Introduction. Relapse after radical correction of congenital hydronephrosis (CH) in children occurs in 5–11% of cases. However, the predictors of repeated obstruction of the pyeloureteral segment (PUS) have not yet been sufficiently evaluated, which determines the relevance of the topic.

Aim: to detect the risk factors for recurrence of hydronephrosis in children to develop methods for its prevention.

Materials and methods. There were examined one hundred children with hydronephrosis divided into 2 groups. Group 1 consisted of 50 patients with recurrent hydronephrosis (RH), group 2 (control) — 50 children without RH with a comparable functional condition of the affected kidney. The analysis of the influence of pre-, intra- and postoperative parameters on the outcome of the primary intervention was carried out.

Results. During primary intervention in CH patients from group 1, we identified the following significant differences compared with patients of group 2: the use of non-resection pyeloplasty; a more extended stricture of the PUS; an indentation of less than 5 mm from the edge of stenosis; tension of the edges of the anastomosis due to insufficient mobilization; acute pyelonephritis during the early postoperative period. When the anastomosis tissues were stretched, only one type of urine drainage (internal or external) was performed in patients from group 1, and combined drainage was provided in patients of group 2.

Conclusion. To prevent recurrence of hydronephrosis in children, it is necessary to perform exclusively resection ureteropyeloplasty with adequate tissue mobilization and a wide margin from the edge of stenosis, use combined drainage when stretching the edges of the anastomosis and ensure the observation of operated children before moving to the adult network.

Contribution:
Petrova A.F., Kovarskiy S.L. — research concept and design of the study;
Petrova A.F., Matveenko E.N. — collection and processing of material;
Petrova A.F. — statistical processing, writing the text;
Kovarskiy S.L., Menovshchikova L.B. — 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: November 07, 2024
Accepted: December 06, 2024
Published: December 25, 2024

Introduction. The method of choice in the treatment of urolithiasis in children is remote shock wave lithotripsy (RSWL). Due to the vastness of the indications, the effectiveness of this method does not correspond to the expected one, which led to the search for predictive factors of the success of the RSWL and the creation of nomograms to determine its effectiveness.

The aim of the work is to identify significant factors influencing the success of remote shock wave lithotripsy and to develop a nomogram to determine its effectiveness in children with urolithiasis.

Materials and methods. Two hundred seventy nine patients (305 renal units) with renal urolithiasis were examined. The median age of the patients was 119 (44–175) months. All patients underwent a comprehensive examination. The RSWL is completed. The criterion for the effectiveness of RSWL was the absence of fragments of concretions > 3 mm in the urinary tract during a control ultrasound performed after 3 months. The data of patients between groups with successful and ineffective RSWL were compared according to the following parameters: gender, age, body mass index, presence of surgical interventions, distance from skin to stone, side of the lesion, two-sidedness of the process, exact localization of concretions, their number, size, volume, and density.

Results. The parameters that have a positive effect on the outcome of RSWL are: female gender, two-sided process, location in one renal compartment, smaller size, volume and density of the stone. The effect of lithotripsy is advers affected by the age of patients from 6 to 14 years, the location of the stone in the lower group of cups. To create a nomogram, variables were selected using logistic regression analysis in accordance with the clinical and statistical significance of each of factors with a deviation of less effective signs. The final nomogram included the following variables: gender, age, exact location, multiplicity of location, and average density, size and volume of stones according to computed tomography (CT) data.

Conclusion. The developed by us nomogram to determine the effectiveness of RSWL is a preoperative planning tool that allows for a personalized and objective approach to the treatment of sick children with urolithiasis. The introduction of such tools into clinical practice for evaluating the effectiveness of operations will optimize the choice of an adequate method of treating patients, increase the effectiveness of operations, reduce the number of additional surgical and anesthetic aids and the duration of the child’s stay in the hospital.

Contribution:
Zorkin S.N., Shakhnovskiy D.S. — concept and design of the study, editing the text;
Lobanova A.D. — data collection and processing;
Lobanova A.D., Bayazitov R.R. — statistical processing of the data, 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: November 08, 2024
Accepted: December 06, 2024
Published: December 25, 2024

Introduction. In modern conditions, the quality of life (QoL) is regarded as one of the main and reliable tools for health state research. Most questionnaires for the quality of life assessment have been developed for children with various diseases, and studies of the quality of life in somatically healthy children are few. The study of the processes of a child’s adaptation to learning in primary school mainly has a psychological and pedagogical focus. There are virtually no scientific papers covering the course of a child’s adaptation to learning in the first grade.

