The aim of the study is to establish the prevalence of neuroendocrine hyperplasia of infancy (NEHI) in the structure of chronic lung diseases (CLD) and congenital lung malformations (CLM), clinical and instrumental diagnostics of these diseases in patients hospitalized at the National Medical Research Center for Children’s Health, Moscow over the period from 2012 to 2022.

Materials and methods. Longitudinal non comparative single-center study of fourteen NEHI patients, diagnosed on the basis of 3 out of 4 signs of childhood CHILD-syndrome and the presence of typical CT signs of diseases, CLD and CLM patients. In all NEHI patients, the prevalence of clinical and instrumental signs was determined according to the scale, which includes 10 signs: onset of signs before the age of 12 months, delayed physical development, absence of drumstick symptom, absence of cough and wheezing (apart from episodes of respiratory infections), chest abnormalities, crackles, hypoxemia, tachypnea, retraction.

Results. NEHI is a rare (0.53%) CLD in infants. The clinical scale for the diagnosis of NEHI is of practical importance in the early diagnosis of diseases; its use can reduce the prescription of drugs that are not effective for NEHI.

Contribution:
Simonova O.I., Meshcheryakov V.V. — concept and design of the study;
Krasyukova A.A., Simonov M.V., Babayan A.R., Kustova O.V. — data collection and processing;
Krasyukova A.A., Simonov M.V. — statistical processing of the data;
Simonova O.I., Smirnova G.I. — writing the text;
Simonova O.I., Ovsyannikov D.Yu., Meshcheryakov V.V. — edi­ting.
All co-authors — аpproval of the final version of the article, responsibility for the integrity of all parts of the article.

Acknowledgment. The study had no sponsorship.

Conflict of interest. The authors declare no conflict of interest. 

Received: June 03, 2022
Accepted: June 10, 2022
Published: July 14, 2022

Introduction. Gastroesophageal reflux disease (GERD) is a common disease characterized by the ingestion of stomach contents into the esophagus, causing symptoms and/or complications. According to various authors, the prevalence of signs of erosive esophagitis in GERD children patients, is 10–50%. Further study of the prevalence and clinical manifestations of erosive esophagitis in children is an urgent task.

Purpose: to study the prevalence of erosive esophagitis in schoolchildren with clinical manifestations of dyspepsia.

Materials and methods. We examined five hundred ninety six children patients who underwent primary gastroenterological exa­mination for persistent signs of dyspepsia. The comparison group consisted of 30 children aged to 18 years. All children underwent endoscopic examination using a GIF XP-20 apparatus from Olympus (Japan). Esophagitis was diagnosed according to the Los Angeles classification.

Results. The prevalence of erosive changes in the esophagus in the examined patients was 17.4%. Erosive lesions of the esophagus occurred with equal prevalence in patients of primary and secondary school age. Boys predominate among patients with erosive esophagitis. Erosive esophagitis at the stage A was detected more often — 90.4%, less often at stages B — 7.7% and C — 1.9%, esophagitis in stage D was not detected in any of the cases.

Conclusion. The main clinical manifestations of erosive esophagitis are abdominal pain, heartburn, belching, and nausea. The features of the clinical course depending on the stage of esophagitis were established.

Contributions:
Latyshev D.Yu., Tekutyeva N.A. — concept and design of the study;
Latyshev D.Yu., Prokudina M.P., Martirosyan M.S., Pimenova D.V. — collection and processing of material;
Latyshev D.Yu., Tekutyeva N.A., Prokudina M.P. — statistical processing of the material;
Latyshev D.Yu., Lobanov Yu.F., Martirosyan M.S., Pimenova D.V. — text writing;
Lobanov Yu.F., Mikheeva N.M., Strozenko L.A. — editing.
All co-authors — approval of the final version of the article, responsibility for the integrity of all parts of the article.

Acknowledgment. The work was not supported financially.

Conflict of interests. The authors declare no conflict of interest.

Received: May 26, 2022 
Accepted: June 10, 2022
Published: July 15, 2022

Introduction. The basis of the work was a retrospective analysis of the course of community-acquired pneumonia (CAP) in children with COVID-19. 

