[The mode of evaluation of sensibilization of children to grain herbs under respiratory allergy.]

The sensibilization of patients to allergens of grain herbs is characterized by expressed crossed allergic reactions to pollen of various representatives of the given family. The investigation of antibody response to allergens of grain herbs and also data of epidemiological studies, results of world and national studies permitted to develop and propose a new mode of diagnostic of allergy with evaluation of level of sensibilization of patient and also qualitative detection in blood serum the level of specific immunoglobulins E (IgE) to allergens of grain herbs. The parameter «concentration of IgE to allergens of cocksfoot¼ - IgE(g3) - is a key one for evaluating in blood serum of patients content of IgE to allergens of grain herbs matched to cocksfoot: randall, timothy, Kentucky bluegrass, field brome, meadow foxtail, French ryegrass. To calculate concentration of IgE to allergens of the mentioned grasses detection of IgE(g3) is necessary and sufficient. The elaborated prognostic table permits evaluating degree of ensibilization of patient to various grain herbs and also detecting concentration of IgE expressed in units kE per l without application of additional serological analyses. Therefore, the elaborated technique permits reducing number of «in vitro¼ tests and minimizing number of blood sample of patient and also speeding up receiving of information concerning sensibilization profile of patient.

[The diagnostic detection of sIgE to allergens of trees' pollen by rest-system «Alkor-Bio¼ and Immunocap technique.]

The article presents the results of preliminary analysis of 320 pair results of testing of children with bronchial asthma and/or allergic rhinitis conditioned by tree pollen. The imported and national test-systems ImmunoCAP and Alkor-Bio were applied. The detailed analysis of study results of the mentioned tests demonstrated that detection of levels of allergen-specific IgE in patients using test-systems Alkor-Bio and ImmunoCAP shows high degree of data matching related to a number of tree allergens. The application of national test-system Alkor-Bio can be considered as an alternative to import methods in evaluation of levels of sIgE to allergens of alder tree, birch, hazel, willow, poplar, pine.

[Technologies for Complex Intelligent Clinical Data Analysis].

UNLABELLED: The paper presents the system for intelligent analysis of clinical information. Authors describe methods implemented in the system for clinical information retrieval, intelligent diagnostics of chronic diseases, patient's features importance and for detection of hidden dependencies between features. Results of the experimental evaluation of these methods are also presented. BACKGROUND: Healthcare facilities generate a large flow of both structured and unstructured data which contain important information about patients. Test results are usually retained as structured data but some data is retained in the form of natural language texts (medical history, the results of physical examination, and the results of other examinations, such as ultrasound, ECG or X-ray studies). Many tasks arising in clinical practice can be automated applying methods for intelligent analysis of accumulated structured array and unstructured data that leads to improvement of the healthcare quality. AIMS: the creation of the complex system for intelligent data analysis in the multi-disciplinary pediatric center. MATERIALS AND METHODS: Authors propose methods for information extraction from clinical texts in Russian. The methods are carried out on the basis of deep linguistic analysis. They retrieve terms of diseases, symptoms, areas of the body and drugs. The methods can recognize additional attributes such as "negation" (indicates that the disease is absent), "no patient" (indicates that the disease refers to the patient's family member, but not to the patient), "severity of illness", disease course", "body region to which the disease refers". Authors use a set of hand-drawn templates and various techniques based on machine learning to retrieve information using a medical thesaurus. The extracted information is used to solve the problem of automatic diagnosis of chronic diseases. A machine learning method for classification of patients with similar nosology and the methodfor determining the most informative patients'features are also proposed. RESULTS: Authors have processed anonymized health records from the pediatric center to estimate the proposed methods. The results show the applicability of the information extracted from the texts for solving practical problems. The records ofpatients with allergic, glomerular and rheumatic diseases were used for experimental assessment of the method of automatic diagnostic. Authors have also determined the most appropriate machine learning methods for classification of patients for each group of diseases, as well as the most informative disease signs. It has been found that using additional information extracted from clinical texts, together with structured data helps to improve the quality of diagnosis of chronic diseases. Authors have also obtained pattern combinations of signs of diseases. CONCLUSIONS: The proposed methods have been implemented in the intelligent data processing system for a multidisciplinary pediatric center. The experimental results show the availability of the system to improve the quality of pediatric healthcare.

[Topical issues of food allergy diagnosis in pediatric practice].

Food allergy (FA) in children, especially in infancy, is still a significant public health problem. The severity and prognosis of disease progression associated with FA considerably depends on the correct and early diagnostics of this pathology, as well as on the following management of a child. At the same time delayed elimination diet administration, unreasonable or overlong dietary intervention might have become abuse management of a patient and have a negative impact on the development of a child and reduce the quality of life. The article summarizes the current practical approaches to the diagnosis of FA based on evidence-based medicine and adopted European and Russian national consensus documents, as well as on our own experience of management of patients with this pathology. FA diagnosis in a child usually includes clinical laboratory tests and clarification of clinical and anamnestic data. Unfortunately, it is a fact that preference is given to laboratory methods for diagnosis based on specific IgE determination or skin samples. However, the basis for cause-significant allergen identifying is detecting detailed medical history and clinical picture of a disease which still appears to be the most reliable tool for FA diagnosis.

[Risk management of a patient on the basis of remote health monitoring: current situation and prospects].

Review is dedicated to the problem of remote monitoring of health status. Existing approaches to the organization of an outdoor monitoring of a patient using telemedicine technologies are reviewed and analyzed. A new approach to risk management of a patient which meets the requirements of pediatric hospital is provided.

[About Minimization of Expenses on Allergy Diagnosis in Children: Analysis of Consistency of in Vitro- and in Vivo-Allergic Examinations Results].

UNLABELLED: High morbidity rate of atopic diseases among children, including high importance of grass pollen as a sensitizing agent, determine the relevance ofstudies on diagnostic examination systems for appointment of adequate therapy. The research of the most relevant allergens for patients to excludeof duplicating and uninformative tests became urgent after development of a new type of diagnostic tests that does not require expensive equipment. The objective of this research was to evaluate the results of in vitro- and in vivo-diagnostic examinations of children with various forms of atopic disease caused by pollen of meadow grasses, and to choose the most significant prognostic parameters for the diagnosis. METHODS: 277 children aged 4-16 years with various forms of atopic disease were included in the study. There were performed skin prick tests and determination of IgE-antibodies levels to allergen extracts of cocksfoot (g3), meadow fescue (g4), timothy grass (g6). RESULTS: In the studied group of patients 32-50% of children have antibodies to grass allergens. There was a close correlation of antibody response on the investigated allergens, quantitative coincidence of IgE-antibodies to g3 andg4 allergens levels. IgE (g6) concentration was close to the IgE(g3) and IgE(g4) levels (85.0 ± 21.6%). Analysis of the skin tests results showed that 44% of patients have a positive response to grass allergens, and in vivo-tests results coincide with serologicaltests results, mostly in a qualitative sense. The most significant relationship was noted between in vivo and in vitro-tests in the results of testing the response to meadow fescue pollen. CONCLUSION: Based on these data IgE concentration index to meadow fescue allergens can be used as a prognostic marker to determine the sensitization of patients with different nosology forms of allergy and can help to improve allergic diagnostics.