠΈΡΠ΅Π²ΡΠΌ Π°Π»Π»Π΅ΡΠ³Π΅Π½Π°ΠΌ ΡΠ°ΡΡΠΈΡΠ΅Π»ΡΠ½ΠΎΠ³ΠΎ ΠΏΡΠΎΠΈΡΡ
ΠΎΠΆΠ΄Π΅Π½ΠΈΡ, Π° Π·Π½Π°ΡΠ΅Π½ΠΈΠ΅ ΠΊΠΎΠ½ΡΠ΅Π½ΡΡΠ°ΡΠΈΠΈ sIgE ΠΊ Π°Π»Π»Π΅ΡΠ³Π΅Π½Π°ΠΌ ΡΠ±Π»ΠΎΠΊΠ° ΡΠ΅ΡΠ½ΠΎ ΡΠ²ΡΠ·Π°Π½ΠΎ Ρ sIgE ΠΊ Π°Π»Π»Π΅ΡΠ³Π΅Π½Π°ΠΌ ΡΡΡΠΊΡΠΎΠ² ΡΠ΅ΠΌΠ΅ΠΉΡΡΠ²Π° ΡΠΎΠ·ΠΎΡΠ²Π΅ΡΠ½ΡΡ
. ΠΡΡΠ²Π»Π΅Π½ΠΈΠ΅ ΡΠ΅Π½ΡΠΈΠ±ΠΈΠ»ΠΈΠ·Π°ΡΠΈΠΈ ΠΊ ΠΌΠΈΠ½ΠΎΡΠ½ΡΠΌ Π°Π»Π»Π΅ΡΠ³Π΅Π½Π°ΠΌ Π²Π»ΠΈΡΠ΅Ρ Π½Π° ΠΏΡΠΎΠ³Π½ΠΎΠ· ΡΡΡΠ΅ΠΊΡΠΈΠ²Π½ΠΎΡΡΠΈ ΡΠ΅ΡΠ°ΠΏΠΈΠΈ. ΠΡΠ²ΠΎΠ΄Ρ: ΡΠ°ΠΊΠΈΠΌ ΠΎΠ±ΡΠ°Π·ΠΎΠΌ, Π΄Π»Ρ ΠΎΡΠ΅Π½ΠΊΠΈ ΡΠΎΠ΄Π΅ΡΠΆΠ°Π½ΠΈΡ Ρ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠ° Ρ Π°ΡΠΎΠΏΠΈΠ΅ΠΉ sIgE ΠΊ ΡΠ°ΡΡΠΈΡΠ΅Π»ΡΠ½ΡΠΌ Π°Π»Π»Π΅ΡΠ³Π΅Π½Π°ΠΌ, Π²ΡΠ·ΡΠ²Π°ΡΡΠΈΠΌ ΠΏΠ΅ΡΠ΅ΠΊΡΠ΅ΡΡΠ½ΡΠ΅ ΡΠ΅Π°ΠΊΡΠΈΠΈ, ΡΡΡΠ΅ΠΊΡΠΈΠ²Π½ΡΠΌ ΡΠ²Π»ΡΠ΅ΡΡΡ ΠΎΠΏΡΠ΅Π΄Π΅Π»Π΅Π½ΠΈΠ΅ sIgE ΠΊ ΠΎΠ³ΡΠ°Π½ΠΈΡΠ΅Π½Π½ΠΎΠΌΡ ΡΠΈΡΠ»Ρ Π°Π»Π»Π΅ΡΠ³Π΅Π½ΠΎΠ² (Π±Π΅ΡΠ΅Π·Π°-Π΄ΡΠ±-ΡΠ±Π»ΠΎΠΊΠΎ). ΠΡΠΈΠΌΠ΅Π½Π΅Π½ΠΈΠ΅ ΠΊΠΎΠΌΠΏΠΎΠ½Π΅Π½Ρ-ΡΠ°Π·Π΄Π΅Π»Π΅Π½Π½ΠΎΠΉ in vitro Π΄ΠΈΠ°Π³Π½ΠΎΡΡΠΈΠΊΠΈ, Π½Π°ΠΏΡΠ°Π²Π»Π΅Π½Π½ΠΎΠΉ Π½Π° Π²ΡΡΠ²Π»Π΅Π½ΠΈΠ΅ ΡΠ΅Π½ΡΠΈΠ±ΠΈΠ»ΠΈΠ·Π°ΡΠΈΠΈ ΠΊ ΠΌΠΈΠ½ΠΎΡΠ½ΡΠΌ Π°Π»Π»Π΅ΡΠ³Π΅Π½Π°ΠΌ, Π°ΠΊΡΡΠ°Π»ΡΠ½ΠΎ ΠΏΡΠΈ ΡΠ΅ΡΠ΅Π½ΠΈΠΈ Π²ΠΎΠΏΡΠΎΡΠ° ΠΎ Π½Π°Π·Π½Π°ΡΠ΅Π½ΠΈΠΈ ΠΠ‘ΠΠ’ ΠΈ ΠΏΡΠΎΠ³Π½ΠΎΠ·ΠΈΡΠΎΠ²Π°Π½ΠΈΠΈ Π΅Π΅ ΡΡΡΠ΅ΠΊΡΠΈΠ²Π½ΠΎΡΡΠΈ. ΠΠ½Π°ΡΠΈΠΌΡΠ΅ ΡΠ΅Π·ΡΠ»ΡΡΠ°ΡΡ ΡΠ΅ΡΠ°ΠΏΠΈΠΈ ΠΏΠΎΠΊΠ°Π·Π°Π½Ρ ΠΏΠΎΡΠ»Π΅ Π΄Π²ΡΠΊΡΠ°ΡΠ½ΠΎΠ³ΠΎ ΠΊΡΡΡΠ° ΠΠ‘ΠΠ’, ΠΊΠΎΡΠΎΡΠ°Ρ ΡΠ°ΠΊΠΆΠ΅ ΠΏΠΎΠ·Π²ΠΎΠ»ΡΠ΅Ρ Π·Π½Π°ΡΠΈΡΠ΅Π»ΡΠ½ΠΎ ΡΠ½ΠΈΠ·ΠΈΡΡ ΠΎΠ±ΡΠ°Π·ΠΎΠ²Π°Π½ΠΈΠ΅ sIgE ΠΊ ΠΏΡΠΈΡΠΈΠ½Π½ΠΎ-Π·Π½Π°ΡΠΈΠΌΡΠΌ Π°Π»Π»Π΅ΡΠ³Π΅Π½Π°ΠΌ ΠΈ ΠΏΠ΅ΡΠ΅ΠΊΡΠ΅ΡΡΠ½ΠΎ ΡΠ΅Π°Π³ΠΈΡΡΡΡΠΈΠΌ ΠΏΠΈΡΠ΅Π²ΡΠΌ Π°Π»Π»Π΅ΡΠ³Π΅Π½Π°ΠΌ ΡΠ°ΡΡΠΈΡΠ΅Π»ΡΠ½ΠΎΠ³ΠΎ ΠΏΡΠΎΠΈΡΡ
ΠΎΠΆΠ΄Π΅Π½ΠΈΡ
Π’ΠΠΠΠΠΠ¦ΠΠ ΠΠΠΠΠΠΠ§ΠΠ‘ΠΠΠ Π ΠΠΠ’Π‘ΠΠΠ Π‘ΠΠΠ Π’ΠΠΠ‘Π’Π Π Π£Π‘ΠΠΠΠΠ―Π₯ Π ΠΠΠΠΠΠΠ¦ΠΠ Π‘ΠΠΠ ΠΠΠΠΠΠΠ Π‘Π’Π ΠΠ’ΠΠΠΠ Π ΠΠΠΠΠ’ΠΠ― ΠΠΠ ΠΠΠΠΠ₯Π ΠΠΠΠΠΠ― Π ΠΠ‘Π‘ΠΠΠ‘ΠΠΠ Π€ΠΠΠΠ ΠΠ¦ΠΠ
Development of maternity and childhood protection service is one of the priorities of the Ministry of Health of the Russian Federation. The strategy for its development is included in the National plan of action for the benefit of children formulated according to the international documents on the rights of a child. The preservation of life and health of children under 5 years has been identified as an important strategic task for preserving life and health of the population as a whole. Tendencies of mortality in children under 5 years and infant mortality as a part of the data had been studied basing on the analysis of Federal State Statistics Service of the Russian Federation and World Bank data bases. It is shown that the reduction in mortality of children under 5 years occurred in all age periods. The level of infant mortality decreased significantly to the same extent due to neonatal and post-neonatal mortality. The leading causes for mortality in children under 5 years in general and infant