An overview of the basic data on the curriculum vitae and creative activity of an outstanding Russian pediatrician, Academician M.Ya. Studenikin is presented. On his initiative, for the first time in the country, specialized departments were established at the Institute of Pediatrics of the USSR Academy of Medical Sciences and there were formed scientific Schools, united by the main goal — to create effective systems of medical rehabilitation for children with various forms of pathology and develop of new prevention methods to ensure the fall in of morbidity and disability in children. In the 1960s, M.Ya. Studenikin contributed to the reform of clinical Pediatrics and the creation of promising scientific directions, thanks to which the Institute of Pediatrics became a multidisciplinary clinical institution. The range of academic interests of Academician M.Ya. Studenikin is very wide. He is the author of more than 300 scientific papers, including 14 monographs and more than 44 chapters in collective manuals. Personal contribution of academician M.Ya. Studenikin’s to pediatric science and practice is determined not only by his monographs, but also foundation of the inventive scientific school: 69 doctoral and 82 PhD theses  were defended under his supervision. In 1996, the Institute of Pediatrics of the Russian Academy of Medical Sciences was named as the leading scientific school of the country by the Grant Council under the President of the Russian Federation, and Academician M.Ya. Studenikin was recognized as the Supervisor of the pediatric scientific school. Time only confirms the contribution to the future made by M.Ya. Studenikin to continue his creative work in various spheres of life of a large scientific team.

Contribution:
Fisenko A.P., Smirnov I.E. — research concept and design of the study, data research and analysis, preparation of publication, editing.

Acknowledgment. The study had no sponsorship.

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

Received: January 17, 2024
Accepted: January 30, 2024
Published: February 28, 2024

Introduction. Autoimmune atrophic gastritis (AAG) is an immune-mediated disease characterized by inflammation and progressive atrophy of the mucous membrane of the fundus and body of the stomach, while the antrum remains intact for the autoimmune process. The pathogenesis of AAG is determined by the development of atrophic, hyperplastic, and metaplastic changes in the mucous membrane of the stomach body, which is a predictor of the development of neuroendocrine tumors type I. However, among pediatricians and gastroenterologists, there is still no proper alertness regarding the diagnosis of AAG. Clinical examples of complex diagnosis of AAG in children using clinical laboratory, endoscopic, and pathohistological methods are presented. To make a diagnosis, attention should be paid to concomitant autoimmune diseases, characteristic endoscopic and pathomorphological signs, as well as clinical and laboratory changes. The analysis of these changes increases the likelihood of a correct diagnosis of AAG, which is an important aspect of cancer prevention.

Contribution:
Tupylenko A.V., Lokhmatov M.M., Alekseeva E.I., Potapov A.S. — concept and design of the study;
Tupylenko A.V., Budkina T.N., Oldakovsky V.I., Korolev G.A., Kulikov K.A., Ilansskaya M.V., Anushenko A.O. — 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: December 20, 2023
Accepted: January 30, 2024
Published: February 28, 2024

Introduction. Studies by foreign authors indicate a decrease in the quality of life in children with chronic abdominal pain within the framework of organic and functional pathology. The aim of the work was to analyze quality of life in children with chronic gastritis, taking into account the psychological characteristics of the patients’ personality.

Materials and methods. The study included 84 patients with chronic gastritis. The average age of the patients was 12.10 ± 2.84 years. The quality of life was assessed using the PedsQL™ 4.0 questionnaire, psycho-emotional characteristics — the HADS and Spielberger–Khanin questionnaires.

Results. All patients are characterized by a significant decrease in the quality of life in general and for each component of the child’s life functioning studied by the questionnaire. A significant difference was revealed at the level of the integral indicator of quality of life (p = 0.023) and within the framework of role functioning (p = 0.035) depended on the intensity of the pain syndrome. In the presence of nausea, the overall quality of life was lower than in its absence (p = 0.008). Quality of life related to physical functioning was lower in children complaining of periodic vomiting (p = 0.002). A high frequency of subclinical and clinically significant depression was revealed (59.5%). Patients with subclinical and clinical significant depression had statistically significantly lower quality of life indicators in terms of emotional (p = 0.014) and social functioning (p = 0.010). A significant prevalence of personal and situational anxiety in children was revealed. A decrease in the quality of life in children was determined within the framework of the general integral indicator with a high degree of situational anxiety (p = 0.038).

