Introduction. Patients with cerebral palsy (CP) are especially vulnerable to the development of osteopenia. Skeletal deformities caused by immobility (prolonged bed rest, limited exercise, immobilization), antiepileptic drugs, hormonal and genetic factors can lead to significant bone loss. Diagnosis of osteoporosis includes densitometry and the study of biochemical markers to assess the state of bone mineralization at the time of the examination. However, densitometry in patients with cerebral palsy may present certain difficulties.

Purpose is to determine changes in the content of bone tissue metabolism markers in CP patients depending on the severity of movement disorders.

Materials and methods. We examined 32 CP patients aged 2 to 15 years for 3 months who were in rehabilitation in 2019–2021. The patients were divided into 2 groups: 18 children in the main group with motor dysfunctions of level IV–V and 14 children in the  comparisons group — with disorders of I–III levels. All children underwent an analysis of anthropometric parameters using the program “WHO AnthroPlus (2009)”, determination of the blood levels of biochemical markers of bone tissue metabolism: calcium, phosphorus, alkaline phosphatase, osteocalcin, vitamin D, parathyroid hormone, bone resorption marker β-CrossLaps.

Results. The indices of alkaline phosphatase, calcium and phosphorus in the majority of CP patients (88%) were within the reference values. The average concentrations of these compounds did not differ significantly in CP patients in the main group and the comparison group, including between children who received and did not receive antiepileptic drugs. There were no significant differences in 25(OH)D concentrations in patients of these groups. CP patients from the main group were found to be supplemented with vitamin D less frequently than children from the comparison group. Indicators of bone tissue resorption (β-CrossLaps) in patients with cerebral palsy increased significantly more than in patients of the comparison group, which indicates a pronounced loss of bone mass in severe impairment of motor functions. More than half of CP patients have high values of the bone resorption marker β-CrossLaps, which, together with an increase in the level of osteocalcin, indicates active osteoreparation, which is higher in children with severe motor disorders. At the same time, a close correlation (r = 0.596; p < 0.05) between the levels of osteocalcin and β-CrossLaps in patients may indicate activation of bone tissue repair in response to pronounced resorption. However, it should be noted that the determination of biomarkers of bone tissue metabolism in children with cerebral palsy is not indicative in the detection of osteopenia and osteoporosis due to the characteristics of these patients: reduced motor activity, growth retardation and psychophysical development.

Contribution:
Zvonkova N.G., Borovik T.E., Fisenko A.P., Kuzenkova L.M., Semikina E.L. — concept and design of the study;
Maslova N.А., Bushueva T.V., Mavrikidi E.F. — collecting the data;
Chernikov V.V. — statistical treatment;
Maslova N.A., Zvonkova N.G., Borovik T.E. — writing the text;
Maslova N.А. — editing the text.
All co-authors — Approval of the final version of the manu­script, responsibility for integrity.

Acknowledgment. The study had no sponsorship.

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

Received: March 31, 2022
Accepted: April 26, 2022
Published: May 07, 2022

Introduction. Constitutionally exogenous obesity (CEO) belongs to a number of significant medical and social problems of the modern world, assumes epidemic proportions and leads among alimentary-dependent pathology in children.

The aim of the work was to determine changes in indicators of endothelial dysfunction (ED) in children of different age with obesity of various severity.

Materials and methods. One hundred twenty six children aged of 6 to 17 years were comprehensively examined, data on changes in the serum content of ED mediators in CEOs grade 1–3 were presented by quantitative determination of nitric oxide, endothelin-1, leptin, homocysteine, intercellular adhesion molecules and vascular cell adhesion-1, tissue-type plasminogen activator inhibitor antigen, Willebrand factor and his antigen.

Results. The regularities of changes in the concentrations of these compounds in the blood depending on the age of patients and the degree of obesity, which reflect the functional state of the endothelial system and can serve as criteria for the severity of ED requiring adequate and timely correction in children, have been established.

Conclusion. Indicators of endothelial dysfunction can serve as criteria for its severity, their detection will allow optimizing early diagnosis and determining the amount of timely therapy.

Contribution:
Smirnov I.E., Kucherenko A.G. — concept and design of the study;
Kucherenko A.G., Postnikova E.V., Smirnova G.I. — collection of material;
Kucherenko A.G., Smirnov I.E. — statistical processing;
Smirnov I.E. — writing of the text;
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 25, 2022
Accepted: April 26, 2022
Published: May 07, 2022

The aim of the work is to develop a method for predicting the severe course of transient tachypnea in full-term newborns in the delivery room to optimize treatment tactics and improve disease outcomes.

Materials and methods. Retrospective, clinical, observational, cohort study. The analysis included 201 newborns and 51 signs characterizing the history of pregnancy and childbirth, as well as the features of the clinical course of the disease.