mortality in particular are certain conditions originating in the perinatal period and congenital malformations which slow further reduction of the mortality in children in this age group. Significant reasons for death in children aged 1β4 years are injuries, poisonings, and oncologic diseases. The reserves of infant and child mortality reduction are found in implementation of prenatal and preimplantation diagnostics and Β«Prenatal consultationΒ» organizational model; broader screening for congenital and hereditary metabolic diseases in the neonatal period including the most common nosological forms of rare (orphan) diseases; expansion of the National Vaccination Calendar; improvement of quality of prehospital medical care to children under the age of 1 year; further development of specialized, rehabilitative, and medical-social support.Π Π°Π·Π²ΠΈΡΠΈΠ΅ ΡΠ»ΡΠΆΠ±Ρ ΠΎΡ
ΡΠ°Π½Ρ ΠΌΠ°ΡΠ΅ΡΠΈΠ½ΡΡΠ²Π° ΠΈ Π΄Π΅ΡΡΡΠ²Π° β ΠΎΠ΄Π½ΠΎ ΠΈΠ· ΠΏΡΠΈΠΎΡΠΈΡΠ΅ΡΠ½ΡΡ
Π½Π°ΠΏΡΠ°Π²Π»Π΅Π½ΠΈΠΉ Π΄Π΅ΡΡΠ΅Π»ΡΠ½ΠΎΡΡΠΈ ΠΠΈΠ½ΠΈΡΡΠ΅ΡΡΡΠ²Π° Π·Π΄ΡΠ°Π²ΠΎΠΎΡ
ΡΠ°Π½Π΅Π½ΠΈΡ Π ΠΎΡΡΠΈΠΉΡΠΊΠΎΠΉ Π€Π΅Π΄Π΅ΡΠ°ΡΠΈΠΈ. Π‘ΡΡΠ°ΡΠ΅Π³ΠΈΡ Π΅Π΅ ΡΠ°Π·Π²ΠΈΡΠΈΡ Π²ΠΊΠ»ΡΡΠ΅Π½Π° Π² ΠΠ°ΡΠΈΠΎΠ½Π°Π»ΡΠ½ΡΠΉ ΠΏΠ»Π°Π½ Π΄Π΅ΠΉΡΡΠ²ΠΈΠΉ Π² ΠΈΠ½ΡΠ΅ΡΠ΅ΡΠ°Ρ
Π΄Π΅ΡΠ΅ΠΉ, ΡΠ°Π·ΡΠ°Π±ΠΎΡΠ°Π½Π½ΡΠΉ Π² ΡΠΎΠΎΡΠ²Π΅ΡΡΡΠ²ΠΈΠΈ Ρ ΠΌΠ΅ΠΆΠ΄ΡΠ½Π°ΡΠΎΠ΄Π½ΡΠΌΠΈ Π΄ΠΎΠΊΡΠΌΠ΅Π½ΡΠ°ΠΌΠΈ ΠΎ ΠΏΡΠ°Π²Π°Ρ
ΡΠ΅Π±Π΅Π½ΠΊΠ°. Π‘ΠΎΡ
ΡΠ°Π½Π΅Π½ΠΈΠ΅ ΠΆΠΈΠ·Π½ΠΈ ΠΈ Π·Π΄ΠΎΡΠΎΠ²ΡΡ Π΄Π΅ΡΠ΅ΠΉ Π² Π²ΠΎΠ·ΡΠ°ΡΡΠ΅ Π΄ΠΎ 5 Π»Π΅Ρ ΠΎΠΏΡΠ΅Π΄Π΅Π»Π΅Π½ΠΎ Π² ΠΊΠ°ΡΠ΅ΡΡΠ²Π΅ Π²Π°ΠΆΠ½ΠΎΠΉ ΡΡΡΠ°ΡΠ΅Π³ΠΈΡΠ΅ΡΠΊΠΎΠΉ Π·Π°Π΄Π°ΡΠΈ ΡΠΎΡ
ΡΠ°Π½Π΅Π½ΠΈΡ ΠΆΠΈΠ·Π½ΠΈ ΠΈ Π·Π΄ΠΎΡΠΎΠ²ΡΡ Π½Π°ΡΠ΅Π»Π΅Π½ΠΈΡ Π² ΡΠ΅Π»ΠΎΠΌ. ΠΠ° ΠΎΡΠ½ΠΎΠ²Π΅ Π°Π½Π°Π»ΠΈΠ·Π° Π΄Π°Π½Π½ΡΡ
Π±Π°Π·Ρ Π€Π΅Π΄Π΅ΡΠ°Π»ΡΠ½ΠΎΠΉ ΡΠ»ΡΠΆΠ±Ρ Π³ΠΎΡΡΠ΄Π°ΡΡΡΠ²Π΅Π½Π½ΠΎΠΉ ΡΡΠ°ΡΠΈΡΡΠΈΠΊΠΈ Π ΠΎΡΡΠΈΠΉΡΠΊΠΎΠΉ Π€Π΅Π΄Π΅ΡΠ°ΡΠΈΠΈ ΠΈ Π±Π°Π·Ρ ΠΡΠ΅ΠΌΠΈΡΠ½ΠΎΠ³ΠΎ Π±Π°Π½ΠΊΠ° Π±ΡΠ»ΠΈ ΠΈΠ·ΡΡΠ΅Π½Ρ ΡΠ΅Π½Π΄Π΅Π½ΡΠΈΠΈ ΡΠΌΠ΅ΡΡΠ½ΠΎΡΡΠΈ Π΄Π΅ΡΠ΅ΠΉ Π΄ΠΎ 5 Π»Π΅Ρ ΠΆΠΈΠ·Π½ΠΈ ΠΈ Π΅Π΅ ΡΠΎΡΡΠ°Π²Π»ΡΡΡΠ΅ΠΉ β ΠΌΠ»Π°Π΄Π΅Π½ΡΠ΅ΡΠΊΠΎΠΉ ΡΠΌΠ΅ΡΡΠ½ΠΎΡΡΠΈ. ΠΠΎΠΊΠ°Π·Π°Π½ΠΎ, ΡΡΠΎ ΡΠ½ΠΈΠΆΠ΅Π½ΠΈΠ΅ ΡΠΌΠ΅ΡΡΠ½ΠΎΡΡΠΈ Π΄Π΅ΡΠ΅ΠΉ Π΄ΠΎ 5 Π»Π΅Ρ ΠΏΡΠΎΠΈΠ·ΠΎΡΠ»ΠΎ Π²ΠΎ Π²ΡΠ΅ Π΅Π΅ Π²ΠΎΠ·ΡΠ°ΡΡΠ½ΡΠ΅ ΠΏΠ΅ΡΠΈΠΎΠ΄Ρ. Π‘ΡΡΠ΅ΡΡΠ²Π΅Π½Π½ΠΎ ΡΠ½ΠΈΠ·ΠΈΠ»ΡΡ ΡΡΠΎΠ²Π΅Π½Ρ ΠΌΠ»Π°Π΄Π΅Π½ΡΠ΅ΡΠΊΠΎΠΉ ΡΠΌΠ΅ΡΡΠ½ΠΎΡΡΠΈ β Π² ΠΎΠ΄ΠΈΠ½Π°ΠΊΠΎΠ²ΠΎΠΉ ΠΌΠ΅ΡΠ΅ Π·Π° ΡΡΠ΅Ρ Π½Π΅ΠΎΠ½Π°ΡΠ°Π»ΡΠ½ΡΡ
ΠΈ ΠΏΠΎΡΡΠ½Π΅ΠΎΠ½Π°ΡΠ°Π»ΡΠ½ΡΡ
ΠΏΠΎΡΠ΅ΡΡ. ΠΠ΅Π΄ΡΡΠΈΠΌΠΈ ΠΏΡΠΈΡΠΈΠ½Π°ΠΌΠΈ ΡΠΌΠ΅ΡΡΠ½ΠΎΡΡΠΈ Π΄Π΅ΡΠ΅ΠΉ Π΄ΠΎ 5 Π»Π΅Ρ Π² ΡΠ΅Π»ΠΎΠΌ ΠΈ ΠΌΠ»Π°Π΄Π΅Π½ΡΠ΅ΡΠΊΠΎΠΉ Π² ΡΠ°ΡΡΠ½ΠΎΡΡΠΈ ΡΠ²Π»ΡΡΡΡΡ ΠΎΡΠ΄Π΅Π»ΡΠ½ΡΠ΅ ΡΠΎΡΡΠΎΡΠ½ΠΈΡ, Π²ΠΎΠ·Π½ΠΈΠΊΠ°ΡΡΠΈΠ΅ Π² ΠΏΠ΅ΡΠΈΠ½Π°ΡΠ°Π»ΡΠ½ΠΎΠΌ ΠΏΠ΅ΡΠΈΠΎΠ΄Π΅, ΠΈ Π²ΡΠΎΠΆΠ΄Π΅Π½Π½ΡΠ΅ Π°Π½ΠΎΠΌΠ°Π»ΠΈΠΈ ΡΠ°Π·Π²ΠΈΡΠΈΡ, ΠΊΠΎΡΠΎΡΡΠ΅ Π΄Π΅Π»Π°ΡΡ ΡΡΡΠ΄Π½ΡΠΌ Π΄Π°Π»ΡΠ½Π΅ΠΉΡΠ΅Π΅ ΡΠ½ΠΈΠΆΠ΅Π½ΠΈΠ΅ ΡΠΌΠ΅ΡΡΠ½ΠΎΡΡΠΈ Π΄Π΅ΡΠ΅ΠΉ ΡΡΠΎΠΉ Π²ΠΎΠ·ΡΠ°ΡΡΠ½ΠΎΠΉ Π³ΡΡΠΏΠΏΡ. Π£ Π΄Π΅ΡΠ΅ΠΉ Π² Π²ΠΎΠ·ΡΠ°ΡΡΠ΅ 1β4 Π»Π΅Ρ Π·Π½Π°ΡΠΈΠΌΡΠΌΠΈ ΠΏΡΠΈΡΠΈΠ½Π°ΠΌΠΈ Π³ΠΈΠ±Π΅Π»ΠΈ ΡΡΠ°Π½ΠΎΠ²ΡΡΡΡ ΡΡΠ°Π²ΠΌΡ, ΠΎΡΡΠ°Π²Π»Π΅Π½ΠΈΡ ΠΈ ΠΎΠ½ΠΊΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΈΠ΅ Π·Π°Π±ΠΎΠ»Π΅Π²Π°Π½ΠΈΡ. ΠΡΠ΅Π΄ΡΡΠ°Π²Π»ΡΠ΅ΡΡΡ, ΡΡΠΎ ΡΠ΅Π·Π΅ΡΠ²Π°ΠΌΠΈ ΡΠ½ΠΈΠΆΠ΅Π½ΠΈΡ ΠΌΠ»Π°Π΄Π΅Π½ΡΠ΅ΡΠΊΠΎΠΉ ΠΈ Π΄Π΅ΡΡΠΊΠΎΠΉ ΡΠΌΠ΅ΡΡΠ½ΠΎΡΡΠΈ ΡΠ²Π»ΡΡΡΡΡ Π²Π½Π΅Π΄ΡΠ΅Π½ΠΈΠ΅ ΠΏΡΠ΅Π½Π°ΡΠ°Π»ΡΠ½ΠΎΠΉ ΠΈ ΠΏΡΠ΅ΠΈΠΌΠΏΠ»Π°Π½ΡΠ°ΡΠΈΠΎΠ½Π½ΠΎΠΉ Π΄ΠΈΠ°Π³Π½ΠΎΡΡΠΈΠΊΠΈ, ΠΎΡΠ³Π°Π½ΠΈΠ·Π°ΡΠΈΠΎΠ½Π½ΠΎΠΉ ΠΌΠΎΠ΄Π΅Π»ΠΈ Β«ΠΏΡΠ΅Π½Π°ΡΠ°Π»ΡΠ½ΡΠΉ ΠΊΠΎΠ½ΡΠΈΠ»ΠΈΡΠΌΒ», Π±ΠΎΠ»Π΅Π΅ ΡΠΈΡΠΎΠΊΠΎΠ΅ ΠΏΡΠΎΠ²Π΅Π΄Π΅Π½ΠΈΠ΅ ΡΠΊΡΠΈΠ½ΠΈΠ½Π³Π° Π½Π° Π²ΡΠΎΠΆΠ΄Π΅Π½Π½ΡΠ΅ ΠΈ Π½Π°ΡΠ»Π΅Π΄ΡΡΠ²Π΅Π½Π½ΡΠ΅ Π±ΠΎΠ»Π΅Π·Π½ΠΈ ΠΎΠ±ΠΌΠ΅Π½Π° Π² Π½Π΅ΠΎΠ½Π°ΡΠ°Π»ΡΠ½ΠΎΠΌ ΠΏΠ΅ΡΠΈΠΎΠ΄Π΅ Ρ Π²ΠΊΠ»ΡΡΠ΅Π½ΠΈΠ΅ΠΌ Π½Π°ΠΈΠ±ΠΎΠ»Π΅Π΅ ΡΠ°ΡΠΏΡΠΎΡΡΡΠ°Π½Π΅Π½Π½ΡΡ
Π½ΠΎΠ·ΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΈΡ
ΡΠΎΡΠΌ ΡΠ΅Π΄ΠΊΠΈΡ
(ΠΎΡΡΠ°Π½Π½ΡΡ
) Π±ΠΎΠ»Π΅Π·Π½Π΅ΠΉ, ΡΠ°ΡΡΠΈΡΠ΅Π½ΠΈΠ΅ ΠΠ°ΡΠΈΠΎΠ½Π°Π»ΡΠ½ΠΎΠ³ΠΎ ΠΊΠ°Π»Π΅Π½Π΄Π°ΡΡ Π²Π°ΠΊΡΠΈΠ½Π°ΡΠΈΠΈ, ΠΏΠΎΠ²ΡΡΠ΅Π½ΠΈΠ΅ ΠΊΠ°ΡΠ΅ΡΡΠ²Π° Π΄ΠΎΠ³ΠΎΡΠΏΠΈΡΠ°Π»ΡΠ½ΠΎΠΉ ΠΌΠ΅Π΄ΠΈΡΠΈΠ½ΡΠΊΠΎΠΉ ΠΏΠΎΠΌΠΎΡΠΈ Π΄Π΅ΡΡΠΌ Π² Π²ΠΎΠ·ΡΠ°ΡΡΠ΅ Π΄ΠΎ 1 Π³ΠΎΠ΄Π°, Π΄Π°Π»ΡΠ½Π΅ΠΉΡΠ΅Π΅ ΡΠ°Π·Π²ΠΈΡΠΈΠ΅ ΡΠΏΠ΅ΡΠΈΠ°Π»ΠΈΠ·ΠΈΡΠΎΠ²Π°Π½Π½ΠΎΠΉ, ΡΠ΅Π°Π±ΠΈΠ»ΠΈΡΠ°ΡΠΈΠΎΠ½Π½ΠΎΠΉ ΠΈ ΠΌΠ΅Π΄ΠΈΠΊΠΎ-ΡΠΎΡΠΈΠ°Π»ΡΠ½ΠΎΠΉ ΠΏΠΎΠΌΠΎΡΠΈ
Π’ΠΠΠΠΠΠ¦ΠΠ ΠΠΠΠΠΠΠ§ΠΠ‘ΠΠΠ Π ΠΠΠ’Π‘ΠΠΠ Π‘ΠΠΠ Π’ΠΠΠ‘Π’Π Π Π ΠΠ‘Π‘ΠΠΠ‘ΠΠΠ Π€ΠΠΠΠ ΠΠ¦ΠΠ Π 1990β2012 ΠΠ.
Objective: Dynamics and causes of infant and child mortality in the Russian Federation in post-Soviet period (1990β2012) under conditions of demographic policy implementation and healthcare system reforming are presented. Methods: Federal State Statistics Service's official statistics data (1990β2012) had been analyzed. The data was compared with similar rates of European Union countries. Results: Itβs been revealed that infant mortality decreased (more than in 2 times) (from 17.4β° to 8.6β°) through all its level indicators (early neonatal, neonatal, post-neonatal mortality) and due to almost all basic reasons (perinatal disorders, infectious diseases, respiratory diseases, congenital anomalies, accidents). Infant mortality rate in rural areas is higher (10.1β° and 8.1β°), however, the gap between rates in rural regions and in cities is decreasing. In Russian Federation the infant mortality has regional distinctions, thusΒ Siberian and Far Eastern regions are the least advantaged areas. Mortality of children under 5 y.o. is declining (from 21.3β° to 10.6β°), but its rate is still higher than in European Union countries (3.5β°). External factors occupy the top position as a death cause of infants and toddlers; the number of clinical cases with a diagnosis of malignant neoplasm increases. Conclusion: Thus, improving of the system of motherhood and childhood protection in the Russian Federation has resulted in significant reduction of infant and child mortality rate.