Conclusion. The study showed a significant decrease in the quality in life of children with chronic gastritis disease in comparison with healthy children, while the degree of decrease correlated with the presence and severity of depression and both personal and situational anxiety. At present, it is quite difficult to say unambiguously what is primary: the influence of emotional status on the disease and quality of life, or vice versa.

Contribution:
Badyan A.S., Okhrimenko A.A., Dudnikova E.V. — concept and design of the study;
Okhrimenko A.A., Polushkin K.A., Sapronova O.R. — collection and processing of material;
Badyan A.S. — statistical processing;
Badyan A.S., Okhrimenko A.A., Besedina E.A. — writing the text;
Badbyan A.S., Dudnikova E.V. — 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: December 21, 2023
Accepted: January 30, 2024
Published: February 28, 2024

Introduction. Community-acquired pneumonia (CAP) in early childhood continues to cause significant morbidity and remains one of the most common serious infections in childhood. Each region of the Russian Federation exhibits specific manifestations of CAP morbidity. Knowledge of CAP etiology is crucial for planning therapeutic and preventive measures.

Aim. To determine the etiological and immunological features of CAP in early childhood, residing in various climatogeographical zones of the Republic of Dagestan.

Materials and methods. The material includes the results of examination and treatment of CAP 204 young children. living in lowland, foothill and mountain climatogeographical zones of the Republic of Dagestan. The selection criterion was the clinical-radiological diagnosis of CAP, using the classification of clinical forms of bronchopulmonary diseases in children.

Results. The study revealed a rise in the incidence of respiratory organ diseases, including CAP, among children in the Republic of Dagestan (RD) over the past 5 years. Among infants under one year, the CAP rate was twice as high. The prevalence can be attributed to the climatogeographical conditions of children’s living environments. Streptococcal infection was also observed to predominate in the ethnostructure of CAP in early childhood across all climatogeographical zones. Streptococcus pneumoniae (48.1%) was more frequently isolated in all climatogeographical zones, while Staphylococcus aureus (13.3%) dominated in the mid-mountain zone. In mild pneumonia, cellular immunity components, represented by reduced CD3, CD4, CD25, CD71, react primarily. Disease exacerbation leads to depletion of CD8, CD16, CD20. Severe pneumonia triggers the involvement of humoral immunity, leading to changes in clinical blood analysis — leukocytosis and an increase in mature and immature forms of neutrophils. The levels of IL-1, IL-6, IL-8 in blood serum increase depending on the area of inflammation and the CAP severity. In observed children with focal-draining and segmental CAP, their levels significantly increased. For empirical antibacterial therapy of CAP, recommendations include amoxicillin, protected ampicillins, third-generation cephalosporins, macrolides, and vancomycin in mono- or combination therapy.

Conclusion. The conducted research highlights the need for managing ethnological monitoring with antibiotic sensitivity testing of infectious agents causing CAP in children.

Contributions:
Arslanova A.Yu., Aliskandiev A.M. — concept and design of the study, statistical processing of the material;
Arslanova A.Yu., Aliskandieva Z.A., Slutskaya M.D. — collection and processing of the material;
Arslanova A.Yu. — writing the text;
Aliskandiev A.M., Aliskandieva Z.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: December 21, 2023
Accepted: January 30, 2024
Published: February 28, 2024

Introduction. Mutant alleles of genes of folate cycle enzymes can lead to the significant deterioration of its function and varying severity of pathology. Several defects in these genes lead to severe hyperhomocysteinemia, the most common form of which is a deficiency of cystathionine beta-synthase B.

Aim: to establish polymorphic substitutions in the genes of folate cycle enzymes that contribute to the formation of hyperhomocysteinemia in children.

Materials and methods. Two hundred seventy one children aged of 13–18 years were examined. The analysis of genetic polymorphisms of the folate cycle was carried out using a molecular genetic method. Quantitative determination of the blood homocysteine and folic acid level was performed by chemiluminescent immunoassay on microparticles. Statistical data processing was carried out using Statistica 6.1 application programs (StatSoft Inc., USA).