Results. As a result of modelling the prognosis of the severity of the course of transient tachypnea newborns (TTNT), 3 variables were identified: the severity of respiratory distress syndrome according to the Downes scale in points, the Apgar score at 1 and 5 minutes in points. The practical solution of the presented method is to predict the risk of hospitalization of TTN patients in the neonatal intensive care unit at the stage of the delivery room with the development of primary respiratory disorders based on clinical data.

Discussion. Making a decision by a neonatologist about the need for early consultation of a TTN patient by a resuscitator is an important point in predicting the course of the disease, and the method we developed is an effective tool with high accuracy (80.9%), sensitivity (82.5%), and specificity (80.3%). The prognosis is carried out directly in the delivery room within a few minutes, it is not traumatic for the newborn, does not require the collection of biological material, expensive reagents or special equipment. We recommend the developed prognostic model to be introduced into the practice of maternity hospitals and perinatal centers to predict the severity of TTN and the risk of hospitalization in the NICU.

Contribution:
Shestak E.V. — the concept and design of the study, the collection and processing of material, writing the text;
Kovtun O.P. — research concept and design, 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 02, 2022
Accepted: April 26, 2022
Published: May 07, 2022

About 80–90% of patients with Noonan syndrome have changes in the cardiovascular system, 30% of which include cardiomyopathy, hypertrophic phenotype in particular. The treatment of cardiomyopathy patients with Noonan syndrome is carried out according to the cli­nical recommendations for the treatment of chronic heart failure (CHF) and cardiomyopathy. Surgical treatment of progressive nature of heart failure with left ventricular outflow tract obstruction and mitral regurgitation can be one of the possible methods. The review presents our experience with septal myectomy (SM) in children suffered from hypertrophic obstructive cardiomyopathy with Noonan syndrome.

Objective. To assess the efficiency of septal myectomy in children suffered from hypertrophic obstructive cardiomyopathy with Noonan syndrome.

Materials and methods. Clinical examination (family history, patient examination), lab tests (NT-proBNP level), echocardiography, electrocardiography, Holter monitoring, Chest X-rays and molecular genetic methods using mass parallel sequencing (NGS) and direct automatic Sanger sequencing. The indications for the SM were determined according to the clinical guidelines for the diagnostic and treatment of hypertrophic cardiomyopathy.

Results. 7 patients out of 48 with Noonan syndrome underwent SM and 1 with Noonan syndrome with multiple lentigo (LEOPARD). Two of them required the removal of obstruction of the outflow tracts of both ventricles, followed by plastic removal of the right ventricle and pulmonary artery valve. Related surgical interventions included aortic (n = 1) and mitral valves (n = 2), permanent pacemaker (n = 1) in the early postoperative period. After a year, all children recorded a decline of NT-proBNP from the average of 16,198 to 3,865 pg/ml, a significant improvement in health, disappearance of shortness of breath, increased physical activity tolerance, improved physical (weight, growth) and speech development. When assessing the dynamics of the Echo parameters 1 year after the SM, normalization of the size of both atria in 4 cases, reduction of severity of isolated dilation of the left atrium in 2 cases was noted. No cases of repeated obstruction have been reported.

Conclusion. Hypertrophic cardiomyopathy (HCM) can be in structure of hereditary syndromes such as Noonan syndrome. Septal myectomy (SM) can now be used in the case of progressive nature of heart failure with left ventricular outflow tract obstruction in children with Noonan syndrome.

Contribution:
Gandaeva L.A., Basargina E.N. — concept and design of the study;
Gandaeva L.A., Basargina E.N., Savostyanov K.V. — collection and processing of material;
Gandaeva L.A. — statistical processing, text writing;
Basargina E.N., Kondakova O.B., Savostyanov K.V. — text editing.
Аll co-authors — аpproval of the final version of the article, responsibility for the integrity of all parts of the article.

Acknowledgement. The study had no financial support.

Conflict of interest. The authors of this article confirmed the lack of financial support and conflict of interest which should be reported.

Received: April 06, 2022
Accepted: April 26, 2022
Published: May 7, 2022

Introduction. Hepatobiliary pathology (HBP) occurs in approximately 30% of patients with inflammatory bowel disease (IBD). However, the features of its course in the pediatric cohort of patients remain insufficiently studied.

Purpose: to study the features of the course of autoimmune forms of HBD in children with IBD.

Materials and methods. A comprehensive clinical, laboratory and instrumental examination was carried out in 84 children with autoimmune forms of HBP in combination with IBD (HBP+IBD), which made up the main group, and 79 patients with isolated forms of IBD included in the comparison group.

