Introduction. Functional gastrointestinal disorders (FGID) in infants are a complex of symptoms from the gastrointestinal tract that cannot be explained by structural or biochemical disorders. To alleviate the symptoms of functional disorders, a set of measures is required, first of all, psychological support for the mother and, of course, rational feeding, which includes maintaining breastfeeding, optimizing the nutrition of the nursing mother. Despite the abundance of professional information on this issue, previous studies demonstrate a low level of women’s awareness of nutrition during breastfeeding. The aim of the work is to determine the effectiveness of recommendations on nursing mother’s nutrition in the complex treatment of breastfed children with FGID and allergy to cow’s milk proteins.

Materials and methods. Seventy five mother–child pairs were included in the study. 1–4 months infants exclusively breastfed during the study were divided into two groups: 1 — FGID infants (n = 51) and 2 — infants with suspected cow’s milk allergy (CMA) n = 24. In addition to the comprehensive treatment of the child, mothers of both groups were given recommendations on the nursing woman’s nutrition. Mothers of children from group 2 were assigned a diagnostic dairy-free diet for a period of 1 month.

Results. On the 2nd visit, when analyzing the symptoms of the FGID in group 1, the number of children with symptoms of regurgitation of more than 2 episodes per day decreased by 28% (p < 0.001), crying for more than 3 hours per day — by 52% (p < 0.001). Children of group 2 with a clear positive effect from the diagnostic dairy-free diet therapy of the mother (n = 20) were diagnosed with Allergic and alimentary gastroenteritis and colitis (K52.2 — 10^th revision of ICD-10), the continuation  of the dairy-free diet for the mother and the supervision of an allergist were prescribed. The survey of women showed that all nursing women were interested in nutrition issues during lactation, 92% of the surveyed mothers searched for this information on the Internet. At the same time, only 12% of women considered this information to be sufficient. Evaluating the presented materials on nutrition, the overwhelming majority of respondents replied that they helped them to adjust their diet and expand nutrition, as well as to maintain breastfeeding.

Conclusion. Thus, an integrated approach in the management of FGID infants and gastrointestinal manifestations of food allergies, including the use of nutrition recommendations developed in the National Medical Research Center of Children’s Health for nursing women, allows achieving a positive effect on the side of symptoms both in FGID and CMA patients, and also contributes to the improvement of the psycho-emotional state of a woman and prolonged breastfeeding.

Contribution:
Butskaya T.V., Makarova S.G. — concept and design of the study;
Galitskaya M.G., Bakovich E.A. — collection of material;
Yasakov D.S. — statistical processing of the material;
Butskaya T.V., Galitskaya M.G. — creating a database, writing the text;
Makarova S.G. — writing the text, editing the text.
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: August 08, 2023
Accepted: September 12, 2023
Published: October 31, 2023

Introduction. The issue of the stratification of the perioperative risk has an evolutionary character for pediatric cardiac surgery. Mortality-based comorbidity indices worldwide have had mixed success in adjusting for risk in children. Despite numerous attempts to predict perioperative mortality and complications after cardiac surgery in adults, an objective model for predicting risks in children has not been developed. The purpose of the study: to analyze the frequency and structure of comorbidities and conditions in children with cardiac surgical pathology in order to assess the perioperative risks of complications and implement their own prognostic risk scale.

Materials and methods. A comprehensive analysis of five hundred cardiac surgery patients hospitalized in the Department of Cardiac Surgery for the period of 2017–2023 was carried out, and there was studied the autopsy material of 350 patients with congenital heart defects according to the pathoanatomical bureau. Patients underwent standard research methods: echocardiography, chest X-ray, neurosonography and abdominal ultrasound, clinical and laboratory studies, blood for IUI, for procalcitonin, immunogram, angiocardiography, CT and MRI according to indications, bacteriological studies of smears, plain radiography of the abdominal cavity in the standard positions, trepanobiopsy, and genetic studies according to indications.