Β Π¦Π΅Π»Ρ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΡ: ΠΎΡΠ΅Π½ΠΈΡΡ ΡΠ΅Π½Π΄Π΅Π½ΡΠΈΠΈ ΠΌΠ»Π°Π΄Π΅Π½ΡΠ΅ΡΠΊΠΎΠΉ (ΠΠ‘) ΠΈ Π΄Π΅ΡΡΠΊΠΎΠΉ ΡΠΌΠ΅ΡΡΠ½ΠΎΡΡΠΈ Π² Π ΠΎΡΡΠΈΠΉΡΠΊΠΎΠΉ Π€Π΅Π΄Π΅ΡΠ°ΡΠΈΠΈ (Π Π€) Π² ΠΏΠΎΡΡΡΠΎΠ²Π΅ΡΡΠΊΠΎΠΌ ΠΏΠ΅ΡΠΈΠΎΠ΄Π΅ (1990β2012Β Π³Π³.) Π² ΡΡΠ»ΠΎΠ²ΠΈΡΡ
ΠΏΡΠΎΠ²Π΅Π΄Π΅Π½ΠΈΡ Π΄Π΅ΠΌΠΎΠ³ΡΠ°ΡΠΈΡΠ΅ΡΠΊΠΎΠΉ ΠΏΠΎΠ»ΠΈΡΠΈΠΊΠΈ ΠΈ ΡΠ΅ΡΠΎΡΠΌΠΈΡΠΎΠ²Π°Π½ΠΈΡ ΡΠΈΡΡΠ΅ΠΌΡ Π·Π΄ΡΠ°Π²ΠΎΠΎΡ
ΡΠ°Π½Π΅Π½ΠΈΡ. ΠΠ΅ΡΠΎΠ΄Ρ: Π²ΡΠΏΠΎΠ»Π½ΡΠ»ΠΈ ΠΌΠ΅Π΄ΠΈΠΊΠΎ-ΡΡΠ°ΡΠΈΡΡΠΈΡΠ΅ΡΠΊΠΈΠΉ Π°Π½Π°Π»ΠΈΠ· ΠΏΠΎΠΊΠ°Π·Π°ΡΠ΅Π»Π΅ΠΉ ΠΠ‘ ΠΈ Π΄Π΅ΡΡΠΊΠΎΠΉ ΡΠΌΠ΅ΡΡΠ½ΠΎΡΡΠΈ ΠΏΠΎ ΠΎΡΠΈΡΠΈΠ°Π»ΡΠ½ΡΠΌ Π΄Π°Π½Π½ΡΠΌ Π ΠΎΡΡΡΠ°ΡΠ° Π·Π° 1990β2012Β Π³Π³. Π Π΅Π·ΡΠ»ΡΡΠ°ΡΡ: ΡΡΡΠ°Π½ΠΎΠ²Π»Π΅Π½ΠΎ Π·Π½Π°ΡΠΈΡΠ΅Π»ΡΠ½ΠΎΠ΅ (Π±ΠΎΠ»Π΅Π΅ ΡΠ΅ΠΌ Π² 2Β ΡΠ°Π·Π°) ΡΠ½ΠΈΠΆΠ΅Π½ΠΈΠ΅ ΠΠ‘ (Ρ 17,4 Π΄ΠΎ 8,6%ΠΎ) Π·Π° ΡΡΠ΅Ρ Π²ΡΠ΅Ρ
Π΅Π΅ ΡΠΎΡΡΠ°Π²Π»ΡΡΡΠΈΡ
(ΡΠ°Π½Π½Π΅ΠΉ Π½Π΅ΠΎΠ½Π°ΡΠ°Π»ΡΠ½ΠΎΠΉ, Π½Π΅ΠΎΠ½Π°ΡΠ°Π»ΡΠ½ΠΎΠΉ, ΠΏΠΎΡΡΠ½Π΅ΠΎΠ½Π°ΡΠ°Π»ΡΠ½ΠΎΠΉ ΡΠΌΠ΅ΡΡΠ½ΠΎΡΡΠΈ) ΠΈ ΠΏΠΎΡΡΠΈ ΠΎΡ Π²ΡΠ΅Ρ
ΠΎΡΠ½ΠΎΠ²Π½ΡΡ
ΠΏΡΠΈΡΠΈΠ½ (ΡΠΎΡΡΠΎΡΠ½ΠΈΡ ΠΏΠ΅ΡΠΈΠ½Π°ΡΠ°Π»ΡΠ½ΠΎΠ³ΠΎ ΠΏΠ΅ΡΠΈΠΎΠ΄Π°, ΠΈΠ½ΡΠ΅ΠΊΡΠΈΠΎΠ½Π½ΡΡ
Π·Π°Π±ΠΎΠ»Π΅Π²Π°Π½ΠΈΠΉ, Π±ΠΎΠ»Π΅Π·Π½Π΅ΠΉ ΠΎΡΠ³Π°Π½ΠΎΠ² Π΄ΡΡ
Π°Π½ΠΈΡ, Π²ΡΠΎΠΆΠ΄Π΅Π½Π½ΡΡ
Π°Π½ΠΎΠΌΠ°Π»ΠΈΠΉ, Π½Π΅ΡΡΠ°ΡΡΠ½ΡΡ
ΡΠ»ΡΡΠ°Π΅Π²). ΠΡΠΌΠ΅ΡΠ°Π΅ΡΡΡ Π±ΠΎΠ»Π΅Π΅ Π²ΡΡΠΎΠΊΠΈΠΉ ΡΡΠΎΠ²Π΅Π½Ρ ΠΠ‘ Π² ΡΠ΅Π»ΡΡΠΊΠΎΠΉ ΠΌΠ΅ΡΡΠ½ΠΎΡΡΠΈ (10,1 ΠΏΡΠΎΡΠΈΠ² 8,1%ΠΎ), ΠΎΠ΄Π½Π°ΠΊΠΎ ΡΠ°Π·ΡΡΠ² ΠΌΠ΅ΠΆΠ΄Ρ Π³ΠΎΡΠΎΠ΄ΡΠΊΠΈΠΌΠΈ ΠΈ ΡΠ΅Π»ΡΡΠΊΠΈΠΌΠΈ ΠΏΠΎΠΊΠ°Π·Π°ΡΠ΅Π»ΡΠΌΠΈ ΡΠΎΠΊΡΠ°ΡΠ°Π΅ΡΡΡ. Π Π Π€ ΠΠ‘ ΠΈΠΌΠ΅Π΅Ρ ΡΠ΅Π³ΠΈΠΎΠ½Π°Π»ΡΠ½ΡΠ΅ ΠΎΡΠΎΠ±Π΅Π½Π½ΠΎΡΡΠΈ ΠΈ Π²Π·Π°ΠΈΠΌΠΎΡΠ²ΡΠ·Ρ Ρ Π΄Π΅ΠΌΠΎΠ³ΡΠ°ΡΠΈΡΠ΅ΡΠΊΠΈΠΌΠΈ ΠΏΠΎΠΊΠ°Π·Π°ΡΠ΅Π»ΡΠΌΠΈ (ΠΎΠ±ΡΠ°Ρ ΡΠΌΠ΅ΡΡΠ½ΠΎΡΡΡ), ΡΠΎΡΠΈΠ°Π»ΡΠ½ΠΎ-ΡΠΊΠΎΠ½ΠΎΠΌΠΈΡΠ΅ΡΠΊΠΈΠΌΠΈ Π΄Π΅ΡΠ΅ΡΠΌΠΈΠ½Π°Π½ΡΠ°ΠΌΠΈ (ΡΡΠΎΠ²Π΅Π½Ρ ΠΏΡΠΎΠΆΠΈΡΠΎΡΠ½ΠΎΠ³ΠΎ ΠΌΠΈΠ½ΠΈΠΌΡΠΌΠ°, Π΄ΠΎΠ»Ρ Π±Π΅Π΄Π½ΠΎΠ³ΠΎ Π½Π°ΡΠ΅Π»Π΅Π½ΠΈΡ ΠΈ ΡΠΈΡΠ»Π΅Π½Π½ΠΎΡΡΡ Π±Π΅Π·ΡΠ°Π±ΠΎΡΠ½ΡΡ
) ΠΈ ΡΠ΅Ρ
Π½ΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΈΠΌΠΈ ΠΏΠΎΠΊΠ°Π·Π°ΡΠ΅Π»ΡΠΌΠΈ (ΡΡΠΎΠ²Π΅Π½Ρ ΠΠΠ Π½Π° Π΄ΡΡΡ Π½Π°ΡΠ΅Π»Π΅Π½ΠΈΡ). Π‘ΠΎΠΊΡΠ°ΡΠ°Π΅ΡΡΡ ΡΠΌΠ΅ΡΡΠ½ΠΎΡΡΡ Π΄Π΅ΡΠ΅ΠΉ Π² Π²ΠΎΠ·ΡΠ°ΡΡΠ΅ Π΄ΠΎ 5Β Π»Π΅Ρ (Ρ 21,3 Π΄ΠΎ 10,6%ΠΎ), ΠΎΠ΄Π½Π°ΠΊΠΎ Π΅Π΅ ΡΡΠΎΠ²Π΅Π½Ρ ΠΎΡΡΠ°Π΅ΡΡΡ Π²ΡΡΠ΅, ΡΠ΅ΠΌ Π² ΡΡΡΠ°Π½Π°Ρ
ΠΠ²ΡΠΎΠΏΠ΅ΠΉΡΠΊΠΎΠ³ΠΎ ΡΠΎΡΠ·Π° (3,5%ΠΎ). Π‘ΡΠ΅Π΄ΠΈ ΠΏΡΠΈΡΠΈΠ½ Π³ΠΈΠ±Π΅Π»ΠΈ Π΄Π΅ΡΠ΅ΠΉ ΡΡΠΎΠΉ Π²ΠΎΠ·ΡΠ°ΡΡΠ½ΠΎΠΉ Π³ΡΡΠΏΠΏΡ ΠΏΠ΅ΡΠ²ΡΠ΅ ΠΌΠ΅ΡΡΠ° Π½Π°ΡΠΈΠ½Π°ΡΡ Π·Π°Π½ΠΈΠΌΠ°ΡΡ Π²Π½Π΅ΡΠ½ΠΈΠ΅ ΡΠ°ΠΊΡΠΎΡΡ, ΡΠ²Π΅Π»ΠΈΡΠΈΠ²Π°Π΅ΡΡΡ Π·Π½Π°ΡΠΈΠΌΠΎΡΡΡ Π·Π»ΠΎΠΊΠ°ΡΠ΅ΡΡΠ²Π΅Π½Π½ΡΡ
Π½ΠΎΠ²ΠΎΠΎΠ±ΡΠ°Π·ΠΎΠ²Π°Π½ΠΈΠΉ. ΠΠ°ΠΊΠ»ΡΡΠ΅Π½ΠΈΠ΅: ΡΠΎΠ²Π΅ΡΡΠ΅Π½ΡΡΠ²ΠΎΠ²Π°Π½ΠΈΠ΅ ΡΠΈΡΡΠ΅ΠΌΡ ΠΎΡ
ΡΠ°Π½Ρ ΠΌΠ°ΡΠ΅ΡΠΈΠ½ΡΡΠ²Π° ΠΈ Π΄Π΅ΡΡΡΠ²Π° Π² Π Π€ ΠΏΠΎΠ·Π²ΠΎΠ»ΠΈΠ»ΠΎ Π·Π½Π°ΡΠΈΡΠ΅Π»ΡΠ½ΠΎ ΡΠ½ΠΈΠ·ΠΈΡΡ ΠΌΠ»Π°Π΄Π΅Π½ΡΠ΅ΡΠΊΡΡ ΠΈ Π΄Π΅ΡΡΠΊΡΡ ΡΠΌΠ΅ΡΡΠ½ΠΎΡΡΡ.