Results. The prevalence of autoimmune HBP in IBD children was 10.2%. Primary sclerosing cholangitis (PSC) was diagnosed in 64.3% of cases, which was mainly associated with ulcerative colitis. The incidence of autoimmune hepatitis (AIH) was 8.3%. In the structure of the overlap syndrome, the most frequent combination was AIH+PSC (15.5%). The debut of the disease was manifested by diarrhea, abdominal pain syndrome, cytolysis and cholestasis syndromes, haemicolitis. With HBP+IBD, there was an increase in serum concentrations of alanine (ALT) and aspartate aminotransferases (AST), total protein, γ-glutamyl transferase (GGT), alkaline phosphatase, direct bilirubin and IgG. Approximately with the same frequency in PSC, antibodies to saccharomycetes (ASCA) — 80% and antibodies to the cytoplasm of neutrophils (ANCA) — 75% were detected. In AIH, antinuclear antibodies (ANA) and antibodies to liver and kidney microsomes (anti-LKM1) were detected in 100%. HBP-IBD equally (28.6%) revealed moderate fibrosis and cirrhosis, no fibrosis in 20.6%, moderate fibrosis in 15.9% of cases, mild fibrosis in 6,3%. Cirrhosis of the liver in 55.6% of cases was the outcome of the course of PSC, in 16.7% — AIH, in 27.8% was associated with the course of the overlap syndrome.

Conclusion. Various forms of autoimmune HBP occur in 10.2% of cases, are more often associated with UC, are represented by PSC and AIH, occur in males, at the onset signs are clinically presented by diarrhea, abdominal pain syndrome, cytolysis and cholestasis syndromes, and haemicolitis.

Contribution:
Usoltseva O.V., Surkov A.N., Movsisyan G.B. — research concept and design of the study;
Usoltseva O.V., Movsisyan G.B., Chernikov V.V. — collection and treatment of materials, statistical processing, text writing;
Surkov A.N., Movsisyan G.B. — editing.
Аll co-authors — аpproval of the final version of the article, responsibility for the integrity of all parts of the article.

Informed consent: informed consent was received from the patients` parents for the participation of a study.

Acknowledgment. The study had no sponsorship.

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

Received: April 05, 2022
Accepted: April 26, 2022
Published: May 07, 2022

Aim. To study age-related features of the association of gastroesophageal reflux disease (GERD) with the activity of the inflammatory process in the gastric mucosa (GM) in schoolchildren.

Materials and methods. At the first stage in the Republic of Tuva, we collected data on the presence of gastroenterological complaints in 1535 schoolchildren using a transverse method. At the second stage we performed esophagogastroduodenoscopy with biopsy of the mucous membrane of the antrum and the body of the stomach in two hundred forty six children including 76 cases aged from 7–11 years and 170 patients aged from 12 to 17 years. Morphological assessment of gastritis was carried out according to the Sydney classification after staining biopsy sections with hematoxylin-eosin; diagnostics of Helicobacter pylori — after staining by Giemsa method.

The study was approved by the ethical committee and the consent of the surveyed patients was obtained.

Results. An increase in the prevalence of GERD was found in the older age group of schoolchildren — 15.6% (7–11 years old — 4.7%; p = 0.0001). GERD schoolchildren showed an insignificant tendency with age to an increase in the activity of the inflammatory process in the mucous membrane of the antrum (p = 0.3408) and the body (p = 0.3346) of the stomach. Among infected GERD schoolchildren in both age groups, gastritis with a high degree (II–III degree) of activity was more often detected than in infected schoolchildren without clinical manifestations of GERD (7–11 years old — p = 0.2551; 12–17 years old — p = 0.0536, respectively) and more often than in those uninfected GERD cases (7–11 years old — р = 0.0082; 12–17 years old — р = 0.0002). The association of highly active forms of gastritis in the body of the stomach in infected schoolchildren with manifestations of GERD has not been established.

Conclusion. The presence of GERD in schoolchildren, regardless of age, aggravates the course of the inflammatory process in the antrum. When infected with Helicobacter pylori, GERD and infection in schoolchildren act as factors that mutually aggravate the inflammatory process in the antrum.

Contribution:
Polivanova T.V., Kasparov E.V.  — research concept and design of the study, text editing;
Polivanova T.V., Vshivkov V.A. — collection and processing of material;
Vshivkov V.A. — statistical processing, text editing;
Polivanova T.V. — text writing.
All authors — approval of the final version of the article, responsibility for the integrity of all parts.

Acknowledgment. The study had no sponsorship.

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

Received: March 29, 2022
Accepted: April 26, 2022
Published: May 07, 2022

Introduction. Currently widely adopted benchmarks of normal levels of cystatin in blood and of GFR based on those levels in young children are non-existent.

Objective: to determine the content of cystatin C in the blood and the glomerular filtration rate based on it in young children. 