Results. A classification of common comorbidities in pediatric cardiac surgery patients is presented and a stratification scale of comorbidity is developed. A high incidence of comorbidity in cardiac surgery patients (70%) and its impact on preoperative and postoperative management, timing of surgery and the development of complications, and financial risks are shown. It is shown that, along with the Aristotle cardiac surgical scale, the surgical risk assessment based on comorbidity developed by us improves the awareness of patients’ parents about the prognosis and risks of heart and vascular surgery.

Conclusion. Evaluation of the role of the coexistence of extracardiac congenital malformations, genetic anomalies and syndromes, metabolic diseases in cardiac surgical patients can significantly affect surgical and therapeutic strategies and outcomes. Early identification of children at high risk of complications and death through the use of different stratification scales can lead to improved treatment outcomes.

Contribution:
Sarsenbayeva G.I. — concept and design of the study, writing the text;
Berdibekov A.B. — collection and processing of the material.
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: July 20, 2023
Accepted: September 12, 2023
Published: October 31, 2023

Introduction. The new coronavirus infection (COVID-19) in children often occurs in a mild, moderate, or asymptomatic. After experiencing COVID-19, some children, as well as adults, had persistent symptoms over more than 12 weeks and could not be explained by alternative diagnoses. These changes are called Post-acute COVID-19 Syndrome (PACS, post-COVID-19 syndrome or post-covid syndrome). Clinical manifestations of post-covid syndrome in children are very diverse, there are combinations of autonomic, psycho-emotional, cognitive and somatic disorders, including disorders of the cardiovascular system.

Aim: analysis of changes in the functional state of the cardiovascular system in children in the post-covid period.

Materials and methods. The study included one hundred thirty one child aged of 5 to 17 years 11 months 29 days (mean age 12 years [9.5; 15]). The observed children were divided into 2 groups: group 1 (main) — children who had a mild new coronavirus infection (n = 76). The comparison group consisted of children who did not have COVID-19, suffered from acute respiratory viral infections of unspecified etiology of a mild course (n = 55). All children were analyzed for medical history, underwent clinical examination, electrocardiographic examination (ECG), echocardiographic examination (ECHO-KG), 24-hour Holter ECG monitoring and 24-hour blood pressure (BP) monitoring.

Results. Children who have had COVID-19 are significantly more often showed sinus tachycardia (p = 0.025), extrasystole (supraventricular, ventricular) (p = 0.046), atrioventricular blockade of the 2^nd degree (p = 0.027) compared with children with ARVI. After undergoing COVID-19, in 19.7% of children an increase in blood pressure was detected, in 15.8% of children there was a significant decrease in blood pressure at night (p = 0.008). In 38.2% of children after COVID-19, there was a decrease in the activity of the parasympathetic division of the nervous system.

Conclusion. Children who have had a new mild coronavirus infection were shown to undergo a clinical examination with a mandatory assessment of blood pressure, heart rate and an ECG 3 and 6 months after the illness.

Contribution:
Isaeva E.P. — concept and design of the study;
Ponkratov D.A., Telesheva I.A., Gur’eva E.V. — collection and processing of the material;
Zaitseva O.V., Lokshina E.E., Krutova A.V., Mukhortykh V.A., Kuznetsova E.V. — writing, editing the text.
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: August 17, 2023
Accepted: September 12, 2023
Published: October 31, 2023

The goal is to assess the state of health in 15–17 years old adolescents and justify the main medical and social directions for its protection.

Materials and methods. An analysis based on the official statistics data in morbidity, disability, and mortality of the adolescent population in the Russian Federation for the period 2012–2022 was carried out.

Results. It has been noted a stagnation of the level of general and primary morbidity in adolescents, in the structure of which the majority were respiratory diseases. Among the general morbidity causes the first places were occupied by diseases of eyes, musculoskeletal system, injuries, poisoning, and other external causes, among the primary morbidity causes are injuries, poisoning and other external causes, diseases of the skin and subcutaneous tissue, eyes. There was a significant reduction in the incidence of socially significant diseases (sexually transmitted infections, mental disorders associated with alcohol consumption, drug addiction, substance abuse, tuberculosis). The prevalence of disability in adolescents significantly exceeds that of the entire child population, and has a steady upward trend. In the structure of the general disability causes the first rank places were occupied by mental disorders and disorders of behaviour, diseases of the nervous, endocrine systems, and congenital anomalies. There is a significant decrease in teenage deaths, but at a pace slower than in the child population as a whole. In the structure of the main causes of mortality in 15–17 years children the vast majority were injuries, poisoning and other external causes, among which cases of damage with uncertain intentions, suicide, road accidents, drowning, and poisoning dominated.