Objective. To assess the adaptation of children to learning in the first grade using QoL indices.

Materials and methods. The study was conducted from the fall of 2022 to the spring of 2023. To assess the QoL, the Russian-language version of the international instrument was chosen — the general questionnaire — Pediatric Quality of Life Inventory — PedsQL 4.0. The Kern–Jerasik test was used to assess the school maturity. A total of 454 questionnaires in 7–8 years of children going in for the school of the Moscow region were analyzed.

Results. When assessing the Kern–Jerasik test for readiness for school, it was found that only a quarter of the children was found to be completely ready for school, the same number of younger schoolchildren had risks at the beginning of the study, and most of the children fell into the “maturing” group with good potential for development. At the end of the school year, a repeat examination of children was conducted. More than 50% were assessed as “mature”, 35% fell into the “maturing” group with a favourable prognosis and 13% of children remained in the risk group at the end of the school year. When assessing the QoL at the beginning of the school year, children from the risk group were noted to have worse scores compared to other groups in physical, social, and school functioning. Assessment of QoLin children in this group at the end of the school year showed the scores on all scales to remain significantly lower than those of children from other groups. When assessing the course of QoL during the school year, both in children at risk and in mature children, the index significantly decreased in all aspects of functioning, primarily due to the emotional aspect.

Conclusion. New data on the QoL in primary school children was obtained. The demonstrated capabilities of the PedsQL 4.0 questionnaire and the Kern–Jerasik Test, when used together, can provide material for creating a more complete picture of the life of children entering school and predicting their adaptation based on changes in QoL indice during the first year of the study.

Contribution:
Vinyarskaya I.V., Antonova E.V., Khramtsov P.I. — concept and design of the study;
Khramtsov P.I., Berezina N.O. — collection and processing of material;
Chernikov V.V. — statistical processing;
Chernikov V.V., Timofeeva A.G. — writing the text;
Fisenko A.P. — 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: October 22, 2024
Accepted: December 06, 2024
Published: December 25, 2024

Aim. To study the quality of life and mental health in adolescents with irritable bowel syndrome.

Material and methods. 12–19 years adolescents were examined. They were divided into two groups: 12 patients with and 170 cases without irritable bowel syndrome (IBS). Grading was carried out in accordance with the Rome IV criteria for functional gastrointestinal disorders. The quality of life of the subjects was studied using the PedsQL questionnaire, and mental health — with the questionnaire «strengths and difficulties» (SDQ). The reliability of differences in quantitative features was analyzed using the Mann-Whitney criterion, qualitative features — with the χ² criterion. Values p < 0.05 were considered statistically significant.

Results. In accordance with the Rome IV criteria IBS was diagnosed in 6.6%. In IBS adolescents, the quality of life according to the emotional functioning scale was significantly reduced (p = 0.017). According to the R. Goodman questionnaire, individuals with functional bowel disorders also more often had problems communicating with peers (p = 0.010) and emotional symptoms (p = 0.003) compared to children without IBS, which characterize mental health disorders. At the same time, deviant mental health disorders were noted in every fourth IBS child, and every third of them had borderline mental disorders, which is higher in total than in individuals without IBS (p = 0.005). To a greater extent, mental health deviations affected the emotional sphere.

Conclusion. In IBS adolescents, mental health disorders with a predominance of emotional disorders in its structure were more often recorded, and a decrease in the quality of life according to the emotional scale was noted.

Contribution:
Polivanova T.V. — concept and design of the study, writing the text;
Polivanova T.V., Vshivkov V.A. — data collection and processing, editing the text;
Vshivkov V.A. — statistical processing of the data.
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: November 14, 2024
Accepted: December 06, 2024
Published: December 25, 2024

Introduction. Meconium ileus is a disease characterized by the formation of thick, viscous meconium in the lumen of the small intestine with the development of low obstructive intestinal obstruction in newborns. Impaired meconium formation in children with cystic fibrosis is associated with a mutation of the CFTR gene, the development of apical dehydration of the secretory epithelium of the intestinal wall and excretory dysfunction of the pancreas.