Π‘ΠΠ‘Π’ΠΠΠΠΠ― Π’ΠΠ ΠΠΠΠ― ΠΠ‘ΠΠ ΠΠΠΠ Π ΠΠΠ’Π‘ΠΠΠ ΠΠΠΠ ΠΠ‘Π’Π (Π§ΠΠ‘Π’Π¬ I)
We include a review of modern methods of systemic therapy of psoriasis in children, indications for which are moderate and severe forms of psoriasis with PASI 10, skin pathological process that is uncontrollable with topical drugs, skin lesions with functional localization (lesions of genitals, palms and soles, facial skin), erythrodermic psoriasis, pustular psoriasis, psoriatic arthritis. We provide information on the techniques of narrow-band phototherapy (UVB 311 nm) that are used in the treatment of psoriasis in children. We provide data on efficacy, safety, necessary monitoring of clinical and laboratory indicators, peculiarities of vaccination during treatment of children with acitretin, methotrexate, cyclosporine.ΠΡΠΈΠ²ΠΎΠ΄ΠΈΡΡΡ ΠΎΠ±Π·ΠΎΡ ΡΠΎΠ²ΡΠ΅ΠΌΠ΅Π½Π½ΡΡ
ΠΌΠ΅ΡΠΎΠ΄ΠΎΠ² ΡΠΈΡΡΠ΅ΠΌΠ½ΠΎΠΉ ΡΠ΅ΡΠ°ΠΏΠΈΠΈ ΠΏΡΠΎΡΠΈΠ°Π·Π° Π²Β Π΄Π΅ΡΡΠΊΠΎΠΌ Π²ΠΎΠ·ΡΠ°ΡΡΠ΅, ΠΏΠΎΠΊΠ°Π·Π°Π½ΠΈΡΠΌΠΈ Π΄Π»Ρ ΠΊΠΎΡΠΎΡΠΎΠΉ ΡΠ²Π»ΡΡΡΡΡ ΡΡΠ΅Π΄Π½Π΅ΡΡΠΆΠ΅Π»ΡΠ΅ ΠΈΒ ΡΡΠΆΠ΅Π»ΡΠ΅ ΡΠΎΡΠΌΡ ΠΏΡΠΎΡΠΈΠ°Π·Π° ΡΒ ΠΈΠ½Π΄Π΅ΠΊΡΠΎΠΌ PASI 10, ΠΊΠΎΠΆΠ½ΡΠΉ ΠΏΠ°ΡΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΈΠΉ ΠΏΡΠΎΡΠ΅ΡΡ, Π½Π΅Β ΠΊΠΎΠ½ΡΡΠΎΠ»ΠΈΡΡΠ΅ΠΌΡΠΉ Π½Π°ΡΡΠΆΠ½ΡΠΌΠΈ ΠΏΡΠ΅ΠΏΠ°ΡΠ°ΡΠ°ΠΌΠΈ, ΠΏΠΎΡΠ°ΠΆΠ΅Π½ΠΈΡ ΠΊΠΎΠΆΠΈ ΡΡΠ½ΠΊΡΠΈΠΎΠ½Π°Π»ΡΠ½ΡΡ
Π»ΠΎΠΊΠ°Π»ΠΈΠ·Π°ΡΠΈΠΉ (ΠΏΠΎΡΠ°ΠΆΠ΅Π½ΠΈΠ΅ ΠΏΠΎΠ»ΠΎΠ²ΡΡ
ΠΎΡΠ³Π°Π½ΠΎΠ², Π»Π°Π΄ΠΎΠ½Π΅ΠΉ ΠΈΒ ΠΏΠΎΠ΄ΠΎΡΠ², ΠΊΠΎΠΆΠΈ Π»ΠΈΡΠ°), ΡΡΠΈΡΡΠΎΠ΄Π΅ΡΠΌΠΈΡΠ΅ΡΠΊΠΈΠΉ ΠΏΡΠΎΡΠΈΠ°Π·, ΠΏΡΡΡΡΠ»Π΅Π·Π½ΡΠΉ ΠΏΡΠΎΡΠΈΠ°Π·, ΠΏΡΠΎΡΠΈΠ°ΡΠΈΡΠ΅ΡΠΊΠΈΠΉ Π°ΡΡΡΠΈΡ. ΠΡΠ΅Π΄ΡΡΠ°Π²Π»Π΅Π½Ρ ΡΠΎΠ²ΡΠ΅ΠΌΠ΅Π½Π½ΡΠ΅ ΡΠ²Π΅Π΄Π΅Π½ΠΈΡ ΠΎΒ ΠΌΠ΅ΡΠΎΠ΄ΠΈΠΊΠ°Ρ
ΡΠ·ΠΊΠΎΠΏΠΎΠ»ΠΎΡΠ½ΠΎΠΉ ΡΠΎΡΠΎΡΠ΅ΡΠ°ΠΏΠΈΠΈ (Π£Π€B 311 Π½ΠΌ), ΠΈΡΠΏΠΎΠ»ΡΠ·ΡΠ΅ΠΌΡΡ
Π²Β Π»Π΅ΡΠ΅Π½ΠΈΠΈ ΠΏΡΠΎΡΠΈΠ°Π·Π° Π²Β Π΄Π΅ΡΡΠΊΠΎΠΌ Π²ΠΎΠ·ΡΠ°ΡΡΠ΅. ΠΡΠΈΠ²ΠΎΠ΄ΡΡΡΡ Π΄Π°Π½Π½ΡΠ΅ ΠΎΠ±Β ΡΡΡΠ΅ΠΊΡΠΈΠ²Π½ΠΎΡΡΠΈ, Π±Π΅Π·ΠΎΠΏΠ°ΡΠ½ΠΎΡΡΠΈ, Π½Π΅ΠΎΠ±Ρ
ΠΎΠ΄ΠΈΠΌΠΎΠΌ ΠΌΠΎΠ½ΠΈΡΠΎΡΠΈΠ½Π³Π΅ ΠΊΠ»ΠΈΠ½ΠΈΠΊΠΎ-Π»Π°Π±ΠΎΡΠ°ΡΠΎΡΠ½ΡΡ
ΠΏΠΎΠΊΠ°Π·Π°ΡΠ΅Π»Π΅ΠΉ, ΠΎΡΠΎΠ±Π΅Π½Π½ΠΎΡΡΡΡ
Π²Π°ΠΊΡΠΈΠ½Π°ΡΠΈΠΈ Π²ΠΎΒ Π²ΡΠ΅ΠΌΡ Π»Π΅ΡΠ΅Π½ΠΈΡ Π΄Π΅ΡΠ΅ΠΉ Π°ΡΠΈΡΡΠ΅ΡΠΈΠ½ΠΎΠΌ, ΠΌΠ΅ΡΠΎΡΡΠ΅ΠΊΡΠ°ΡΠΎΠΌ, ΡΠΈΠΊΠ»ΠΎΡΠΏΠΎΡΠΈΠ½ΠΎΠΌ
Π‘ΠΈΡΡΠ΅ΠΌΠ½Π°Ρ ΡΠ΅ΡΠ°ΠΏΠΈΡ ΠΏΡΠΎΡΠΈΠ°Π·Π° Π² Π΄Π΅ΡΡΠΊΠΎΠΌ Π²ΠΎΠ·ΡΠ°ΡΡΠ΅ (ΡΠ°ΡΡΡ II): Π²ΠΎΠΏΡΠΎΡΡ Π±ΠΈΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΎΠΉ ΡΠ΅ΡΠ°ΠΏΠΈΠΈ
The authors present an overview of the present day knowledge of methods of biological therapy used for treatment of severe psoriasis at an early age. Data is presented on efficiency, safety, required monitoring of clinical and laboratory performance, specifics of vaccination during the treatment of children with genetically engineered biological drugs. Data is presented on the authorsβ own clinical observations of 10 adolescents who were administered the preparation of ustekinumab. The objective of the observational study was assessment of efficiency and safety of application of ustekinumab for treatment of severe psoriasis with children over 12 years of age. Materials and Methods. The observation covered 10 children, their average age being 15Β±2.8 years old, the PASI index 39.3Β±9.5, who were administered ustekinumab at a dose of 45 mg under a standard