Materials and methods. Two hundred thirty seven infants aged up 3 years without kidney diseases were examined and divided into subgroups by age, degree of maturity and birth weight. The serum cystatin C was studied by enzyme-immunoassay, GFR was calculated according to Larsson’s formula.

Results. Normal levels of serum cystatin C and GFR levels were determined in young children with Larsson’s formula. The dependency of the serum level of cystatin C and GFR calculated on the basis of the age of the infant was proved. The serum cystatin C level depends on the degree of prematurity and body weight at birth. The level of GFR was not influenced by the degree of prematurity, however, infants born with extremely low body weight exhibited lower GFR levels in comparison to those born with normal body weight.

Conclusion. The obtained serum cystatin C levels are deemed as normal for young children — full-term infants and those with varying degrees of prematurity.

Contribution:
Tsintsadze B.D., Kazakova K.A. — research concept and design of the study;
Tsintsadze B.D., Kazakova K.A., Zhuzhula A.A., Alyabieva N.M. — collection and processing of material;
Chernikov V.V. — statistical processing;
Tsintsadze B.D., Kazakova K.A. — text writing;
Fisenko A.P., Tsygin A.N. — editing.
All authors are responsible for the integrity of all parts of the manuscript and approval of the manuscript final version. 

Acknowledgment. The study had no sponsorship.

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

Received: April 25, 2022
Accepted: April 26, 2022
Published: May 07, 2022

Perinatal stroke (PS), characterized by sudden disappearance or impairment of brain functions, is a socially significant form of pathology that leads to the death and/or disability of children. Depending on the extent of the lesion, the severity of the consequences of a PS varies from a slight lag in learning to lifelong disability and inability to independently take care of yourself. The most common complications are cerebral palsy and epilepsy. Since the possibilities of diagnosis and therapy in the acute period are extremely limited, the efforts of health care providers and scientists are aimed at improving approaches to the rehabilitation of such patients. The authors presented an overview of modern methods of modelling PS in various experimental conditions. It is established that the modelling of PS is continuously being improved, new ways of forming ischemic brain damage are being created, each of which is necessary for the development of new scientific criteria for its early diagnosis and prediction of outcomes in standardized conditions. It is shown that a special place in the diagnosis of ischemic brain damage is occupied by wide-field optical visualization, which allows determining the formation of neural networks and functional maps of the cortex of the developing brain, provides an opportunity to analyze the spatiotemporal activity of neurons in large areas of the cerebral cortex and the processes of restoring cortical functions in the post-traumatic period. With the advent of genetically encoded ion sensor proteins and technologies for obtaining transgenic animal lines that specifically express sensors directly in neurons, opportunities have been created for optical registration of neural activity by analyzing changes in spontaneous activity of calcium signals and other mechanisms, which allows us to study brain neuroplasticity at a new level and create new ways to correct ischemic brain damage.

Contribution:
Surin A.M., Lizunova N.V., Kislukhina E.N. — concept and design;
Kislukhina E.N., Lizunova N.V. — collecting material, writing text;
Surin A.M. — editing.
Аll coauthors — аpproval of the final version of the article, responsibility for the integrity of all parts.

Acknowledgment. The study had no sponsorship.

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

Received: April 12, 2022
Accepted: April 26, 2022
Published: May 07, 2022

Vaccines against the new coronavirus infection (COVID-19 or SARS-CoV-2) have been developed at an unprecedented pace since the beginning of the pandemic. Some of them have received permission for mass production already at the stage of clinical trials. COVID vaccines are now being used on a large scale over the world. In the review article describes the characteristics of used both abroad and in Russia COVID vaccines, differed in structure and mechanism of action. The data of clinical research on their efficiency and safety is presented. In modern conditions of a pandemic of a new coronavirus infection, vaccination was shown to be the most effective method of prevention, which can significantly reduce morbidity and mortality due to coronavirus. There are considered such nuances of coronavirus vaccination, as the need for a booster dose, vaccination of children and adolescents. Rare adverse events are described. However, given the relatively small experience and short duration of the use of coronavirus vaccines, there are many questions concerning vaccination of persons with disorders in the immune system, vaccination of infants, the impact of changes in coronavirus strains on the effectiveness of the vaccines used, and many others. All these issues require further research, which continues all over the world. The authors recommend applying the knowledge about COVID vaccines in daily practice, constantly updating them, which will indirectly help to ensure maximum vaccination coverage of the population against coronavirus, including children and adolescents.

Contribution:
Galitskaya M.G., Makarova S.G. — research concept and design of the study;
Galitskaya M.G. — collection and processing of material and text writing;
Makarova S.G., 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: March 28, 2022
Accepted: April 26, 2022
Published: May 07, 2022