The aim of the investigation was to estimate the possibilities of using relative body mass index (RBMI) for determining age-and gender-specific aspects of nutritional status in children and adolescents with bronchial asthma (BA) of different severity degrees.Materials and Methods. The study involved 887 children and adolescents with BA of different severities, aged 5-17 years (61-215 months), of them 655 were boys. Their body mass index (BMI) was evaluated based on the Z-score criterion and nutritional status was determined as recommended by the World Health Organization (WHO). To unify nutritional status assessment in patients of different age and gender groups, there was introduced RBMI representing the ratio of the patient's BMI to gender-and age-specific median BMI value presented in the WHO reference data.Results. Nutritional status and its relation to BA were studied in children and adolescents using two parameters: the standard nutritional status indicator based on BMI Z-scores as recommended by WHO, and a new parameter, RBMI, representing the ratio of the patient's BMI to gender-and age-specific median BMI value recommended by WHO. No significant nutritional status differences were found in the studied sample of patients with various degrees of BA severity. There was revealed a tendency to a decrease in the proportion of children with normal body weight and an increase in the proportion of overweight children as BA severity increased, χ 2 =26.82; р=0.08. Conclusion. Using RBMI for assessment of BA patients makes it possible to significantly facilitate clinical data analysis and obtain new data unavailable when standard parameters are applied.Key words: bronchial asthma; nutritional status of children; obesity in asthma; body mass index; relative body mass index.

The global prevalence of tobacco and nicotine-containing product use has now reached epidemic proportions, a problem particularly relevant when it comes to adolescents. Major trends in the prevalence of tobacco use among adolescents include the flattening of gender differences, the decreasing age of initiation of smoking, and the emergence of alternative uses of nicotine-containing products. The main provisions of the book devoted to tobacco use prevention among children and teenagers as the problem of the present time, edited by professors N.A. Geppe, I.M. Osmanov, N.F. Gerasimenko with the participation of a large group of authors, published in 2021 by MedCom-Pro Publishing House are presented in this work. The issues of negative influence of tobacco and nicotine-containing products not only on the somatic state of teenage smokers but also on their psychological status are reflected. Health risks associated with smoking electronic cigarettes and vape cigarettes by adolescents are described, and the correlation between smoking electronic cigarettes by adolescents and the use of other psychoactive substances is noted. As an example of Russian experience of express-prevention of smoking among adolescents the program developed at the Department of Children's Diseases of Sechenov First Moscow State Medical University (Sechenov University) by candidate of medical sciences N.G. Mashukova, candidate of medical sciences, "PARUS" (Teenage Anti-Smoking Russian Universal Training System), gave recommendations on prevention of tobacco smoking in children and teenagers in conditions of real pediatric practice, noted that introduction into practice of anti-smoking programs aimed at development of motivation to quit smoking is the most perspective measure in prevention of tobacco smoking in teenagers today.

Bronchial asthma (BA) is a disease that is one of the most frequent chronic diseases of childhood. Characteristic clinical symptoms of BA are wheezing, cough, difficulty in breathing, shortness of breath and, of course, recurrent episodes of bronchial obstruction. They require mandatory clarification of family and individual allergoanamnesis, assessment of symptoms, differential diagnosis with other diseases that may occur with BA. The Global Initiative for the Treatment and Prevention of Bronchial Asthma (GINA 20202021) preserves and develops the ageappropriate approach to verification of diagnosis and therapy selection, which is supported in the Russian National Program "Bronchial Asthma in Children" and in the Russian clinical guidelines "Bronchial Asthma 2021 When the diagnosis of BA is made, therapy should be started as early as possible. Administration of low-dose inhaled glucocorticosteroids (IGCS) immediately after the diagnosis allows not only to control the inflammatory process, which is the basis of BA, but also to reduce the severity of exacerbations. IGCS are the most effective drugs for children of any age, they ensure control of the disease and reduce the risk of AD exacerbations.

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Study Objective: To find out the cytokine profile in blood serum of children with acute bronchiolitis. Study Design: Comparative study. Materials and Methods. We examined 52 patients aged 1 to 12 months who were hospitalised to Pulmonary Department with acute bronchiolitis and respiratory distress of various severity. All children had interleukins (IL) 4, 6, and 18 in their blood measured. Study Results. Patients demonstrated some trends in changes in their cytokine profile changes depending on respiratory distress severity. We have found direct correlations between high IL-18 levels and respiratory distress (r = 0.86), and between a history of allergies and high IL-4 levels (r = 0.78). Patients with rhinovirus had higher IL-6 values at any respiratory distress severity vs children with rhinosyncytial viral infection, who had higher IL-18 level. Conclusion. Acute bronchiolitis is characterised by a clear pattern of interleukin expression depending on presence of confounding factors impacting the course of disease and respiratory distress severity. Patients with bronchiolitis had marked changes in their cytokine profile depending on respiratory distress severity: increased IL-18 concentration and reduced IL-4 levels. Such changes in interleukin concentrations can be used as markers in forecasting the course of pathological process. Keywords: bronchiolitis, interleukins, respiratory distress.

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