Conclusion. The problem of preserving and promoting the health and life of adolescents requires an integrated approach to its solution within the framework of special federal and regional programs. It is necessary to carry out targeted coordinated actions of federal executive bodies, services of the state and municipal health care system, social protection and education, executive authorities of the subjects of the Federation, local governments, scientific, and public organizations.

Contribution of authors:
Antonova E.V. — concept and design of the study, editing the text;
Terletskaya R.N. — collection and processing of material, statistical processing;
Terletskaya R.N., Vinyarskaya I.V. — writing the text.
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: July 11, 2023
Accepted: September 12, 2023
Published: October 31, 2023

Goal: to study modern socio-psychological factors affecting adolescent health to substantiate the current directions of preventive work.

Materials and methods. A survey of 11-17 years schoolchildren was conducted during 2020–2022. The study included six thousand two hundred fifty three children from eight Federal Districts of the Russian Federation. Study design: a single-center, non-randomized, uncontrolled study.

Results. The study showed interrelated socio-psychological factors that have an adverse impact on the physical, psychological, and social well-being in adolescents to be still widespread: social — low physical activity — 22.6%, lack of managed leisure (clubs, sections) — 26%, traumatism — use of electronic digital devices and the Internet without following hygienic norms — 30%, irrational nutrition (fast food consumption) — 17% and psychological — problematic relations with father/mother — 25/13%, teachers — 12%, peers — 30%, bullying — 21%, cyberbullying — 16%. With age, adolescents show adverse trend in separate socio-psychological factors, such as management of nutrition (consumption of fruits and vegetables), time regulations for the use of gadgets, and trustful relationships with loved ones.

Conclusion. As priority measures to improve the situation, we consider necessary the introduction of monitoring of socio-psychological factors affecting the health in adolescents in annual preventive medical examinations, optimization of measures to promote healthy lifestyles, improvement of interdepartmental cooperation in working with adolescents, increasing the responsibility of parents regarding the preservation of health.

Contribution:
Lazurenko S.B., Fisenko A.P., Khitruk V.V. — concept and design of the study;
Sviridova T.V., Komarova O.V. — collection and processing of material;
Konova S.R., Sviridova T.V. — statistical processing;
Konova S.R., Svi­ridova T.V. — writing the text;
Lazurenko S.B., Konova S.R. — editing the text.
All co-authors — approval of the final version of the article, responsibility for the integrity of all parts of the article.

Acknowledgement. The study had no sponsor support. Performed within the framework of the State Assignment № 075-00693-23-00 dated 27.12.2022 FGBU “Russian Academy of Education”.

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

Received: August 31, 2023
Accepted: September 12, 2023
Published: October 31, 2023

Introduction. The quality of life reflects a personal health state and its ability to live a normal and fulfilling life.

Study purpose: the quality of life (QoL) determination in teenagers studying in closed general educational institutions in Barnaul.

Materials and methods. The study included one hundred sixty eight teenagers studying in closed general educational institutions in the city of Barnaul. The quality of life indicators were estimated using a valid, randomized Pediatric Quality of Life Questionnaire PEDsQL™4.0, for children aged up 13 to 18 years. There were obtained such 5 QoL indicators as physical, emotional, social and school functioning and psychosocial health.

Results. The analysis of the results of QoL indicators by teenagers revealed that the generalized QoL indicator in the general group of children was equal to 77.71 scores. The highest score was obtained for the indicator of physical functioning — 88.29 scores. The social functioning scale took the next place in terms of total scores — 83.57. The lowest scores on scales related to QoL were noted in emotional functioning — 67.73 scores and school environment — 70.47 scores. Based on the results it was possible to establish that the lowest scores were obtained on the scales of emotional and school functioning, which compared with the total score, shows a lower integrated indicator of psychosocial health and is equal to 73.81 scores.

