Introduction. To improve the quality of surgical treatment and prevent postoperative complications, there is needed an integrated multidisciplinary professional approach including a combination of nutritional support with therapeutic methods and psychological assistance that reduces stress throughout the perioperative period. Clinical guidelines and standards to manage the patients on this issue in pediatric surgical hospitals have not been developed.

Objectives: to assess the nutritional risk of malnutrition and nutritional status in children with surgical diseases, to elaborate algorithms for nutritional support over the pre- and postoperative periods.

Materials and methods. The single center non-comparative study included sixty children aged from 1 month to 17 years 5 months, with diseases of the esophagus, intestine, and genitourinary system, were admitted for surgical treatment at the Research Institute of Pediatric Surgery of the Federal State Autonomous Institution «National Medical Research Center for Children’s Health» of the Ministry of Health of Russia. All patients underwent a nutritional risk screening according to a validated Russian version of the STRONGkids. Clinical and anamnestic data were analyzed. Anthropometric indices (Z-scores: weight/age, height/age, BMI/age) using the WHO AnthroPlus program (2009), and biochemical parameters (concentrations of C-reactive protein, total protein, albumin, prealbumin, transferrin) were evaluated.

Results. A high nutritional risk at admission was established in more than half (57%) of patients, moderate — in 36% of patients, low — only in 7% of cases. Malnutrition (Z-score BMI/age from –1 to –3) was diagnosed in 26 (43%) patients, 58% of them suffered from diseases of the esophagus, 37% — the intestine pathology, and 36% of the genitourinary disorders.

Conclusion. Nutritional risk screening and nutrition status assessment are necessary in all patients admitted to pediatric surgical hospitals for the timely appointment of adequate nutritional support, which will reduce the incidence of postoperative complications, and allow diminishing the length of the hospital stay.

Contribution:
Borovik T.E., Yatsyk S.P., Alkhasov A.B. — concept and design of the study;
Fomina M.V., Gusev A.A., Guseva I.M. — collection and processing of material;
Sokolov I., Bushueva T.V. — statistical processing of the material;
Borovik T.E., Yatsyk S.P., Zvonkova N.G. — writing the text;
Fisenko A.P., Skvortsova V.A., Bushueva T.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: March 02, 2023
Accepted: March 21, 2023
Published: April 28, 2023

Introduction. A comprehensive analysis of the polymorphisms of the genes of the renin-angiotensin system in children with different nosological forms of nephropathies is a necessary step in determining the clinical and genetic features of the formation of chronic kidney disease (CKD).

Aim: to establish the features of ACE (D/I), GT (Thr174Met), AGT (Met235Thr) and AGTR1 (A1166C) gene polymorphisms in CKD children and determine their significance in the progression of the disease.

Materials and methods. A retrospective and prospective study included one hundered 1 to 17 years children with nephropathies, examined in the children’s nephrology department of the Samara Regional Hospital over 10 years. In children, the identification of single nucleotide polymorphisms of genes was carried out using an allele-specific polymerase chain amplification reaction using test systems. Evaluation of clinical and paraclinical markers of progression in CKD was carried out twice a year. The results of the study were evaluated with the calculation of the Student–Fisher criteria and correlation analysis.

Results. in patients with kidney diseases, there was a trend towards an increase in the occurrence of single nucleotide polymorphisms of genes that affect the renin-angiotensin system (RAS). CKD patients at the stage 3–5 accounted for 35%. They had D/D ACE alleles combined with alleles AGT Thr174Met (27.9 ± 6.83%) and Met235Thr (41.86 ± 7.5%), Thr235Thr (30.2 ± 7.0%) and AGTR1 A1166C (37.2 ± 7.32%) more often than in milder CKD (0 and 7.5 ± 3.37%; 5.2 ± 2.94% and 5.2 ± 2.94%; respectively, p ≤ 0.010).

Соnclusion. The study of clinical and genetic features of CKD is relevant for the purpose of timely implementation of preventive measures.

Contribution:
Sedashkina O.A. — concept and design of the study;
Sedashkina O.A., Poretskova G.Yu. — collection and processing of material, statistical processing of material, writing the text;
Makovetskaya G.A. — editing.
All co-authors — approval of the desired version of the article, responsibility for the preservation of all parts of the article.

Acknowledgement. The study had no sponsorship.