Aim. To determine the features of the course of CAP before and during the COVID-19 pandemic in children from birth to 18 years.

Materials and methods. A retrospective analysis of the medical records of ninety five children (n = 95) who were treated at the Speransky Children’s Hospital No. 9 before the pandemic (October–November 2019; n = 45) and during the COVID-19 pandemic (April–May 2020 and October–November 2020; n = 50). All the received data are processed statistically.

Results. It was found that before the COVID-19 pandemic, mainly adolescents aged 13–17 years were ill, during the pandemic younger children (6–12 years old) became ill more often. With the onset of the pandemic, the course of CAP changed significantly: fever, cough, shortness of breath were typical clinical signs; local signs were more pronounced in children during the pandemic: weakened and hard breathing was more often detected. Leukocytosis and accelerated ESR prevailed in patients with CAP before the pandemic. At the same time, CRP was a more sensitive marker of inflammation. It was revealed that with the beginning of the COVID-19 pandemic, the number of atypical pneumonia decreased, which may be due to anti-epidemic measures, but the preva­lence of pneumonia of unknown etiology increased. Decreased oxygen saturation was a more frequent rule in CAP during the pandemic. Lobar pneumonia prevailed in children before the pandemic, and polysegmental pneumonia prevailed in patients during the pandemic. 

Conclusion. The features presented by the authors of the manifestations of community-acquired pneumonia in children before and during the COVID-19 pandemic make it possible to optimize their diagnosis using clinical and laboratory signs.

Contribution:
Savelyeva E.I., Gadetskaya S.G. — research concept and design of the study, collection and processing of material;
Savelyeva E.I. — statistical processing, text writing;
Korsunskiy A.A. — editing.
All co-authors — approval of the final version of the article, responsibility for the integrity of all parts of the article. 

Acknowledgment. The study had no sponsorship.

Conflict of interest. The authors declare no conflict of interest.

Received: May 30, 2022
Accepted: June 10, 2022
Published: July 14, 2022

Aim of the study: to show the possibilities of magnetic resonance imaging for the diagnosis of acute osteomyelitis.

Materials and methods. One hundred thirty two children with hematogenous osteomyelitis (n = 112 — 84.8%), including BCG-osteomyelitis (n = 20 — 15.2%), aged 1 to 17 years, average age — 9.1 ± 4.9 years, were examined between 2011 and 2020. Out of 132 children, 77 were operated on (58.3%). Boys predominated — 70 (53%) patients, girls — 62 (47%). MRI was performed on a Philips Achieva dStream 3.0 T.

Results. Over the first three days after onset of the disease, when radiography and CT did not reveal bone pathological changes, according to MRI acute osteomyelitis was detected in all patients (n = 51). The topical location of osteomyelitis foci was clearly established.

Discussion. MRI is the most informative method for visualizing acute hematogenous osteomyelitis over first days of the disease. MRI clearly shows initial bone remodelling and bone marrow edema, including the such earliest sign as perifocal myositis. The most effective MRI sequences are STIR and T2WI, regardless of the pulse sequence, in which a pronounced hyperintense signal is visualized. Whole body MRI combined with clinical data is considered a promising method for distinguishing inflammatory processes from other specific diseases.

Contribution:
Akhadov T.A., Mitish V.A., Valiullina S.A. — research concept and design of the study;
Melnikov I.A., Bozhko O.V., Nalbandyan R.T., Dmitrenko D.M. — conducting research;
Bozhko O.V., Dmitrenko D.M. — collection and analysis of data;
Ublinskiy M.V., Manzhurtsev A.V. — statistical analysis;
Akhadov T.A. — writing the text;
Melnikov I.A., Ublinskiy M.V. — editing;
Akhadov T.A., Mitish V.A., Valiullina S.A. — approval of the final version of the article;
Akhadov T.A. — responsibility for the integrity of all parts of the article.
All co-authors — approval of the final version of the article, responsibility for the integrity of all parts of the article.