The aim of the review: to identify the leading mechanisms of formation of meconium ileus in newborn children to optimize its treatment. A review of the literature on the topic meconium ileus. In premature newborns, the development of obstructive intestinal obstruction is associated not only with the presence of dense meconium, but also with immaturity of the motor function of the gastrointestinal tract. Hyperechogenic masses in the intestinal lumen, calcifications in the abdominal cavity, dilation of intestinal loops, and free fluid in the abdominal cavity according to prenatal ultrasound indicate a high probability of cystic fibrosis in the fetus, which requires genetic counselling parents. One of the therapeutic and diagnostic methods for meconium ileus is the setting of a hypertensive enema with a water-soluble hyperosmolar contrast agent. This tactic being acceptable for use in simple forms of meconium ileus as a conservative therapy is effective in 25% of cases. Complicated forms of meconium ileus are characterized by the presence of secondary atresia, isolated inversion of the small intestine, severe ischemia or intestinal necrosis. In severe cases, meconium peritonitis develops simultaneously with perforation of the intestinal wall. Surgical methods for the treatment of simple and complicated forms of meconium ileus include washing meconium from the intestine with the imposition of primary anastomosis, alternative low-traumatic operations (enterotomy), as well as various options for stoma operations. However, a protocol for the treatment of meconium ileus has not yet been developed (including patients with cystic fibrosis). Difficulties remain in choosing the method of surgical correction of the meconium ileus of premature infants.

Contribution:
Gurskaya A.S., Dyakonova E.Yu. — concept and design of the work;
Piloyan F.S., Gurskaya A.S. — collection and processing of the material;
Piloyan F.S. — writing the text;
Gurskaya A.S., Dyakonova E.Yu. — 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:  November 08, 2024
Accepted: December 06, 2024
Published: December 25, 2024

Introduction. Timely diagnosis of various forms of pyelonephritis in children requires special attention and knowledge concerning clear clinical and laboratory criteria, since pyelonephritis tends to become chronic and contributes to the formation of chronic renal failure. The aim of the review is to establish the leading factors of formation, diagnosis, and prognosis determining the features of the course and outcomes of pyelonephritis in children. Pubmed, Google Scholar, Medline, and eLIBRARY.RU databases were used in the review. Pyelonephritis has been established to be a variant of endogenous infection caused by opportunistic bacteria that can live in the body for a long time and lead to infection only under certain conditions. Hematogenous and direct invasion is relatively rare. The clinical picture of pyelonephritis in children is quite diverse and depends on various factors. Given that insufficiently examined patients have a high risk of chronization of the course of the disease with the subsequent formation of foci of nephrosclerosis, an accurate diagnosis of the location of lesions in pyelonephritis is necessary. After receiving urine test data, determining biomarkers of the activity of the process and the presence of clinical manifestations of pyelonephritis in children, it is necessary to immediately prescribe empirical antibacterial therapy with prior urine culture and mandatory determination of antibiotic resistance, which will significantly reduce the risks of complications and nephrosclerosis.

Contribution:
Zokirov N.Z., Smirnova A., Fedorova E.V., Sukhodolsky A.A. — concept and design of the study;
Smirnova A.I. — collection and processing of material;
Smirnova A.I., Sukhodolsky A.A., Kolosova P.A. — writing the text;
Zokirov N.Z., Fedorova E.V., Sytkov V.V., Kolosova P.A., Sukhodolsky A.A., Ranshakov A.S. — editing the text.
All co-authors — approval of the final version of the article, responsibility of 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: October 23, 2024
Accepted: December 06, 2024
Published: December 25, 2024

Increased daytime sleepiness is an important symptom of disturbed night sleep, which should not be neglected. Hypersomnia reduces the quality of life, complicates socialization, can provoke insomnia, impulsive behaviour, and even depression or suicidal tendencies. The causes of increased daytime sleepiness may be non-compliance with sleep hygiene, nighttime sleep disorders (obstructive sleep apnea syndrome, etc.). If these conditions are excluded, you need to pay attention to rare forms of sleep pathology included in the group of central hypersomnia.

Aim of the review: to determine the prevalence, pathogenesis, clinic, diagnosis, and treatment of hypersomnia in children.