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

Received: February 16, 2023
Accepted: March 21, 2023
Published: April 28, 2023

Introduction. The microbiota of the upper airways and intestine in preschool children is directly involved in protecting the growing body from acute respiratory infections (ARI), which are the most common infections in children, about 65% of them turn into recurrent respiratory infections (RRI). Aim. To establish changes in the microbiota of the upper airways and intestine in the treatment of ARI in preschool children.

Materials and methods. The study involved sixty 1–6 year (Me = 3.38 years) frequently ill children. They were divided into 3 groups depending on the chosen treatment lasting 90 days. Children of group 1 (n = 20) underwent nutrition correction. Children of group 2 (n = 20) received additional probiotics. Children of group 3 (n = 20) received both nutritional correction and probiotics at the prescribed doses. Before and after treatment, the composition of the microbiota of the oropharyngeal zone and intestine was determined by genetic sequencing of the V3–V4 region of the 16S ribosomal RNA gene, followed by bioinformatic analysis.

Results. Significant differences were found mainly in the relative content of Firmicutes in the microbiota of patients treated. The content of Firmicutes in the microbiota of children receiving probiotics against the background of nutrition correction (30%) was significantly higher than in patients with nutrition correction (26.91%) and in children receiving only probiotics (25.95%). In patients of different groups, after treatment, a decrease in the content of Proteobacteria in the microbiota of the oropharyngeal zone was revealed. A significant decrease in the relative content of Bacteroidota (by more than 3 times) in 95% of patients, and a decrease in Proteobacteria (by more than 4.5 times) in 100% of patients was also found in the intestinal microbiota of group 3 patients treated with probiotics. In addition, there was a significant increase in the Firmicutes microbiota from 21.97% to 30.07% in 85% of patients, and an increase in the content of Actinobacteriota from 1.9% to 5.7% in 95% of patients. The relative content of undifferentiated microbiota after therapy was also significantly higher (70.08%) than before treatment (58.40%) in 85% of patients.

Contribution:
Krasnorutskaya O.N., Kurdyukova T.I. — research concept and design of the study;
Kurdyukova T.I., Bugrimov D.Yu., Shevtsov A.N. — collection and processing of material;
Kurdyukova T.I. — statistical processing;
Kurdyukova T.I., Krasnorutskaya O.N. — text writing;
Krasnorutskaya O.N., Bugrimov D.Yu., Shevtsov A.N. — 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: February 17, 2023
Accepted: March 21, 2023
Published: April 28, 2023

Introduction. In the adult population, a high prevalence of the gastroesophageal reflux disease (GERD) and irritable bowel syndrome (IBS) can vary from 3 to 79%. As for children, there are a few works on the overlap between functional dyspepsia and IBS, GERD and functional constipation.

Aim. To determine the prevalence of overlap of the GERD syndrome with irritable bowel syndrome and functional dyspepsia in school-age children.

Materials and methods. The study included ninety eight cases including 71 boy and 27 girls, aged of 7 to 17 years (mean age 11.4 ± 2.1 years) suffered from erosive GERD. The comparison group consisted of 30 patients (11 boys and 19 girls), of mean age of 12.7 ± 1.8 years without erosive GERD). The criterion for inclusion in the main group was the presence of erosive changes in the esophagus according to fibrogastroduodenoscopy, in the comparison group the — manifestation of heartburn, with occurrence, at least twice a week over the past three months and the absence of erosive changes in the esophagus according to fibrogastroduodenoscopy. The exclusion criterion was the presence of organic pathology with sides of the upper (peptic ulcer, etc.) and lower parts of the digestive tract (ulcerative colitis, Crohn’s disease, etc.).

Results. Every fourth GERD patient (25.8%) has an overlap with functional bowel diseases, while GERD is more often combined with IBS with diarrhea (15.6%) than IBS with constipation/functional constipation (10.2%). Overlap of IBS with postprandial distress syndrome is much less common — only in 7.0% of children.

Conclusion. School-age GERD children are characterized by frequent overlap with functional bowel diseases, the frequency of which reaches 25.8%. The combination of all three diseases (IBS, GERD and postprandial distress syndrome) was observed in 2.3% of cases. These patterns are typical for patients with both erosive and non-erosive forms of GERD.