administration regimen. Results. The therapeutic effect was assessed based on the PASI index, which was found to decrease by 75% with 6 adolescents, and by 90% with 4 adolescents as soon as by week 14 of the therapy. As is shown by the follow-up observation, the skin pathological process was completely resolved with 80% of adolescents after 3 injections of ustekinumab, and with 100% after 4 injections. Conclusion. The preparation of ustekinumab is efficient and safe for treatment of psoriasis at an early age. As based on the PASI index as the main criterion of assessment of treatment efficiency, ustekinumab (Stelara) is the medicine of choice for treatment of severe forms of the disease from the age of 12 years old.ΠΠ²ΡΠΎΡΡ ΠΏΡΠΈΠ²ΠΎΠ΄ΡΡ ΠΎΠ±Π·ΠΎΡ ΡΠΎΠ²ΡΠ΅ΠΌΠ΅Π½Π½ΡΡ
Π΄Π°Π½Π½ΡΡ
ΠΎ ΠΌΠ΅ΡΠΎΠ΄Π°Ρ
Π±ΠΈΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΎΠΉ ΡΠ΅ΡΠ°ΠΏΠΈΠΈ ΡΡΠΆΠ΅Π»ΡΡ
ΡΠΎΡΠΌ ΠΏΡΠΎΡΠΈΠ°Π·Π° Π² Π΄Π΅ΡΡΠΊΠΎΠΌ Π²ΠΎΠ·ΡΠ°ΡΡΠ΅. ΠΡΠ΅Π΄ΡΡΠ°Π²Π»Π΅Π½Ρ Π΄Π°Π½Π½ΡΠ΅ ΠΎΠ± ΡΡΡΠ΅ΠΊΡΠΈΠ²Π½ΠΎΡΡΠΈ, Π±Π΅Π·ΠΎΠΏΠ°ΡΠ½ΠΎΡΡΠΈ, Π½Π΅ΠΎΠ±Ρ
ΠΎΠ΄ΠΈΠΌΠΎΠΌ ΠΌΠΎΠ½ΠΈΡΠΎΡΠΈΠ½Π³Π΅ ΠΊΠ»ΠΈΠ½ΠΈΠΊΠΎ-Π»Π°Π±ΠΎΡΠ°ΡΠΎΡΠ½ΡΡ
ΠΏΠΎΠΊΠ°Π·Π°ΡΠ΅Π»Π΅ΠΉ, ΠΎΡΠΎΠ±Π΅Π½Π½ΠΎΡΡΡΡ
Π²Π°ΠΊΡΠΈΠ½Π°ΡΠΈΠΈ Π²ΠΎ Π²ΡΠ΅ΠΌΡ Π»Π΅ΡΠ΅Π½ΠΈΡ Π΄Π΅ΡΠ΅ΠΉ Π³Π΅Π½Π½ΠΎ-ΠΈΠ½ΠΆΠ΅Π½Π΅ΡΠ½ΡΠΌΠΈ Π±ΠΈΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΈΠΌΠΈ ΠΏΡΠ΅ΠΏΠ°ΡΠ°ΡΠ°ΠΌΠΈ. ΠΡΠΈΠ²ΠΎΠ΄ΡΡΡΡ ΡΠΎΠ±ΡΡΠ²Π΅Π½Π½ΡΠ΅ ΡΠ΅Π·ΡΠ»ΡΡΠ°ΡΡ ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ Π½Π°Π±Π»ΡΠ΄Π΅Π½ΠΈΡ Π·Π° 10 ΠΏΠΎΠ΄ΡΠΎΡΡΠΊΠ°ΠΌΠΈ, ΠΏΠΎΠ»ΡΡΠ°Π²ΡΠΈΠΌΠΈ Π»Π΅ΡΠ΅Π½ΠΈΠ΅ ΠΏΡΠ΅ΠΏΠ°ΡΠ°ΡΠΎΠΌ ΡΡΡΠ΅ΠΊΠΈΠ½ΡΠΌΠ°Π±. Π¦Π΅Π»ΡΡ Π½Π°Π±Π»ΡΠ΄Π°ΡΠ΅Π»ΡΠ½ΠΎΠ³ΠΎ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΡ ΡΠ²ΠΈΠ»Π°ΡΡ ΠΎΡΠ΅Π½ΠΊΠ° ΡΡΡΠ΅ΠΊΡΠΈΠ²Π½ΠΎΡΡΠΈ ΠΈ Π±Π΅Π·ΠΎΠΏΠ°ΡΠ½ΠΎΡΡΠΈ ΠΏΡΠΈΠΌΠ΅Π½Π΅Π½ΠΈΡ ΠΏΡΠ΅ΠΏΠ°ΡΠ°ΡΠ° ΡΡΡΠ΅ΠΊΠΈΠ½ΡΠΌΠ°Π± Π² Π»Π΅ΡΠ΅Π½ΠΈΠΈ ΡΡΠΆΠ΅Π»ΡΡ
ΡΠΎΡΠΌ ΠΏΡΠΎΡΠΈΠ°Π·Π° Ρ Π΄Π΅ΡΠ΅ΠΉ ΡΡΠ°ΡΡΠ΅ 12 Π»Π΅Ρ. ΠΠ°ΡΠ΅ΡΠΈΠ°Π»Ρ ΠΈ ΠΌΠ΅ΡΠΎΠ΄Ρ. Π Π½Π°Π±Π»ΡΠ΄Π΅Π½ΠΈΠ΅ Π²ΠΊΠ»ΡΡΠ΅Π½Ρ 10 Π΄Π΅ΡΠ΅ΠΉ, ΡΡΠ΅Π΄Π½ΠΈΠΉ Π²ΠΎΠ·ΡΠ°ΡΡ ΠΊΠΎΡΠΎΡΡΡ
ΡΠΎΡΡΠ°Π²ΠΈΠ» 15Β±2,8 Π³ΠΎΠ΄Π°, ΠΈΠ½Π΄Π΅ΠΊΡ PASI β 39,3Β±9,5, ΠΏΠΎΠ»ΡΡΠ°Π²ΡΠΈΡ
ΡΡΡΠ΅ΠΊΠΈΠ½ΡΠΌΠ°Π± Π² Π΄ΠΎΠ·Π΅ 45 ΠΌΠ³ ΠΏΠΎ ΡΡΠ°Π½Π΄Π°ΡΡΠ½ΠΎΠΉ ΡΡ
Π΅ΠΌΠ΅ Π²Π²Π΅Π΄Π΅Π½ΠΈΡ ΠΏΡΠ΅ΠΏΠ°ΡΠ°ΡΠ°. Π Π΅Π·ΡΠ»ΡΡΠ°ΡΡ. Π’Π΅ΡΠ°ΠΏΠ΅Π²ΡΠΈΡΠ΅ΡΠΊΠΈΠΉ ΡΡΡΠ΅ΠΊΡ Π±ΡΠ» ΠΎΡΠ΅Π½Π΅Π½ Ρ ΠΏΠΎΠΌΠΎΡΡΡ ΠΈΠ½Π΄Π΅ΠΊΡΠ° PASI, ΡΠ½ΠΈΠΆΠ΅Π½ΠΈΠ΅ ΠΊΠΎΡΠΎΡΠΎΠ³ΠΎ Π½Π° 75% Π½Π°Π±Π»ΡΠ΄Π°Π»ΠΎΡΡ Ρ 6 ΠΏΠΎΠ΄ΡΠΎΡΡΠΊΠΎΠ², Π½Π° 90% Ρ 4 ΠΏΠΎΠ΄ΡΠΎΡΡΠΊΠΎΠ² ΡΠΆΠ΅ ΠΊ 14-ΠΉ Π½Π΅Π΄Π΅Π»Π΅ ΡΠ΅ΡΠ°ΠΏΠΈΠΈ. ΠΠ°ΡΠ°ΠΌΠ½Π΅ΡΡΠΈΡΠ΅ΡΠΊΠΎΠ΅ Π½Π°Π±Π»ΡΠ΄Π΅Π½ΠΈΠ΅ ΠΏΠΎΠΊΠ°Π·Π°Π»ΠΎ, ΡΡΠΎ ΠΏΠΎΠ»Π½ΠΎΠ΅ ΡΠ°Π·ΡΠ΅ΡΠ΅Π½ΠΈΠ΅ ΠΊΠΎΠΆΠ½ΠΎΠ³ΠΎ ΠΏΠ°ΡΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ ΠΏΡΠΎΡΠ΅ΡΡΠ° Π½Π°ΡΡΡΠΏΠΈΠ»ΠΎ Ρ 80% ΠΏΠΎΠ΄ΡΠΎΡΡΠΊΠΎΠ² ΠΏΠΎΡΠ»Π΅ 3 ΠΈΠ½ΡΠ΅ΠΊΡΠΈΠΉ ΡΡΡΠ΅ΠΊΠΈΠ½ΡΠΌΠ°Π±Π° ΠΈ Ρ 100% ΠΏΠΎΡΠ»Π΅ 4 ΠΈΠ½ΡΠ΅ΠΊΡΠΈΠΉ. ΠΠ°ΠΊΠ»ΡΡΠ΅Π½ΠΈΠ΅. ΠΡΠ΅ΠΏΠ°ΡΠ°Ρ ΡΡΡΠ΅ΠΊΠΈΠ½ΡΠΌΠ°Π± ΡΠ²Π»ΡΠ΅ΡΡΡ ΡΡΡΠ΅ΠΊΡΠΈΠ²Π½ΡΠΌ ΠΈ Π±Π΅Π·ΠΎΠΏΠ°ΡΠ½ΡΠΌ Π΄Π»Ρ Π»Π΅ΡΠ΅Π½ΠΈΡ ΠΏΡΠΎΡΠΈΠ°Π·Π° Ρ Π΄Π΅ΡΠ΅ΠΉ. ΠΠΏΠΈΡΠ°ΡΡΡ Π½Π° ΠΈΠ½Π΄Π΅ΠΊΡ PASI ΠΊΠ°ΠΊ Π½Π° Π³Π»Π°Π²Π½ΡΠΉ ΠΊΡΠΈΡΠ΅ΡΠΈΠΉ ΠΎΡΠ΅Π½ΠΊΠΈ ΡΡΡΠ΅ΠΊΡΠΈΠ²Π½ΠΎΡΡΠΈ Π»Π΅ΡΠ΅Π½ΠΈΡ, ΡΡΡΠ΅ΠΊΠΈΠ½ΡΠΌΠ°Π± (Π‘ΡΠ΅Π»Π°ΡΠ°) ΡΠ²Π»ΡΠ΅ΡΡΡ ΠΏΡΠ΅ΠΏΠ°ΡΠ°ΡΠΎΠΌ Π²ΡΠ±ΠΎΡΠ° Π² ΡΠ΅ΡΠ°ΠΏΠΈΠΈ ΡΡΠΆΠ΅Π»ΡΡ