Among the central hypersomnia, narcolepsy is more common than the rest in the population. Idiopathic hypersomnia and Kleine-Levin syndrome are more rare forms of pathology. The pathogenesis of central hypersomnia has not yet been sufficiently studied, disorders of the immune system are of key importance, but there may be other causes. The leading clinical manifestation is daytime sleepiness, which worsens the child’s quality of life. In the diagnosis of hypersomnia, polysomnography and multiple sleep latency test (MTLS) are of key importance, in some cases other diagnostic methods (MRI) should be used. Pharmacotherapy relieves the condition in sick children, but does not completely eliminate the symptoms. New medicines are being developed. Treatment of hypertension should be comprehensive, not limited to drug therapy.

Contribution:
Kozhevnikova O.V., Lebedev V.V. — concept and design of the review;
Lebedev V.V., Gazaryan A.A. — collection and processing of material, writing the text;
Kozhevnikova O.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: October 16, 2024
Accepted: December 06, 2024
Published: December 25, 2024

Introduction. Sleep disorders are associated with the onset and progression of cardiovascular diseases, including hypertension, stroke, arrhythmias, coronary heart disease, and heart failure. However, awareness of the prevalence of sleep disorders and their impact on comorbidities, including cardiovascular diseases, remains insufficient.

The aim of the review: to determine the importance of early detection of sleep disorders for improving the effectiveness of prevention of cardiovascular diseases. A literature search was conducted on the topic: sleep disorders as a trigger of cardiovascular pathology. Significant links have been established between sleep disorders and the development of various forms of pathology of the cardiovascular system, both in adults and children, which necessitates timely sleep screening.

Conclusion. A certain connection between sleep disorders and cardiovascular diseases necessitates increased awareness in doctors regarding sleep disorders for the prevention of diseases of the cardiovascular system.

Contribution:
Kozhevnikova O.V. — concept and design of the study;
Tikhonovskiy P.A., Blazhievskaya T.O., Kustova E.A. — data collection, processing, writing the text;
Kozevnikova O.V. — research concept, 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: November 21, 2024
Accepted: December 06, 2024
Published: December 25, 2024

Relevance. Peutz–Jeghers syndrome is an orphan variant of hereditary polyposis, which manifests itself by the formation of melanin spots on the mucous membrane, lips, and skin, as well as the formation of hamartomatous polyps in the gastrointestinal tract.

The aim of the work is to demonstrate a rare manifestation of Peutz–Jeghers syndrome with a single giant polyp in the colon.

Clinical observation. The patient’s parents first began to notice “freckles” in the nasolabial triangle at the age of two years. At the age of 6 years, streaks of blood appeared in the stool. The reason for contacting a medical specialist was the presence of blood clots in the stool several months later. The child was diagnosed with formations in the descending colon. The patient was referred for further examination and determination of treatment tactics.

Conclusion. Hamartomatous polyposis usually the manifests itself by the formation of multiple polyps along the gastrointestinal tract. In Peutz–Jeghers syndrome, the vast majority of polyps are formed in the small intestine and stomach, but in clinical practice, atypical manifestations of this disease may be encountered, requiring a multidisciplinary approach to determine the treatment tactics.

Contribution:
Korolev G.A., Lokhmatov M.M., Khvatova E.I., Dyakonova E.Yu. — the concept and design of the study;
Khvatova E.I., Korolev G.A., Budkina T.N., Oldakovskiy V.I., Tupylenko A.V., Khazykova D.V., Bekin A.S. — 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: October 28, 2024
Accepted: December 06, 2024
Published: December 25, 2024

Relevance. According to the results of surgical treatment, the sagittal imbalance of the spine was eliminated, the pain syndrome was stopped, and the patient’s independent movement was restored without the use of auxiliary devices (walkers).

Results. In patients with combined pathology of the spine and hip joints, violations of the X-ray anatomical indices of the trunk balance lead to the development of severe pain syndrome, reduces exercise tolerance, and the quality of life. Correction of sagittal imbalance of the trunk becomes particularly relevant in this group of patients.

Conclusion. If it is impossible to perform hip replacement to correct sagittal imbalance of the trunk in patients with combined pathology of the hip joint and spine corrective osteotomy of the lumbar spine is a non-standard treatment method, is potent of improving prognosis and quality of life in patients.

Contribution:
Chelpachenko O.B. — concept and design of the study, statistical processing of the material, editing the text;
Chelpachenko O.B., Butenko A.S., Pimbursky I.P. — collection and processing of the material;
Plotnikov A.P. — 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: November 22, 2024
Accepted: December 06, 2024
Published: December 25, 2024