Introduction. To date, Рalivizumab is the only approved monoclonal antibody preparation used to prevent the development of respiratory syncytial virus (RSV) infection. The aim of the work is to evaluate the benefits of immunization with Palivizumab in premature infants with bronchopulmonary dysplasia in a day hospital of the Federal Center. Materials and methods. One hundred seven infants of different gestational age at birth were immunized with Palivizumab in the day patient department of hospital-replacing technologies. The preparation was administered to infants at risk for the formation of severe consequences of an RSV infection. Results. Of the 107 children hospitalized in the day hospital, 74 premature babies were diagnosed with bronchopulmonary dysplasia (69%). Before immunization all infants were consulted by pediatrician, pulmonologist, and if necessary, other specialists. Discussion. The length of stay of children in a day hospital ranged from 2 to 3.5 hours on average. Each child stayed with their parents in a separate room. During this time period, the patient received the full range of the services associated with immunization. Conclusion. Thus, immunization with Palivizumab in a day hospital of the Federal Center allows implementing a comprehensive multidisciplinary and individual approach to each infant, without exposing him to an undesirable risk of infection, in compliance with the principle of staged nursing of premature infants for patients with a new form of bronchopulmonary dysplasia who need a long follow-up observation.

A clinical case of early diagnosis of Pentalogy of Cantrell (POC) in a newborn infant is presented. The features of the formation of the defect and its classification are described. A crucial role in verifying the diagnosis was performed by CT scan with intravenous contrast, which revealed a narrowing of the pulmonary artery trunk; located subcutaneously above the umbilical ring, the diverticulum of the left ventricle of the heart, originating from the apical section of the left ventricle and connected to its cavity by a linear isthmus located along the middle line, as well as a local defect of the diaphragm in the anterior section. Taking into account the accumulated experience, it is generally recognized that when establishing this diagnosis in the first trimester, termination of pregnancy is more preferable. Therefore, parents should be notified of a possible adverse outcome in a timely manner. The presented observation reflects the high importance of early diagnosis of congenital forms of combined pathology in children, requiring the use of modern research methods to determine the tactics and conduct timely effective treatment.

The purpose of the work is comprehensive examination of a newborn with cholestasis syndrome to determine congenital hypopituitarism. Materials and methods. The child was hospitalized on the 30th day of his life. At admission, complaints were noted about the ictericity of the skin, low body weight gain, convulsive syndrome (history). Differential diagnosis was carried out between diseases such as: impaired liver function, against the background of the course of the infectious-inflammatory process; diseases of the liver and bile ducts of hereditary nature; congenital malformations of the bile tract; metabolic and hormonal disorders. Results. During the survey, the following deviations from the norm were obtained: in the biochemical analysis there was an increase in the level of transaminases, alkaline phosphatase, total and direct bilirubin, hypoglycemia. When evaluating the hormonal profile, an increase in the level of prolactin, thyroid hormone, a decrease in the level of T4 free, insulin, and a complete absence of cortisol were revealed. Magnetic resonance imaging (MRI) of the brain - a picture of subependymal nodes of gray matter heterotopia, ectopia of the neurophysis. Conclusions. Lowering glucose levels, especially when combined with cholestasis syndrome, may be an early but nonspecific sign of congenital hypopituitarism. Hypoglycemia in newborns occurs as a result of intrauterine insufficiency of somatotropic hormone and cortisol related to contrinsular hormones. Cortisol deficiency also contributes to the development of cholestasis syndrome by reducing the expression of tubule transport proteins that regulate bile secretion into bile tubules. In addition to studying the hormonal profile, a brain MRI is performed to verify the diagnosis. Patients with congenital hypopituitarism are characterized by the detection of characteristic signs: the picture of the “empty” or “partially empty” Turkish saddle, as well as the classic triad of symptoms: hypoplasia/pituitary leg aplasia, neurophysis ectopia, adenohypophysis hypoplasia. This clinical case demonstrates that cholestasis syndrome may lie in the debut of a more severe pathology. At the same time, early diagnosis and adequately selected hormone replacement therapy leads to a rapid cessation of life-threatening conditions and an improvement in the quality of life of the child.

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Introduction. To assess the features of the course of new coronavirus infection over the first month of life. Materials and methods. The article presents four clinical cases of coronavirus infection in newborn children aged 8 to 30 days, treated at the covid centre of the National Medical Research Center for Children’s Health. Results. The incubation period lasted from 2 to 10 days. The clinical picture included prevalence of hyperemic palatine arches, lethargy, impaired sucking, hyperemia of the conjunctiva, sneezing, mucous discharge from the nose, cough of varying severity. In more severe cases, an elevation in body temperature, a change in the auscultatory picture of lungs, abnormalities in the electrocardiogram. In the general blood test, there was noted anaemia, relative and absolute neutropenia, lymphocytosis and monocytosis; enlargement of activated partial thromboplastin time, increasing the level of D-dimer in the coagulogram. Computed tomography of the chest showed focal infiltrative changes in the lung tissue or uneven pneumatisation. Conclusion. Our observations show coronavirus infection in newborns, most often to show a mild and moderate course, which does not require the appointment of antibacterial drugs and hormonal, and anticoagulant therapy without strict indications. According to the recommendations of the World Health Organization, the mother, and baby should remain together throughout the day, regardless of the suspicion or confirmation of a viral infection. To date, there is no conclusive evidence mother-to-child transmission of COVID-19 through breastfeeding is possible, and the benefits of breastfeeding far outweigh the minimal risk of infection. In addition, IgA and IgG to SARS-CoV-2, detected in milk, neutralise the effect of the virus.