Results. The frequency of the T allele of the MTHFR 677 gene was revealed to be higher in adolescents of the main group compared with the control (p = 0.043). The frequency of the homozygous genotype 66 AA of the MTRR gene in children of the comparison group was significantly higher (p = 0.049), however, the heterozygous genotype 66 AG of the MTRR gene was significantly more often detected in adolescents of the main group (p = 0.008). The average concentrations of homocysteine in children of the main group were 11.6 mmol/L, in adolescents of the control group 9.3 mmol/L (p = 0.021). Hyperhomocysteinemia in children of the main group was detected in 217 (80.1%) adolescents, and in 57 (49.6%) children of the control group (p < 0.001). The baseline serum folate level was determined in the children of the main group. The average amount of vitamin B9 in the blood of children of the main group was 3.7 ng/ml, and in 145 (53.5%) children this indicator was significantly reduced.

Conclusion. Low levels of folic acid contribute to an increase in homocysteine in blood plasma. Taking vitamin B9 and vitamin folate complexes significantly reduces the level of homocysteine in blood plasma (p < 0.001).

Contribution:
Strozenko L.A. — concept, research design;
Ponomarev V.S., Sanina O.O. Sukmanova I.A., Shevchenko K.I. — collection and processing of material;
Lobanov Yu.F., Skudarnov E.V. — editing the text;
Dorokhov N.A. — 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. This work was carried out within the framework of a grant from the Governor of the Altai Territory in the field of medical prevention, rehabilitation and health protection of the population.

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

Received: January 11, 2024
Accepted: January 30, 2024
Published: February 28, 2024

Introduction. Concomitant diseases as a risk factor for surgery remain an urgent problem in pediatric cardiac surgery. The article presents the role of comorbidity in pediatric cardiac surgery. A comparative analysis of the indicators of cardiac surgical treatment of patients with and without extracardiac pathology was carried out. Aim: to determine the significance of extracardiac causes as an additional risk factor in the correction of congenital heart lesions in children.

Materials and methods. Prospective analysis of five hundred patients who had undergone cardiac surgery in the departments of cardiac surgery and interventional cardiology. Patients were divided into a main group of patients with concomitant pathology (n = 350) and a control group (n = 150) without concomitant pathology. A complex of modern therapeutic and diagnostic procedures and a multidisciplinary approach were used.

Results. A high incidence of complications was shown in the main group (70%). Hospital mortality was higher in patients with concomitant pathology and amounted to 17.4%, compared to 3.3% in the group without concomitant pathology. The average duration in the ICU for patients with concomitant pathology was 18 ± 2 bed days, for patients without concomitant pathology — 4 ± 2 bed days.

Conclusion. The presence of concomitant pathology has been shown to influence significantly on the development of complications and be a prognostic risk factor that must be included in modern prediction models.

Acknowledgment. The study had no sponsorship.

Conflict of interest. The author declares no conflict of interest.

Received: December 08, 2023
Accepted: January 30, 2024
Published: February 28, 2024

Introduction. Symptoms of gastro esophageal reflux disease are noticed in 2–7% of children. Manifestations of this disease may be limited to symptoms (e.g., heartburn, regurgitation) or have more complicate complex, such as erosive esophagitis, esophageal strictures or Barrett’s esophagus.

Study purpose. To study the prevalence of esophagitis in school-age children with symptoms of dyspepsia.

Materials and methods. The retrospective study included 7–18 years 2935 children patients aged with symptoms of dyspepsia. The presence of endoscopic signs of distal catarrhal esophagitis and erosions (epithelialized and non-epithelialized) was assessed; in the case of non-epithelialized erosions, the stage of esophagitis according to the Los Angeles classification was taken into account (1998).