Conclusion. To prevent undesirable consequences for the health of adolescents with low QoL indicators, a protective and developmental regime should be recommended and, if necessary, dispensary supervision of a pediatrician with additional involvement of doctors of narrow specialties on an individual basis.

Contribution:
Strozenko L.A. — concept;
Ponomarev V.S. — design of the study;
Sanina O.O. — collection and processing of material;
Lobanov Yu.F., Skudarnov E.V. — editing the text;
Dorokhov N.A. — writing text.
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: July 26, 2023
Accepted: September 12, 2023
Published: October 31, 2023

Introduction. The presented review revealed pronounced trends in the increase in the number of disabled children in the world, including those with autism spectrum disorders (ASD). The considered features of the psychological status in ASD children are characterized by difficulties in socialization and communication, reduced ability to establish emotional connections; impaired speech development, perception, motor skills, memory, low concentration of attention. The peculiarities of the interaction of ASD children and adolescents determine the difficulties of their adaptation in the conditions of inclusive education in schools, colleges and universities. The necessity of a comprehensive system of support for children and adolescents by tutors, social educators, as well as providing special training for teachers working with ASD children and adolescents is substantiated. Attention is paid to the issues of occupational orientation in ASD persons. The use of distance learning, which should be an auxiliary method so as not to interfere with the adaptation of ASD persons in the team, is considered.

Contribution:
Shubochkina E.I., Khramtsov P.I. — research concept and design of the study;
Chekalova S.A., Shubochkina E.I. — collection and processing of material, writing, editing the text.
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: August 24, 2023
Accepted: September 12, 2023
Published: October 31, 2023

A systematic review of data on the interrelationship between the gut microbiota and autism spectrum disorder (ASD) in children is presented. The search was conducted in Pubmed, Google Academic, and Web of Science databases for the keywords: autism, autism spectrum disorder, gut microbiota. Articles published between January 2000 and August 2023 were reviewed, and preference was given to data obtained in recent years. It was found that 40% of ASD children have various forms and severity of manifestations of gastrointestinal dysfunction (constipation, diarrhea, chronic abdominal pain, etc.), which accompany psychopathological symptoms and correlate with the severity of ASD. Disorders of the intestinal microbiota are detected in more than 80% of cases of ASD in children. At the same time, it was found that representatives of the fila Firmicutes, Bacteroidetes and Proteobacteria are the most common in the intestinal microbiota in ASD children, although their qualitative and quantitative ratios in ASD differ. In patients with ASD, a decrease in the content of representatives of the phylum Firmicutes and a relatively high prevalence of Bacteroidetes producing short-chain fatty acids were revealed, due to this, they can influence the central nervous system and behaviour in autism. Differences in the biodiversity of the intestinal microbiota in ASD are determined by heterogeneity of demographic and geographical characteristics, differences in diet, concomitant forms of pathology, severity of behavioural and gastrointestinal symptoms, different methods of analysis and treatment. Modification of the intestinal microbiome by fecal microbiota transplantation is potentially the most promising way to improve gastrointestinal and behavioural symptoms in ASD children.

Contribution:
Smirnova G.I. — concept and design of the work;
Mulenkova A.V., Susloparova P.S. — collection and processing of the material;
Smirnova G.I., Mulenkova A.V., Susloparova P.S. — writing the text;
Korsunsky A.A. — editing the text.
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: August 23, 2023
Accepted: September 12, 2023
Published: October 31, 2023