ΡΠΎΡΠΌ Π·Π°Π±ΠΎΠ»Π΅Π²Π°Π½ΠΈΡ Ρ Π΄Π΅ΡΠ΅ΠΉ Ρ 12-Π»Π΅ΡΠ½Π΅Π³ΠΎ Π²ΠΎΠ·ΡΠ°ΡΡΠ°
ΠΠ ΠΠΠΠΠΠ« ΠΠΠ’Π‘ΠΠΠ ΠΠΠΠΠΠΠΠΠΠ‘Π’Π Π Π‘ΠΠΠ ΠΠΠΠΠΠΠ Π ΠΠ‘Π‘ΠΠ
Β Creation of system of early prophylaxis of children disability and support of the families bringing up disabled children and children with limited opportunities are among the main priorities of the Russian Federation state social policy. There are a number of problems requiring immediate solutions. Dynamics of childrenβs disability in our country is characterized by process stagnation. The age and gender structure of childrenβs disability practically doesnβt change. The analysis of its nosological structure shows that alienations and disorders of behavior, illness of a nervous system and congenital anomalies of development steadily occupy more than 60% among the illnesses which caused disability of children of all age groups. There was a decrease in the prevalence of total disability in most classes of diseases, such as injuries, diseases of the genitourinary system, respiratory system, musculoskeletal system, digestive system and growth of disability caused by neoplasms and diseases of the endocrine system. The underestimation of childrenβs disability bound to various reasons is supposed: social motivation of a family, complexity of legal veneering, strict requirements of service of medico-social examination, insufficient medical experts awareness on criteria of disability. Among disability formations risk factors the most discussed are the achievements of perinatology leading to improvement of nursing of prematurely born and small newborns, and wide uses of auxiliary genesial technologies. An important part of all preventive measures aimed at reducing the genetic load of population is prenatal and preimplantation diagnosis. It seems appropriate to extend the screening to congenital and hereditary metabolic diseases in neonatal period, including the most common nosological forms of infrequent illnesses. In solving problems of childhood disability prevention a priority should be given to development of services of family planning; improving antenatal and perinatal care; preventive work with healthy but having deviations in development children; development of medical genetic services; implementation of programs of different types of pathology screening.Π‘ΠΎΠ·Π΄Π°Π½ΠΈΠ΅ ΡΠΈΡΡΠ΅ΠΌΡ ΡΠ°Π½Π½Π΅ΠΉ ΠΏΡΠΎΡΠΈΠ»Π°ΠΊΡΠΈΠΊΠΈ ΠΈΠ½Π²Π°Π»ΠΈΠ΄Π½ΠΎΡΡΠΈ Ρ Π΄Π΅ΡΠ΅ΠΉ ΠΈ ΠΏΠΎΠ΄Π΄Π΅ΡΠΆΠΊΠ° ΡΠ΅ΠΌΠ΅ΠΉ, Π²ΠΎΡΠΏΠΈΡΡΠ²Π°ΡΡΠΈΡ
Π΄Π΅ΡΠ΅ΠΉ-ΠΈΠ½Π²Π°Π»ΠΈΠ΄ΠΎΠ² ΠΈ Π΄Π΅ΡΠ΅ΠΉ Ρ ΠΎΠ³ΡΠ°Π½ΠΈΡΠ΅Π½Π½ΡΠΌΠΈ Π²ΠΎΠ·ΠΌΠΎΠΆΠ½ΠΎΡΡΡΠΌΠΈ Π·Π΄ΠΎΡΠΎΠ²ΡΡ, Π²Ρ
ΠΎΠ΄ΡΡ Π² ΡΠΈΡΠ»ΠΎ ΠΎΡΠ½ΠΎΠ²Π½ΡΡ
ΠΏΡΠΈΠΎΡΠΈΡΠ΅ΡΠΎΠ² Π³ΠΎΡΡΠ΄Π°ΡΡΡΠ²Π΅Π½Π½ΠΎΠΉ ΡΠΎΡΠΈΠ°Π»ΡΠ½ΠΎΠΉ ΠΏΠΎΠ»ΠΈΡΠΈΠΊΠΈ Π ΠΎΡΡΠΈΠΉΡΠΊΠΎΠΉ Π€Π΅Π΄Π΅ΡΠ°ΡΠΈΠΈ. Π‘ΡΡΠ΅ΡΡΠ²ΡΠ΅Ρ ΡΡΠ΄ ΠΏΡΠΎΠ±Π»Π΅ΠΌ, ΡΡΠ΅Π±ΡΡΡΠΈΡ
Π½Π΅Π·Π°ΠΌΠ΅Π΄Π»ΠΈΡΠ΅Π»ΡΠ½ΠΎΠ³ΠΎ ΡΠ΅ΡΠ΅Π½ΠΈΡ. Π£ΡΠΎΠ²Π΅Π½Ρ Π΄Π΅ΡΡΠΊΠΎΠΉ ΠΈΠ½Π²Π°Π»ΠΈΠ΄Π½ΠΎΡΡΠΈ Π² Π½Π°ΡΠ΅ΠΉ ΡΡΡΠ°Π½Π΅ Ρ
Π°ΡΠ°ΠΊΡΠ΅ΡΠΈΠ·ΡΠ΅ΡΡΡ ΡΡΠ°Π³Π½Π°ΡΠΈΠ΅ΠΉ ΠΏΡΠΎΡΠ΅ΡΡΠ°. ΠΠΎΠ·ΡΠ°ΡΡΠ½Π°Ρ ΠΈ Π³Π΅Π½Π΄Π΅ΡΠ½Π°Ρ ΡΡΡΡΠΊΡΡΡΠ° Π΄Π΅ΡΡΠΊΠΎΠΉ ΠΈΠ½Π²Π°Π»ΠΈΠ΄Π½ΠΎΡΡΠΈ ΠΏΡΠ°ΠΊΡΠΈΡΠ΅ΡΠΊΠΈ Π½Π΅ ΠΌΠ΅Π½ΡΠ΅ΡΡΡ. ΠΠ½Π°Π»ΠΈΠ· Π΅Π΅ Π½ΠΎΠ·ΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΎΠΉ ΡΡΡΡΠΊΡΡΡΡ ΠΏΠΎΠΊΠ°Π·ΡΠ²Π°Π΅Ρ, ΡΡΠΎ ΠΏΡΠΈΡ