Results. The prevalence of endoscopic signs of esophagitis among 7 to 17 years 11 months children with symptoms of dyspepsia was 1858/2935 (63.3%). Changes in the type of epithelialized erosions of the esophagus were detected in 593/2935 (20.2%), non-epithelialized erosions in 222/2935 (7.6%) children. Overall, erosive changes in the esophagus were noted in 815/2935 (27.8%) children with symptoms of dyspepsia. Erosive changes in the esophagus are more often observed in boys. The proportion of child­ren with erosive esophagitis is the same in all age groups. Among patients with non-epithelialized erosions, according to the Los Angeles classification stage A was established in 149/222 (67.1%), stage B — in 63/222 (28.4%), stage C — in 8/222 (3.5%), in 2/222 (0.9%) single ulcers of the esophagus were identified.

Conclusion. There is a high prevalence of esophagitis in school-age children with symptoms of dyspepsia, the frequency of erosive esophagitis, taking into account epithelialized and non-epithelialized erosions, was 27.8%, the frequency of non-epithelialized erosions — 7.6%.

Contribution:
Latyshev D.Yu. — concept, research design;
Latyshev D.F., Strozenko L.A. — collecting, processing material, writing the text;
Lobanov Yu.F. — 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: December 22, 2023
Accepted: January 30, 2024
Published: February 28, 2024

Irritable bowel syndrome (IBS) is the most common functional disorder of the intestine in children. In recent years, IBS has been defined as functional pathology of the intestine, manifested by visceral recurrent pain that occurs at least once per week, characterized by the following two or more signs: associated with defecation; with changes in the frequency and shape of stools. These symptoms had to be noted in the patient for the last 3 months, with a total duration of at least 6 months, without signs of organic damage to the gastrointestinal tract (GIT). The gut microbiota is of particular importance in the pathogenesis of IBS. In patients with IBS, an increase in Enterobacteriaceae, Ruminococcus, Clostridium, Dorea species and a decrease in the number of Lactobacillus, Bifidobacterium and Faecalibacterium species were found. At the same time, a similar microbial profile was found in patients with different subtypes of IBS. The established patterns of changes in the composition of the microbiota in IBS in children and adults indicate IBS and functional disorders of the GIT to have a pronounced microbial pathogenesis. In this regard, the personalized use of prebiotics, probiotics, synbiotics, and fecal microbiota transplantation can effectively affect the intestinal microbiome in IBS.

Conclusion. Correction of disorders of intestinal microbiota is the most important method of treating IBS in children. Determining the patterns of formation of changes in the intestinal microbiome in IBS children creates new opportunities for improving methods of their correction.

Contribution:
Smirnova G.I. — concept and design of the study;
Smirnova G.I., Labinov V.S. — collection and processing of the material; writing the text;
Korsunsky 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: January 15, 2023
Accepted: January 30, 2024
Published: February 28, 2024

The diagnosis of hyperandrogenism may be based on clinical manifestations or on determining the blood level of androgens. Causes of hyperandrogenism in the peripubertal period are polycystic ovary syndrome (PCOS), non-classical forms of congenital adrenal hyperplasia (NCCAH), androgen-producing tumors, obesity, idiopathic hirsutism, and other rare causes. Physiological hyperandrogenism of peripubertal period passes within 2 years. PCOS affects from 4 to 21% of women of reproductive age and from 6 to 18% of adolescent girls. To date, there is no consensus on the diagnostic criteria for PCOS in teenage girls. At least, three symptoms are necessary: menstrual disorders, clinical and biochemical hyperandrogenism and polycystic ovaries. Diagnosis of NCCAH includes measurement of the level of 17-hydroxyprogesterone and a test with adrenocorticotropic hormone. The purpose of the treatment of these diseases is to reduce the manifestations of hyperandrogenism, regulate the menstrual cycle and improve the quality of life. Effective methods of pharmacotherapy are combined oral contraceptives and antiandrogens. An important stage is lifestyle changes in PCOS and obesity patients.