Introduction. Cow’s milk and dairy products are important sources of high-quality animal proteins, calcium, vitamins, and minerals. They are widely used in the diet of preschool and school-age children and contribute to the normal development and resilience of children against the effects of adverse external factors. However, cow’s milk can cause serious allergic reactions in children, even leading to anaphylaxis. Allergy to cow’s milk proteins is one of the common allergic reactions among preschool-age children. Through conducted research, patterns of the natural course of milk allergy over time have been established. In most cases, by the age of 5 years, children develop tolerance to cow’s milk proteins. However, some school-age children may retain heightened sensitivity to them. Sustaining such prolonged milk allergy in a school-age child requires identifying the cause and conducting in-depth examinations for each specific patient. In such cases, valuable information about elevated sensitivity to whole cow’s milk protein and its components is provided by molecular (component-based) diagnostics. This enables the identification of causally significant components (α-lactalbumin, β-lactoglobulin, bovine serum albumin) of milk protein for the purpose of rational diet therapy, considering cross-reactions with beef meat. The presented article summarizes and systematizes literary and proprietary data on allergy to cow’s milk proteins and its components, as well as to beef meat. Understanding the characteristics of allergy to cow’s milk proteins and its components, cross-reacting with beef, will help avoid serious consequences of irrational elimination diets.

Contribution:
Revyakina V.A. — research concept and design of the study, writing the text;
Larkova I.A., Mukhortykh V.A., Kuvshinova E.D. — collection and processing of material;
Mukhortykh V.A., Larkova I.A. — editing the text.
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: August 10, 2023
Accepted: September 12, 2023
Published: October 31, 2023

Sexually transmitted infections (STIs), remained relevant to this day, are a huge problem for the global health system. The most common bacterial causative agents of STIs are Chlamydia trachomatis and Neisseria gonorrhoeae, which cause numerous urogenital symptoms and can also affect the organs of the female reproductive system, and the course of pregnancy. The group of viral STIs includes a large number of pathogens, among which the hepatitis B virus is of particular interest. The greatest problem in relation to STIs is the antibiotic resistance of pathogens, which greatly complicates the treatment of patients. The ability to solve this problem lies in the creation of fast and accurate methods for diagnosing STI pathogens. An important role in the struggle against STIs can be played by sexual education of adolescents, giving them an idea of the risks and consequences that sexual contact can lead to.

The search for works for inclusion in this review was carried out using the PubMed, Scopus, Google Scholar databases. The keywords used in the search were “Chlamydia trachomatis”, “Neisseria gonorrhoeae”, “hepatitis B”, “reproductive outcomes” and “sex education”.

The search input identified four hundred fifty three reports. During the review of abstracts and full texts of papers, 58 reports were selected, among which there were 5 systematic reviews and 18 clinical studies.

Both chlamydial infection and gonorrhea are associated with the development of infertility, where the tubal factor plays a key role, and pregnancy complications. The use of rapid tests, which provide fast and accurate results in the diagnosis of STIs, shortens the period from the patient’s admission to the appointment of the correct treatment regimen, which speeds up the recovery process for patients. Data on hepatitis B are mixed, but it is associated with numerous complications of pregnancy, while no association with infertility was observed. Sex education can reduce the number of STIs and unwanted pregnancies, which has a positive effect on the physical and emotional state of adolescents.

Contribution:
Adamyan L.V., Sibirskaya E.V. — concept and design of the study;
Sharkov S.M. — editing the text;
Pivazyan L.G., Shapovalenko R.A., Zakaryan A.A. — collection and processing of material, writing the text, editing the text.
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: August 14, 2023
Accepted: September 12, 2023
Published: October 31, 2023

Simultaneous development of atrioventricular (AV) blockade and Wolf–Parkinson–White syndrome (WPW) are described extremely rarely and mainly in adults. A few observations have shown the appearance of A-B blockade against the background of the already existing permanent form of premature ventricular excitation (WPW). We have described a case of simultaneous primary development of the WPW phenomenon and complete A-B blockade in a child with severe systemic disease after undergoing COVID-19.

Contribution:
Kozhevnikova O.V. — concept and design of the work;
Blazhievskaya T.O., Akhmedova E.E., Rodionova A.M. — collection and processing of the material;
Kozhevnikova O.V., Abashidze E.A. — writing the text;
Alekseeva E.I. — editing the text.
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: August 29, 2023
Accepted: September 12, 2023
Published: October 31, 2023