Contribution:
Latyshev D.Yu. — concept and design of the study;
Latyshev D.Yu., Rimer N.K. — collection and processing of material;
Latyshev D.Yu., Strozenko L.A. — statistical processing of the material;
Latyshev D.Yu., Lobanov Yu.F. — writing the text;
Strozenko L.A., Lobanov Yu.F. — 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: February 10, 2023
Accepted: March 21, 2023
Published: April 28, 2023

The esophageal lung is a rare congenital malformation of the foregut, characterized by the existence of the lung tissue, a segment of the lung, and the main bronchus between the esophagus and the part of respiratory system. Because of the rare occurrence of this defect, examples of the treatment of this disease can be found only in foreign literature, in Russian-language sources, there are no described cases of treatment of the esophageal lung. In this regard, the literature data was analyzed and there was presented, clinical picture, classification, diagnosis, and treatment of this defect, as well as a case from practical activities was carried out: diagnosis and treatment of a premature one month baby with an esophageal lung.

Contribution:
Alhasov A.B., Nakovkin O.N. — research concept and design of the study;
Karnuta I.V., Akhmedova D.M., Konovalenko M.A. — data research and analysis;
Bayazitov R.R., Ratnikov S.A., Varichkina M.A. — preparation of publication;
Gurskaya A.S., Kazakova K.A. — editing.
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 sponsorship.

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

Received: December 25, 2022
Accepted: March 21, 2023
Published: April 28, 2023

Introduction. Crohn’s disease (CD) is an inflammatory disease of the digestive tract of unknown etiology with segmental transmural inflammation of various parts of the gastrointestinal tract. The annual increase in the number of children with newly diagnosed CD, late diagnosis and untimely surgical treatment is one of the urgent problems due to the lack of a single algorithm of surgical treatment.

The aim: to determine the effectiveness of surgical treatment of CD in children.

Materials and methods. The study included thirty six patients with complicated CD Over the period from 2018 to 2022, a retrospective and prospective analysis of children who received medical care for CD with two-stage surgical treatment (resection of the affected area with enterostomy and subsequent restoration of gastrointestinal continuity) was carried out.

Results. Clinical activity according to Pediatric Crohn’s Disease Activity Index (PCDAI) in 23 (63.8%) children before treatment was recorded as high (30.0–75.2 points), in 15 (36.2%) children had average activity (11–29 points). After the staged surgical treatment, there was a change in the indicators — the onset of remission in 2 (5.5%) children and in 34 (94.5%) mild course (p < 0.05). Statistical analysis of anthropometric indicators revealed positive changes (HAZ p < 0.05 and BAZ p < 0.001) with increase in weight and height criteria. Assessment of laboratory dynamics revealed positive changes (p < 0.001) — the absence of anemia, hypoalbuminemia and relief of bacterial inflammation. CD debuted before the age of 10 years in 7 children (19.4%), aged 10 to 16 years — in 29 (80.5%). In 24 (66.7%) children, genetic engineering biological therapy (GEBT) at the time of the development of surgical complications was not performed, from them 15 (62.5%) received hormonal and immunomodulatory therapy while it was not effective, while for 9 (37.5%) patients the timely verification was diagnosed at the stage of development of CD complications. However, the development of surgical complications was noted in 12 (33.3%) children, despite the timely verification and appointment of treatment for genetic engineering biologic therapy (GEBT). Biological therapy was continued for 7 (58.3%) children who received GEBT before surgery, and in 5 (41.7%) patients, treatment was continued with a change of GEBT. The period of stay with a stoma was found to be  from 7 to 31 months (Me = 8).

Conclusions. In complicated forms of CD in children, despite drug therapy, including GEBT, the development of complications requiring surgical treatment was noted, which indicates an aggressive and progressive course of CD. However, the use of stage-by-stage surgical treatment showed efficiency due to the positive dynamics of anthropometric indicators, laboratory markers, the potency of surgical treatment, and made it possible to achieve stable remission against the background of specific therapy and improve the quality of life in CD children.

Contribution:
Dyakonova E.Yu., Gusev A.A. — concept and design of the study;
Bekin A.S., Potapov A.S., Lokhmatov M.M., Zvonareva A.V., Golberg M.A. — collection and processing of medical data;
Dyakonova E.Yu., Golberg M.A. — writing the text;
Yatsyk S.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: February 16, 2023
Accepted: March 21, 2023
Published: April 28, 2023

Introduction. Serratia marcescens is an opportunistic gram-negative microorganism, currently has been detected with increasing frequency in various clinical biomaterials from sick persons is the causative agent of nosocomial infections.

The aim of the work is to determine microbiological and clinical features of S. marcescens in bloodstream infections in children. 

Materials and methods. Nineteen isolates of S. marcescens were isolated from blood cultures. Antibiotic sensitivity was determined by broth microdilution method. Carbapenemase gene were determined using real-time polymerase chain reaction. Biofilm formation was studied on abiotic surfaces using polystyreneplates. Population diversity was determined by multilocus genotypic analysis. 