Acknowledgment. The study had no sponsorship.

Conflict of interest. The authors declare no conflict of interest.

Received: June 02, 2022
Accepted:  June 10, 2022
Published: July 14, 2022

The purpose of the study is to determine the trends and causes of in-hospital mortality among the children’s population of the Russian Federation, to establish the relationship of its level with the resource provision of medical care.

Materials and methods. The level and structure of the causes of in-hospital mortality in children’s population of the Russian Federation over 2015–2020 were studied. The interrelation between its level and the resource provision of medical care for children (medical personnel, bed fund) was established.

Results. Against the background of the revealed decrease in the level of in-hospital mortality, unfavourable trends in mortality of children aged 0–17 years from congenital anomalies, diseases of the nervous, endocrine and genitourinary systems were noted. In its structure, the largest share was accounted for by individual conditions of the perinatal period, congenital anomalies and neoplasms. There were similar trends, i.e. gradual decrease, in the trend in in- hospital mortality among children under the age of 1 year of life. However, there was an increase in mortality of children from diseases of the nervous, endocrine systems and neoplasms. In the structure of in-hospital mortality, the largest proportion were individual conditions of the perinatal period, congenital anomalies and diseases of the nervous system. There was an unstable decrease in daily mortality in all age groups. Among those who died on the first day of admission to the hospital, the overwhelming majority were children under 1 year of life. A statistically significant correlation of the level of in-hospital mortality with the provision of medical personnel (pediatricians, and neonatologists) and with the level of their qualifications was revealed. The greatest degree of inverse correlation of hospital mortality was established with the provision of pathology of newborns and premature babies with beds and less (statistically not significant) with pediatric and specialized beds.

Conclusion. The level and structure of pediatric in-hospital mortality should serve as an important criterion in assessing the quality of medical care in inpatient medical institutions and be the basis for the development of differentiated measures to reduce it.

Contribution of authors:
Terletskaya R.N. — concept and design of the study, statistical processing;
Terletskaya R.N., Zelinskaya D.I. — collection and processing of material, writing the text;
Zelinskaya D.I. — editing.
All co-authors — approval of the final version of the article, responsibility for the integrity of all parts of the article.

Acknowledgment. The study had no sponsorship.

Conflict of interest. The authors declare no conflict of interest. 

Received: May 25, 2022
Accepted: June 10, 2022
Published: July 14, 2022

Introduction. The most important area of work of medical and nursing staff is the development of children’s healthcare and the provision of qualified personnel for medical institutions. To care for patients, it is necessary to master increasingly complex medical and technical knowledge and master new skills, and improve those already acquired. High-tech medical care is a complex of medical and diagnostic medical services conducted in the conditions of research centers, one of which is the National Medical Research Center for Children’s Health of the Ministry of Health of Russia (hereinafter the Center), using complex and unique medical technologies with significant resource intensity.

The purpose of the work: to establish the features of the professional activity of the specialists of the nursing link of the medical research center and to determine the ways of further development of nursing care.

Materials and methods. The data of the personnel records of the Center and the data of the Federal Statistical Observation in Russia and Moscow, own data of surveys and questionnaires are analyzed.

Results. 35% of the Center’s nurses were found to have the highest qualification category. The staffing of the Center with nursing staff is 84.5%, which is higher than the average in Russia. Nurses participated in providing care to 37,000 patients of the round-the-clock hospital and providing 860,000 outpatient services. They made presentations at 8 scientific and practical conferences, textbooks and articles were published with the participation of nurses, 6 patents for inventions were obtained, advanced training programs were prepared.

Conclusion. The Medical Research Center is a launching pad for innovative work of nursing staff, continuous improvement of their knowledge and skills. The formation of new motivations is the key to the success of the creative activity of children’s nurses. 

Authors presented ways  to improve the quality of the work of children’s nurses of the research Center that will ensure the expansion of the functions of nursing specialists, allow the development of average medical staff in the profession and fully use their capabilities for the qualified provision of nursing care to children.

