Pain management in the neonataL intensive care unit remains chaLLenging for many cLinicians and in many compLex care circumstances. The authors review generaL pain management principLes and address the use of pain scaLes, non-pharmacoLogic management, and various agents that may be usefuL in generaL neonataL practice, proceduraLLy, or at the end of Life. Chronic pain and neonataL abstinence are aLso noted.

Hypophosphatasia is a rare hereditary progressive metaboLic disease caused by a Low activity of aLkaLine phosphatase. More than 340 known mutations in ALPL gene (aLkaLine phosphatase Liver/bone/kidney-type), which encodes tissue non-specific isoenzyme of aLkaLine phosphatase (tnAF), Lead to hypophosphatasia development. The tnAF enzyme is expressed in aLL tissues; by now, the best known is its activity in provision of bone mineraLization and functioning of the centraL nervous system: vitamin B6 metaboLism, metaboLism of transmitters, and at earLy stages of deveLopment - neuronaL proLiferation, differentiation and migration. Hypophosphatasia cLinicaL picture is characterized by considerabLe variabiLity. The earLier the disease begins, the worse it becomes (usuaLLy). The most severe forms of hypophosphatasia are perinataL and infantiLe, which are characterized by high mortaLity, except for perinataL benign form. In 10% of cases, hypophosphatasia, which debuted prenataLLy, spontaneousLy improves, acquiring Less aggressive course. In the review speciaL aspects of disease state, diagnosis and treatment options of hypophosphatasia perinataL and infantiLe forms are represented.

This articLe reLates to the assessing of the pain syndrome in newborns, in particuLar - who has extremeLy Low body weight. We try to highLight evoLution of pain assessment in preterm neonates. ALso the symptoms and consequences of an inappropriate pain management in a newborn are mentioned. We describe steroid hormones as the pain markers. ALso comparative evaLuation of the muLti-steroid anaLysis vs wideLy-used pain assessment scaLes have been done.

Hospital-acquired infections represent the majority of diseases affecting preterm infants in NICUs. Among multiple strategies that have been designed to reduce infant mortality is the search for safe and effective drugs that target the underlying immaturity of immune system in premature infants. It is known that breast milk reduces the incidence of bacteremia and necrotizing enterocolitis. It is suggested that the breast milk biomolecules modify the intestinal microbiome, protecting the intestinal mucosa and promoting its growth, have a positive effect on the development of local immunity. One of these bioactive molecules, partLy expLaining the properties of breast miLk, is the protein of Lactoferrin (LF). LF protects against pathogens in muLtipLe ways: it sequesters iron essentiaL for bacteriaL growth and prevents forming bacteriaL biofiLms; binds to LipopoLysaccharide on the ceLL surface of Gram negative bacteria, disrupting the bacteriaL ceLL membrane; has immunomoduLatory properties. We anaLyzed internationaL Literature in the databases PubMed, CLinicaLKey, MEDLINE. The purpose of oursearch was the use of Lactoferrin in neonates. In this review, we incLuded reports on randomized, bLind, pLacebo-controLLed triaLs. CurrentLy, the resuLts of bLind randomized pLacebo-controLLed triaLs indicate that suppLementaL Lactoferrin (in combination or without probiotics) reduces the incidence of Late-onset sepsis and necrotizing enterocoLitis (>II stage according to BeLL's cLassification) in premature infants. Its use is safe and does not cause side effects.

In perinataL medicine, despite Large number evaLuation methods of centraL nervous system (CNS) condition in newborns, it is urgent to search for earLy predictors of brain damage. Identification of CNS damage markers aLLows to evaLuate effectiveness of perinataL asphyxia, hypoxic-ischemic encephaLopathy and intraventricuLar hemorrhages various methods of treatment, and to assess risk of neuroLogicaL impairment. To predict hypoxic trauma consequences, a wide biomarker paneL is studied: neuroproteins, caLcium-binding protein, vasoactive substances, oxidative stress markers, infLammatory mediators. It is known that in case of brain damage, an increase of biomarkers concentration in various bioLogicaL fLuids is observed, degree of which correLates to Lesion severity, regardLess of deLivery date. Thus, the aim of this review is to evaLuate biomarkers roLe in infant brain damage identification and estimation.

A case of non-immune hydropsy in a premature chiLd caused by Treponema paLLidum, with cLinicaL manifestations of congenitaL pneumonia, pLeurisy, meningitis, hepatospLenomegaLy, thrombocytopenia.

This article demonstrates 2 cases of a combination of neonatal alloimmune thrombocytopenia with genetic syndromes (with Edwards syndrome and Turner syndrome). The article presents the principles of diagnosis and treatment of a threatening condition for children in the neonatal period - neonatal alloimmunethrombocytopenia

The first resuLts of a cLinicaL and Laboratory study of the use of an adapted formuLa based on whoLe goat miLk (Dairy Goat Co-operative Ltd, HamiLton, New ZeaLand) with newLy born babies and babies up to 3 months of age, incLuding babies with fuLL-term Low birth weight for their gestationaL age. Good toLerabiLity of the formuLa was reveaLed when it was used as the main food. The tested formuLa mixture forms an adequate nutritionaL status, providing stabLe weight gain in cases of moderate weight deficit at birth and postnataL hypotrophy, and has a positive effect in cases of infant functionaL eating disorders in the form of fLatuLence and regurgitation.

Neonatal hyperammonemiais a pathological condition often leading to severe neurological disorders without treatment. It can be caused by different disorders, but most often inborn errors of metabolism. Neonatal hyperammonemia may also have a transient state, especially in preterm infants. Initial nonspecific symptoms of hyperammonemia may mimic sepsis.