Results. Carbapenems, fosfomycin and biseptol showed the highest antimicrobial activity in vitro. Resistance to aminoglycosides, aztreonam, cefepime, and ticarcillin/clavulanate was over 50%. According to PCR data, only OXA-48 carbapenemases were found in 11% of isolates, NDM — in 5%, and a combination of carbapenemases — in 15%. Biofilms of moderate intensity were formed in 13 (68%) isolates, and weak biofilms — in 6 (32%). According to the genotypic analysis, a large proportion of isolates with multiple resistance were included in one group. All of them were singled out over one year from one department — perhaps there was a single source. In 3 cases, patients were diagnosed with sepsis, 1 of them had an unfavourable outcome. Bacteremia occurred on the 3^rd day after the initial isolation of S. marcescens. An unfavourable outcome occurred on the 10^th day of bacteremia. S. marcescens in this case had multiple resistance and a combination of resistance genes, also belonged to genotypic group I, which is often found in our work.

Conclusion. S. marcescens in bloodstream infections is a serious problem for pediatric patients. Natural resistance to polymyxins, as well as acquired resistance to carbapenems and aminoglycosides, cause particular alertness and attention to this microbial agent.

Contribution:
Sadeeva Z.Z., Lazareva A.V. — research concept and design of the study;
Sadeeva Z.Z., Novikova I.E., Samoilova E.A., Yanushkina O.G. — collection and processing of material;
Sadeeva Z.Z., Lazareva A.V. — text writing;
Alyabyeva N.M. — statistical processing;
Lazareva A.V., Karaseva O.V., Vershinina M.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: February 17, 2023
Accepted: March 21, 2023
Published: April 28, 2023

Introduction. Informing the population about chronic kidney disease is an important factor for preventing or combating the disease, and maintaining the health of the younger generation.

Objective: to study the level of awareness of parents about chronic kidney disease. 

Methods. In a specially designed form, an anonymous survey of 112 parents of children treated at the department regarding chronic kidney disease was conducted. Statistical processing of the obtained results was carried out.

Results. In most children (91.6%), the diagnosis of chronic kidney disease was established at the stage C3–C5 in the hospital. Moreover, in 100% of cases, this diagnosis was a “random finding”; 75.9% of respondents showed lack of information about the disease and its treatment, and the level of awareness is directly related to the stage of the disease. Moreover, as a result of insufficient information, the parents admitted to fail to comply with the terms of visiting the child, a nephrologist (22.9%), the recommendations to limit the diet of protein (19.3%) and potassium (36.2%), fluid volume (61.5%). At the same time, the parents believed the cause of the progression of chronic kidney disease in the child to be the lack of follow-up (43.7%), late diagnosis (33.7%), improper treatment (13.3%), and the late beginning of the treatment (9.6%). 

Conclusion. The work proved a low degree of awareness about chronic kidney disease, which contributes to the late diagnosis of the disease and low adherence to treatment. This problem requires improving methods and forms of informing the population, including expanding the capacity of outpatient care (preventive examinations, health education in nephrology schools).

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

Acknowledgment. The study had no sponsorship.

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

Received: February 27, 2023
Accepted: March 21, 2023
Published: April 28, 2023

Introduction. The state of bone tissue mineralization reflects the quality of the overall development in children and adolescents, their functional status, and the level of general health. The formation of a genetically determined peak bone mass begins at birth and continues until the age of 25 years, providing skeletal strength throughout life.

Materials and methods. There were examined five hundred seventy five people including 427 11–18 years schoolchildren and 148 19–25 years students. Bone mineral density (BMD) was assessed by 2-energy X-ray absorptiometry in the distal forearm bones using a DTX-200 densitometer (USA). A decrease in BMD was recorded at Zscore < –2.0 SD for a given age and gender. A questionnaire was used to assess risk factors for a decrease in BMD.

Results. A decrease in BMD among schoolchildren was registered in 9.9% of respondents. The prevalence of BMD deficiency in girls was 13.3%, in boys — 5.4%. The results of densitometry among students showed a decrease in bone mineralization in 12.1%. A comparative analysis of the decrease in BMD in the age aspect among schoolchildren and students did not reveal significant differences. In all schoolchildren with insufficient BMD, there were noted following risk factors as a pronounced deficiency in dietary calcium intake, physical inactivity, sugar abuse, vitamin D deficiency in 76.1%, deficiency in 23.9%, a history of fractures — 25.5%, smoking — 31.1%. In all students with a decrease in BMD also there were found 4 or more risk factors including low intake of dietary calcium, physical inactivity, low levels of vitamin D (deficiency — 64.2%, deficiency — 35.8%), more than 5 cups of coffee per day — 35.1%, smoking — 46.6%, history of fractures — 33%.