Contribution:
Biryukova E.G., Fisenko A.P. — research concept and design of the study;
Biryukova E.G., Borisov I.A. — collection and processing of material;
Biryukova E.G. — statistical processing;
Biryukova E.G., Borisov I.A. — writing the text;
Komarova O.V. — editing.
All co-authors — approval of the final version of the article, responsibility for the integrity of all parts of the article. 

Acknowledgment. The study had no sponsorship.

Conflict of interest. The authors declare no conflict of interest.

Received: June 07, 2022
Accepted:  June 10, 2022
Published: July 14, 2022

Introduction. According to the latest data, about forty-three million children under 5 years of age are overweight worldwide and more than 340 million children and adolescents aged 5 to 19 years are overweight or obese. Health-related quality of life is a promising tool that allows including a subjective description of the condition by the patient himself, along with laboratory, instrumental and other examinations, for a more complete assessment of his clinical status.

Aim. To study the influence of the severity of obesity and individual components of the metabolic syndrome on the indicators of the quality of life in schoolchildren.

Materials and methods. The study included twenty-eight obese children (SDS BMI ≥+2), 17 boys (60.7%), 11 girls (39.3%), mean age 12.2 ± 1.9 years. Obesity Ι degree (SDS BMI 2–2.5) was diagnosed in 13 cases, ΙΙ degree (SDS BMI ≥ 2.6–3.0) — in 7, ΙΙΙ degree (SDS BMI 3.1–3.9) — in 8 children. When establishing the diagnosis of metabolic syndrome, the standard criteria for me­tabolic syndrome in patients over 10 years were used. The comparison group consisted of 30 conditionally healthy children of comparable age. The quality of life was assessed using the Russian version of the Pediatric Quality of Life Inventory — PedsQLTM4.0.

Results. Obese children scored lowest on emotional well-being (62.4; 95% CI 54.5–70.3) and school functioning (61.1; 95% CI 54.6–67.5) in relation to the responses of healthy children (EF — 79.1; 95% CI 77.3–80.8 points; FFS — 85.7; 95% CI 82.7–88.7 points; p < 0.001). A negative correlation was found between the severity of obesity (SDS BMI) and the scale of physical functioning. Arterial hypertension has the most pronounced negative impact on the quality of life, and on indicators of physical and psychosocial functioning. The identified disorders of lipid and carbohydrate metabolism were determined  have no any significant impact on the quality of life parameters.

Conclusion. In obese children, there is a significant decrease in quality of life indicators for all studied parameters (p < 0.001), excluding the indicator of social functioning (p = 0.249). Among the components of the metabolic syndrome, arterial hypertension has a significant negative impact on the indicators of physical and psychosocial functioning.

Contributions:
Latyshev D.Yu. — concept and design of the study, collection and processing of material, writing the text, statistical processing of the material;
Lobanov Yu.F. — text writing, editing;
Tekutyeva N.A. — concept and design of the study, statistical processing of the material;
Strozenko L.A. — statistical processing of the material, editing.
All co-authors — approval of the final version of the article, responsibility for the integrity of all parts of the article.

Acknowledgment. The work was not supported financially.

Conflict of interests. The authors declare no conflict of interest.

Received: May 20, 2022 
Accepted: June 10, 2022 
Published: July 14, 2022

The important role of the micronutrient status of the body for the formation of an adequate immune response, including to respiratory viruses, is currently beyond doubt. In connection with the beginning of the pandemic caused by SARS-CoV-2, numerous publications have appeared on the supposedly protective effect of many micronutrients, especially vitamin D in relation to the prevention of COVID-19 disease. Later, the results of most studies confirmed this assumption. From 2020 to early 2022, there were published 17 analytical reviews and meta-analyses summarizing the results of various studies evaluating both the preventive potential of vitamin D provision in various population groups and the role of vitamin D in reducing the incidence of severe forms of COVID-19 and mortality. The analysis of literature data presented in this review suggests vitamin D currently to have the greatest evidence base as a micronutrient promoting reduction the risk of disease and severe forms of COVID-19. Current recommendations on vitamin D subsidies, including in pediatric practice, are given.

