Aim.The practical guidelines are intended for primary care physicians, general practitioners, paediatricians, gastroenterologists and general internists to advance the treatment and prevention of gastroenterological diseases in adults and children in therapies with probiotics, prebiotics, synbiotics and their enriched functional foods.Key points.Probiotics are live microorganisms that sustain health of the host when supplied in adequate amounts. Prebiotics include human-indigestible but accessible to gut microbiota substances expediting specific changes in the composition and/or activity of gastrointestinal microbiota that favour the host health. The mechanism of probiotic action comprises the quorum resistance maintenance, nutrient substrate metabolism and end metabolite recycling, macroorganism-sustaining substrate production, as well as the mediation of local and adaptive immune responses.The Russian Federation regulates market differently for biologically active food additives (BAFA), medicinal products (drugs) and functional food products (FFP). We overview the probiotic strains regulated in Russia as BAFAs, drugs and FFPs and provide recommendations on the use of these strains in treatment and prevention of gastroenterological diseases in children and adults.Conclusion.The clinical efficacy of probiotics, prebiotics, synbiotics and fortified functional foods depends on the prebiotic and strain properties and is verified in appropriate comparative clinical trials. Not all probiotics registered in Russia as BAFAs, drugs and FFPs have a strain identity, which provides no warranty of the clinical effect expected. The FFP legislation demands improved regulation mechanisms and control for therapeutic efficacy.

Objective of the research: to determine clinical and epidemiological features of the course of the new coronavirus infection (COVID-19) caused by SARS-CoV-2 in children in the Russian Federation (RF). Materials and methods: a retrospective analysis of all confirmed COVID-19 cases in children in the first half of 2020 in the Russian Federation was performed. Information about patients (age, sex, examination date, place of residence, disease severity final diagnosis, etc.) was taken from the database containing the Rospotrebnadzor report form № 970 «Information on cases of infectious diseases in persons with suspected new coronavirus infection» January – June 2020 across the Russian Federation. Research results were processed using the IBM SPSS Statistics 26 program. To assess the differences in nominal indicators (proportions), the Pearson χ2 test was used. The results were considered statistically significant at p0,05). In children, the maximum number of cases is registered in family foci – 75%. Upper respiratory tract infections were diagnosed in 72,1% of patients. The proportion of pneumonia was 1,8%, and 2/3 of children were over 3 years old (p<0,001). In almost 1/3 of patients, the infection course had no clinical manifestations. 18,2% of children at the disease onset had increased body temperature, while only 3,5% of children had hyperthermia above 390 C. Cough was registered in 50,8% of cases. Rhinitis/rhinopharyngitis developed only in every 4th child. Symptoms pathognomonic for COVID-19, such as loss of smell (anosmia) and taste (ageusia), were recorded only in 17% of cases. 41,3% of patients received treatment in a hospital, and among them children under 3 years of age predominated. Conclusion: in children in the RF, the new coronavirus infection COVID-19 is generally favorable.

   Aim: to optimize outcomes of the treatment and prevention of gastrointestinal diseases in adults and children.   Key points. The Methodological Guidelines contain sections on the terminology, classification, mechanisms of action, requirements for sale in the Russian Federation, requirements for proving the efficacy and safety of probiotics, prebiotics, synbiotics and metabiotics, as well as functional foods enriched with them. An overview of relevant data allowing to include these drugs and products in the treatment an d prevention of gastrointestinal diseases in adults and children is presented.   Conclusion. The clinical efficacy of probiotics, prebiotics, synbiotics and metabiotics depends on the specificity and quantity of their components, the dosage form, the regimen and duration of treatment. Products and functional foods with proven efficacy and safety are recommended for the treatment and prevention of gastrointestinal diseases in adults and children.

Humanity has recently encountered an infection caused by a new strain of human coronavirus (SARS-CoV-2). This infection is characterized by a variety of clinical symptoms with lesions not only to the respiratory tract, but also to other organs, lack of causal therapy, and high mortality rate. Wide spread of COVID-19 contributes to the development of this disease in children. Objective. To identify clinical and epidemiological characteristics of new coronavirus infection in children in the Russian Federation (RF). Materials and methods. We performed a retrospective analysis of all confirmed COVID-19 cases among children in the RF between January and June 2020. Information on patients (age, gender, place of residence, reason and date of examination, and clinical form of the disease) was taken from the database containing reports of the Federal Service for Surveillance on Consumer Rights Protection and Human Wellbeing according to from No. 970 ‘Information on cases of infectious diseases in people with suspected coronavirus infection’ for January–June 2020. The results were processed by generally accepted statistical methods with the calculation of the Fisher s-criterion. Differences were considered significant at p 0.05). The majority of hospitalized children were younger than 3 years of age. The proportion of pneumonia among children treated in inpatient departments was 4.4% and two-thirds of them were older than 3 years (p < 0.001). Upper respiratory tract infections were diagnosed in 83% of children. Almost one-fifth of children (18.2%) had hyperthermia at the disease onset, although high-grade fever (>39°С) was detected only in 2.6% of children. Half of the patients (50.8%) had cough. Only one in four children developed rhinitis/rhinopharyngitis. Symptoms that are pathognomonic for COVID-19, such as loss of smell (anosmia) and taste (ageusia), were registered in 17% of cases only. Conclusion. Children with new coronavirus infection usually have mild disease. Key words: children, coronavirus, COVID-19

Objective. To evaluate the efficacy and safety of Ergoferon in children and adults with acute respiratory viral infections (ARVIs). Material and methods. We have analyzed the results of 10 randomized controlled trials involving 1732 patients. The outcome measures included duration of fever, disease severity, frequency of deteriorations, number of adverse events (AEs), and assessment of drug interaction. We have conducted statistical analysis of pooled data and meta-analysis using logistic regression. Results. Patients receiving Ergoferon were 1.5 times more likely to have shorter period of fever than those receiving placebo (ОR = 1.499, р = 0.0002). Patients in the Ergoferon group had milder ARVI and influenza than patients in the placebo group (according to the AUC analysis: 32.83 ± 18.12 vs 36.94 ± 19.08 units in the placebo group, p = 0.0083). The frequency of deterioration in the Ergoferon group was 7 times lower than that in the placebo group (0.6% vs 4.4% of cases). Treatment safety was confirmed by fewer patients having AEs in the experimental group (0.6% vs 10.8%, p = 0.0006.) and no drug interactions. Conclusion. Our findings suggest that Ergoferon significantly reduced duration of fever in patients with ARVI and influenza compared to placebo. Ergoferon alleviated the disease and reduced the incidence of bacterial complications. Moreover, this drug demonstrated good tolerability and compatibility with other drugs. Key words: ARVI, influenza, meta-analysis, ARVI treatment, influenza treatment, Ergoferon

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