For correspondence: Laura G. Pivazyan, 

Contribution:
Adamyan L.V., Sibirskaya E.V., Pivazyan L.G., Sharkov S.M. — concept and design of the study, editing the text;
Sarkisova A.I., Ananyeva V.S. — collecting and processing material, writing the text;
Adamyan L.V., Pivazyan L.G. — 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: December 22, 2023
Accepted: January 30, 2024
Published: February 28, 2024

Gastroschisis is a congenital malformation of the anterior abdominal wall with a defect to the right of the normally formed umbilical cord and eventration of the abdominal organs. Evented internal organs not covered with amniotic membrane are under the direct influence of amniotic fluid. Despite the increase in the incidence of the defect from 3.6 to 4.9 per 10,000 live births, over the past ten years mortality has sharply decreased to 5%. Antenatal diagnosis makes it possible to reliably identify cases of gastroschisis, starting from the 12^th week of gestation, which is important especially when diagnosing complicated forms. Surgical correction involves primary radical plastic surgery of the anterior abdominal wall with simultaneous immersion of the eventrated organs into the abdominal cavity. However, in approximately every fifth patient, immediate correction is impossible due to the occurrence of viscero-abdominal disproportion and concomitant diseases. In these cases, temporary abdominal cavity occurs with delayed plasty of the anterior abdominal wall, enterostomy for intestinal decompression, resection of non-viable areas and interintestinal anastomoses. Among patients with complicated forms, there was an 8-fold increase in mortality. Despite significant advances in reducing mortality, the development of various treatment methods continues to provide an alternative method of correcting this lesion.

Acknowledgment. The study had no sponsorship.

Conflict of interest. The author declares no conflict of interest.

Received: December 18, 2023
Accepted: January 30, 2024
Published: February 28, 2024

The incidence of congenital malformations is increasing annually, with a single kidney developmental disorder accounting for 4–8% of urinary system malformations. If the contralateral organ is normal, agenesis of the kidney is not clinically apparent and is usually detected during a preventive examination of the child or during an examination for combined anomalies of the genitourinary and urinary system.This pathology occurs due to a disruption of the interstitial interaction between the ureteral bud and the metanephrogenic tissue from  4^th to 8^th gestation weeks. By this time, the mesonephral (Wolff) ducts are already fully formed, in contrast to the paramesonephral (Müllerian) ducts, which develop only by the 5^th week of the intrauterine period, that is, in the period of high risk of malformations of the urinary system. Accordingly, anomalies of the female genital system are more common than those of the male one, with concomitant agenesis of the ipsilateral kidney. Diagnosis of unilateral agenesis of the kidney is possible when performing routine antenatal screening or conducting preventive examinations at decreed dates. In girls, the most common genital anomalies are true unicornuate uterus (65%), bicornuate uterus with one rudimentary horn (7.3%), atrophy of one fallopian tube and ovary, absence or hypoplasia of the vagina, and vaginal doubling. In boys with unilateral agenesis of the kidney, the seminal vesicles, prostate gland, and testicular appendage may be rudimentary or absent. Agenesis of the kidney is a component of such genetic syndromes as OHVIRA, Kallman, Zinner, and Mayer–Rokitansky–Küster–Hauser syndromes. It is also combined with other congenital anomalies of the kidney and urinary tract and extrarenal anomalies, including mainly malformations of the gastrointestinal tract, heart and musculoskeletal system. Consequently, children with this pathology should be fully screened to rule out associated malformations and anomalies.

Acknowledgement. The study had no financial support.

Conflict of interest. The author has no conflicts of interest to declare.

Received: December 26, 2023
Accepted: January 30, 2024
Published: February 28, 2024

There is presented the clinical report of the diagnosis and surgical treatment of such rare malformation as tubular duplication of the small intestine in an 11-years girl. Clinical manifestations were intense abdominal pain and intestinal bleeding of unknown origin. Video capsule enteroscopy (VCE) made it possible to identify the pathological area and determine its location. The article presents modern ideas about duplication of the small intestine. There are indicated diagnostic methods and signs to allow suspecting this malformation. The possibilities and criteria for VCE in diagnosing subepithelial lesions and identifying the source of intestinal bleeding are described.

Contribution:
Shcherbakova O.V., Habibullina L.R., Lokhmatov M.M., Budkina T.N. — concept and design of the work;
Shcherbakova O.V., Habibullina L.R., Budkina T.N., Korolev G.A. — writing the text;
Korolev G.A., Oldakovsky V.I., Tupylenko A.V. — collection of material, 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: January 12, 2024
Accepted: January 30, 2024
Published: February 28, 2024