Conclusion. The goal of educational work among parents, schoolchildren and students should be the formation of correct food preferences, which in the future will be the base for the prevention of a decrease in BMD.

Contribution:
Sutovskaya D.V. — concept and design of the study;
Sutovskaya D.V., Karachevtseva D.Y. — collection and processing of material;
Sutovskaya D.V., Gorbacheva L.V. — statistical processing of the material;
Karachevtseva D.Y., Gorbacheva L.V. — writing the text;
Burlutskaya A.V., Sutovskaya D.V. — editing.
All co-authors — approval of the desired version of the article, responsibility for the preservation of all parts of the article.

Acknowledgment. The study had no sponsorship.

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

Received: November 24, 2022
Accepted: March 21, 2023
Published:  April 28, 2023

Early detection of such a formidable complication of bronchopulmonary dysplasia (BPD) as pulmonary hypertension (PH) is an urgent problem in pediatrics. Echocardiography is currently recognized as the most accessible and non-invasive method for determining pressure in the pulmonary artery. Disorders of alveogenesis and angiogenesis of the vessels of the small circulatory circle in premature infants forming BPD require careful echocardiographic control with using additional analysis of changes in the systolic eccentricity index (EI) as a reliable marker of PH in BPD infants. To increase the information content, it is also necessary to expand the use of EchoCG data in combination with analysis of the blood content of B type natriuretic peptide or the N-terminal pro-B-type natriuretic peptide.

Contribution:
Basargina M.A., Davydova I.V. — concept and design of the study;
Basargina M.A., Turko Kh.R., Seli­verstova A.A., Bondar V.A. — data collection and processing;
Basargina M.A., Davydova I.V. — writing 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: February 17, 2023
Accepted: March 21, 2023
Published: April 28, 2023

Introduction. Inflammatory diseases of the pelvic organs (IDPO) are common forms of pathology, which are often accompanied by serious complications.

Aim: to determine the leading reproductive outcomes in adolescent girls with IDPO.

Materials and methods. The review is based on the analysis of the features of the course of IDPO and the impact of their complications on the reproductive function of adolescent girls. A search was conducted in the PubMed and Cochrane Library databases with a depth of 5 years.

Results. It has been established that the highest incidence of IDPO in adolescent girls is at the age of 15–19 years due to the early onset of sexual activity, the lack of effective contraception and the presence of several frequently infected partners. Recurrent infections, chronic pelvic pain, purulent complications (salpingitis, pyosalpinx, tubo-ovarian abscess), ectopic pregnancy, premature birth, endometriosis and infertility are the leading outcomes of IDPO in adolescent girls. It was revealed that the absence of sexual activity does not exclude the occurrence of IDPO and its complications in girls. This is due to the state of immune protection against infectious pathogens in girls, and the qualitative and quantitative composition of the microbiota of the genital tract. Therefore, it is so necessary to manage and conduct a wide screening of adolescents for the presence of sexually transmitted infections to prevent their negative impact on the fertility of young males and females, and  effective training of adolescents on all significant issues of reproductive health.

Contribution:
Adamyan L.V., Sibirskaya E.V. — concept and design of the study;
Pivazyan L.G., Loshkareva M.A. Dzharullayeva Z.U. — collection and processing of the material;
Kirillova Yu.A., Loshkareva M.A. — writing the text;
Adamyan L.V., Sibirskaya E.V., Sharkov S.M. — 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: February 10, 2023
Accepted: March 21, 2023
Published: April 28, 2023

The article describes a clinical report of a combination of congenital heart disease due to total anomalous pulmonary venous drainage into the right atrium with congenital lung disease — lymphoangiectasia in a newborn infant. The role of extracardiac pathology on the course and outcome of cardiac surgery and the complexity of early diagnosis of a rare lung pathology are presented.

Contributors:
Sarsenbayeva G.I. — concept and design of the study;
Sadykova A.Zh., Berdibekov A.B., Khasanova O.Z. — collection and processing of the material;
Sarsenbayeva G.I. — writing and editing of 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:  February 16, 2023
Accepted: March 21, 2023
Published: April 28, 2023