ΠΈΡΠ΅ΡΠΊΠΈΠ΅ ΡΠ°ΡΡΡΡΠΎΠΉΡΡΠ²Π° ΠΈ ΡΠ°ΡΡΡΡΠΎΠΉΡΡΠ²Π° ΠΏΠΎΠ²Π΅Π΄Π΅Π½ΠΈΡ, Π±ΠΎΠ»Π΅Π·Π½ΠΈ Π½Π΅ΡΠ²Π½ΠΎΠΉ ΡΠΈΡΡΠ΅ΠΌΡ ΠΈ Π²ΡΠΎΠΆΠ΄Π΅Π½Π½ΡΠ΅ Π°Π½ΠΎΠΌΠ°Π»ΠΈΠΈ ΡΠ°Π·Π²ΠΈΡΠΈΡ ΡΡΠ°Π±ΠΈΠ»ΡΠ½ΠΎ ΡΠΎΡΡΠ°Π²Π»ΡΡΡ Π±ΠΎΠ»Π΅Π΅ 60% ΡΡΠ΅Π΄ΠΈ Π±ΠΎΠ»Π΅Π·Π½Π΅ΠΉ, ΠΎΠ±ΡΡΠ»ΠΎΠ²ΠΈΠ²ΡΠΈΡ
ΠΈΠ½Π²Π°Π»ΠΈΠ΄Π½ΠΎΡΡΡ Π΄Π΅ΡΠ΅ΠΉ Π²ΡΠ΅Ρ
Π²ΠΎΠ·ΡΠ°ΡΡΠ½ΡΡ
Π³ΡΡΠΏΠΏ. ΠΡΠΎΠΈΠ·ΠΎΡΠ»ΠΎ ΡΠ½ΠΈΠΆΠ΅Π½ΠΈΠ΅ ΡΠ°ΡΠΏΡΠΎΡΡΡΠ°Π½Π΅Π½Π½ΠΎΡΡΠΈ ΠΎΠ±ΡΠ΅ΠΉ ΠΈΠ½Π²Π°Π»ΠΈΠ΄Π½ΠΎΡΡΠΈ ΠΏΠΎ Π±ΠΎΠ»ΡΡΠΈΠ½ΡΡΠ²Ρ ΠΊΠ»Π°ΡΡΠΎΠ² Π±ΠΎΠ»Π΅Π·Π½Π΅ΠΉ (ΠΏΡΠΈ ΡΡΠ°Π²ΠΌΠ°Ρ
, Π·Π°Π±ΠΎΠ»Π΅Π²Π°Π½ΠΈΡΡ
ΠΌΠΎΡΠ΅ΠΏΠΎΠ»ΠΎΠ²ΠΎΠΉ ΡΠΈΡΡΠ΅ΠΌΡ, ΠΎΡΠ³Π°Π½ΠΎΠ² Π΄ΡΡ
Π°Π½ΠΈΡ, ΠΊΠΎΡΡΠ½ΠΎ-ΠΌΡΡΠ΅ΡΠ½ΠΎΠΉ ΡΠΈΡΡΠ΅ΠΌΡ, ΠΎΡΠ³Π°Π½ΠΎΠ² ΠΏΠΈΡΠ΅Π²Π°ΡΠ΅Π½ΠΈΡ) ΠΈ ΡΠΎΡΡ ΠΈΠ½Π²Π°Π»ΠΈΠ΄Π½ΠΎΡΡΠΈ, ΠΎΠ±ΡΡΠ»ΠΎΠ²Π»Π΅Π½Π½ΠΎΠΉ Π½ΠΎΠ²ΠΎΠΎΠ±ΡΠ°Π·ΠΎΠ²Π°Π½ΠΈΡΠΌΠΈ ΠΈ Π±ΠΎΠ»Π΅Π·Π½ΡΠΌΠΈ ΡΠ½Π΄ΠΎΠΊΡΠΈΠ½Π½ΠΎΠΉ ΡΠΈΡΡΠ΅ΠΌΡ. ΠΡΠ΅Π΄ΠΏΠΎΠ»Π°Π³Π°Π΅ΡΡΡ Π½Π΅Π΄ΠΎΡΡΠ΅Ρ Π΄Π΅ΡΡΠΊΠΎΠΉ ΠΈΠ½Π²Π°Π»ΠΈΠ΄Π½ΠΎΡΡΠΈ, ΡΠ²ΡΠ·Π°Π½Π½ΡΠΉ Ρ ΡΠ°Π·Π»ΠΈΡΠ½ΡΠΌΠΈ ΠΏΡΠΈΡΠΈΠ½Π°ΠΌΠΈ, Π° ΠΈΠΌΠ΅Π½Π½ΠΎ Ρ ΡΠΎΡΠΈΠ°Π»ΡΠ½ΠΎΠΉ ΠΌΠΎΡΠΈΠ²ΠΈΡΠΎΠ²Π°Π½Π½ΠΎΡΡΡΡ ΡΠ΅ΠΌΡΠΈ, ΡΠ»ΠΎΠΆΠ½ΠΎΡΡΡΠΌΠΈ ΡΡΠΈΠ΄ΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ ΠΎΡΠΎΡΠΌΠ»Π΅Π½ΠΈΡ, ΠΆΠ΅ΡΡΠΊΠΈΠΌΠΈ ΡΡΠ΅Π±ΠΎΠ²Π°Π½ΠΈΡΠΌΠΈ ΡΠ»ΡΠΆΠ±Ρ ΠΌΠ΅Π΄ΠΈΠΊΠΎ-ΡΠΎΡΠΈΠ°Π»ΡΠ½ΠΎΠΉ ΡΠΊΡΠΏΠ΅ΡΡΠΈΠ·Ρ, Π½Π΅Π΄ΠΎΡΡΠ°ΡΠΎΡΠ½ΠΎΠΉ ΠΎΡΠ²Π΅Π΄ΠΎΠΌΠ»Π΅Π½Π½ΠΎΡΡΡΡ ΠΎ ΠΊΡΠΈΡΠ΅ΡΠΈΡΡ
ΠΈΠ½Π²Π°Π»ΠΈΠ΄Π½ΠΎΡΡΠΈ ΠΌΠ΅Π΄ΠΈΡΠΈΠ½ΡΠΊΠΈΡ
ΡΠΏΠ΅ΡΠΈΠ°Π»ΠΈΡΡΠΎΠ². Π‘ΡΠ΅Π΄ΠΈ ΡΠ°ΠΊΡΠΎΡΠΎΠ² ΡΠΈΡΠΊΠ° ΡΠΎΡΠΌΠΈΡΠΎΠ²Π°Π½ΠΈΡ ΠΈΠ½Π²Π°Π»ΠΈΠ΄Π½ΠΎΡΡΠΈ Π½Π°ΠΈΠ±ΠΎΠ»Π΅Π΅ ΠΎΠ±ΡΡΠΆΠ΄Π°Π΅ΠΌΡΠΌΠΈ ΡΠ²Π»ΡΡΡΡΡ Π΄ΠΎΡΡΠΈΠΆΠ΅Π½ΠΈΡ ΠΏΠ΅ΡΠΈΠ½Π°ΡΠΎΠ»ΠΎΠ³ΠΈΠΈ, ΠΏΡΠΈΠ²ΠΎΠ΄ΡΡΠΈΠ΅ ΠΊ ΡΠ»ΡΡΡΠ΅Π½ΠΈΡ Π²ΡΡ
Π°ΠΆΠΈΠ²Π°Π½ΠΈΡ Π½Π΅Π΄ΠΎΠ½ΠΎΡΠ΅Π½Π½ΡΡ
ΠΈ ΠΌΠ°Π»ΠΎΠ²Π΅ΡΠ½ΡΡ
Π½ΠΎΠ²ΠΎΡΠΎΠΆΠ΄Π΅Π½Π½ΡΡ
, ΠΈ ΡΠΈΡΠΎΠΊΠΎΠ΅ ΠΏΡΠΈΠΌΠ΅Π½Π΅Π½ΠΈΠ΅ Π²ΡΠΏΠΎΠΌΠΎΠ³Π°ΡΠ΅Π»ΡΠ½ΡΡ
ΡΠ΅ΠΏΡΠΎΠ΄ΡΠΊΡΠΈΠ²Π½ΡΡ
ΡΠ΅Ρ
Π½ΠΎΠ»ΠΎΠ³ΠΈΠΉ. ΠΠ°ΠΆΠ½ΠΎΠΉ ΡΠ°ΡΡΡΡ Π²ΡΠ΅Ρ
ΠΏΡΠΎΡΠΈΠ»Π°ΠΊΡΠΈΡΠ΅ΡΠΊΠΈΡ
ΠΌΠ΅ΡΠΎΠΏΡΠΈΡΡΠΈΠΉ, Π½Π°ΠΏΡΠ°Π²Π»Π΅Π½Π½ΡΡ
Π½Π° ΡΠ½ΠΈΠΆΠ΅Π½ΠΈΠ΅ Π³Π΅Π½Π΅ΡΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ Π³ΡΡΠ·Π° ΠΏΠΎΠΏΡΠ»ΡΡΠΈΠΈ, ΡΠ²Π»ΡΠ΅ΡΡΡ ΠΏΡΠ΅Π½Π°ΡΠ°Π»ΡΠ½Π°Ρ ΠΈ ΠΏΡΠ΅ΠΈΠΌΠΏΠ»Π°Π½ΡΠ°ΡΠΈΠΎΠ½Π½Π°Ρ Π΄ΠΈΠ°Π³Π½ΠΎΡΡΠΈΠΊΠ°. ΠΡΠ΅Π΄ΡΡΠ°Π²Π»ΡΠ΅ΡΡΡ ΡΠ΅Π»Π΅ΡΠΎΠΎΠ±ΡΠ°Π·Π½ΡΠΌ ΡΠ°ΡΡΠΈΡΠ΅Π½ΠΈΠ΅ ΡΠΊΡΠΈΠ½ΠΈΠ½Π³Π° Π½Π° Π²ΡΠΎΠΆΠ΄Π΅Π½Π½ΡΠ΅ ΠΈ Π½Π°ΡΠ»Π΅Π΄ΡΡΠ²Π΅Π½Π½ΡΠ΅ Π±ΠΎΠ»Π΅Π·Π½ΠΈ ΠΎΠ±ΠΌΠ΅Π½Π° Π² Π½Π΅ΠΎΠ½Π°ΡΠ°Π»ΡΠ½ΠΎΠΌ ΠΏΠ΅ΡΠΈΠΎΠ΄Π΅, Π²ΠΊΠ»ΡΡΠ΅Π½ΠΈΠ΅ Π² Π½Π΅Π³ΠΎ Π½Π°ΠΈΠ±ΠΎΠ»Π΅Π΅ ΡΠ°ΡΠΏΡΠΎΡΡΡΠ°Π½Π΅Π½Π½ΡΡ
Π½ΠΎΠ·ΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΈΡ
ΡΠΎΡΠΌ ΡΠ΅Π΄ΠΊΠΈΡ
Π±ΠΎΠ»Π΅Π·Π½Π΅ΠΉ. Π ΡΠ΅ΡΠ΅Π½ΠΈΠΈ ΠΏΡΠΎΠ±Π»Π΅ΠΌ ΠΏΡΠΎΡΠΈΠ»Π°ΠΊΡΠΈΠΊΠΈ Π΄Π΅ΡΡΠΊΠΎΠΉ ΠΈΠ½Π²Π°Π»ΠΈΠ΄Π½ΠΎΡΡΠΈ ΡΠ»Π΅Π΄ΡΠ΅Ρ ΠΎΡΠ΄Π°Π²Π°ΡΡ ΠΏΡΠΈΠΎΡΠΈΡΠ΅Ρ ΡΠ°Π·Π²ΠΈΡΠΈΡ ΡΠ»ΡΠΆΠ± ΠΏΠ»Π°Π½ΠΈΡΠΎΠ²Π°Π½ΠΈΡ Π΄Π΅ΡΠΎΡΠΎΠΆΠ΄Π΅Π½ΠΈΡ, ΡΠΎΠ²Π΅ΡΡΠ΅Π½ΡΡΠ²ΠΎΠ²Π°Π½ΠΈΡ Π°Π½ΡΠ΅Π½Π°ΡΠ°Π»ΡΠ½ΠΎΠΉ ΠΈ ΠΏΠ΅ΡΠΈΠ½Π°ΡΠ°Π»ΡΠ½ΠΎΠΉ ΠΏΠΎΠΌΠΎΡΠΈ, ΠΏΡΠΎΡΠΈΠ»Π°ΠΊΡΠΈΡΠ΅ΡΠΊΠΎΠΉ ΡΠ°Π±ΠΎΡΠ΅ ΡΠΎ Π·Π΄ΠΎΡΠΎΠ²ΡΠΌΠΈ Π΄Π΅ΡΡΠΌΠΈ, Π½ΠΎ ΠΈΠΌΠ΅ΡΡΠΈΠΌΠΈ ΠΎΡΠΊΠ»ΠΎΠ½Π΅Π½ΠΈΡ Π² ΡΠ°Π·Π²ΠΈΡΠΈΠΈ, Π²Π½Π΅Π΄ΡΠ΅Π½ΠΈΡ ΡΠΊΡΠΈΠ½ΠΈΡΡΡΡΠΈΡ
ΠΏΡΠΎΠ³ΡΠ°ΠΌΠΌ Π½Π° ΡΠ°Π·Π½ΡΠ΅ Π²ΠΈΠ΄Ρ ΠΏΠ°ΡΠΎΠ»ΠΎΠ³ΠΈΠΈ, ΡΠ°Π·Π²ΠΈΡΠΈΡ ΠΌΠ΅Π΄ΠΈΠΊΠΎ-Π³Π΅Π½Π΅ΡΠΈΡΠ΅ΡΠΊΠΎΠΉ ΡΠ»ΡΠΆΠ±Ρ
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