Contribution:
Makarova S.G., Yasakov D.S. — research concept and design of the study;
Pronina I.Yu., Ereshko O.A., Gordeeva I.G., Galimova A.A., Chumbadze T.R., Emelyashenkov E.E., Lebedeva A.M. — collection and processing of material;
Makarova S.G., Yasakov D.S. — text writing;
Fisenko A.P. — editing.
All co-authors — approval of the final version of the article, responsibility for the integrity of all parts of the article.

Acknowledgment. The study had no sponsorship.

Conflict of interest. The authors declare no conflict of interest.

Received: April 15, 2022
Accepted:  June 10, 2022
Published: May 07, 2022

The need to search for new markers of the functional state of the kidneys is increasing due to the gain in the number of extremely premature infants. The review analyzes publications on the possibilities of assessing kidney function using cystatin C and lipocalin in children born prematurely. The constant rate of cystatin C production in all tissues, its elimination through the renal glomerular filter, the absence of secretion in the proximal tubules, as well as independence from many factors, including gender, age, diet, inflammation are ideal conditions for its use as an endogenous biochemical marker of glomerular filtration. Due to biochemical features, the analysis of serum levels of cystatin C was established to be a promising method in the diagnosis of acute renal injury (AKI) in premature infants. For a comprehensive assessment of kidney function in premature infants, simultaneous determination of lipocalin and cystatin C levels in the blood may be important. At the same time, the evaluation of these indicators may have diagnostic significance in predicting the development of chronic kidney disease in children who underwent AKI in infancy. The absence of reference values of lipocalin and cystatin C in premature infants was concluded to hinder the clinical use of their quantitative analysis for a comprehensive assessment of the functional state of the kidneys.

Acknowledgment. The study had no sponsorship.

Conflict of interest. The author has declared that there are no conflicts of interest

Received: May 18, 2022
Accepted: June 10, 2022
Published: July 14, 2022

Introduction. Edwards syndrome is characterized by multiple congenital malformations and peculiar phenotypic signs. The presence of important phenotypic signs, including manifestations of the musculoskeletal system in almost 90% of newborns with this pathology allows improving the chances of early diagnosis of chromosomal diseases, while their absence cannot deny the presence of this disease. A genetic examination is necessary to clarify the diagnosis. The purpose of the description of the clinical case was an atypical course of a previously known disease.

Case description. There is presented a description of a clinical case of a newborn with Edwards syndrome, which was observed from birth. Owing to the introduction into clinical practice of the method of prenatal (ultrasound and biochemical) screening at the time of 16/3 weeks, an increased genetic risk for the development of chromosomal abnormalities and /or congenital malformations in the fetus was revealed according to the age factor of the mother (42 years). Postnatally, the birth of a newborn with a non-classical manifestation of the phenotype of Edwards syndrome caused difficulties in making a diagnosis. The genetic research made it possible to establish trisomy 18, meiotic non-divergence, Edwards syndrome, trisomal form (Q91.0) in the infant during the first month who died at the age of 2 months. Comparison of clinical and pathoanatomical diagnosis allowed presenting the completeness of clinical manifestations of this disease.

The presented clinical example demonstrates the important role of pre- and neonatal screening in the early diagnosis of chromosomal diseases and emphasizes the importance of continuous medication support, including work with parental stress and parental support. An atypical manifestation of a chromosomal disease does not deny its presence and a genetic study is necessary to clarify the diagnosis.

Сontribution:
Kizatova S.T., Medetbekova A.A. — concept and design of the study;
Babulova A.S., Utegenov A.A., Medetbekova A.A. — data collection;
Babulova A.S., Bulegenova D.B. — text writing;
Kizatova S.T. — text editing.
All co-authors — approval of the final version of the article, responsibility for the integrity of all its parts.

Acknowledgment. The study had no sponsorship.

Conflict of interest. The authors declare no conflict of interest.

Received: April 19, 2022
Accepted: June 10, 2022
Published: May 07, 2022