Introduction. There were conducted numerous studies to assess the management of nutrition in young children living in the Russian Federation. However, this problem remains poorly studied in the regions of the North Caucasus Federal District and requires further development. Aim. To determine the features of nutrition management and the frequency of alimentary-dependent conditions in young children living in the regions of the North Caucasus Federal District (using the cities of Stavropol, Nalchik, and Cherkessk as examples).

Materials and methods. A multicenter non-randomized cross-sectional study was conducted: a survey of pediatricians and parents on the management of rational nutrition in, children from 1 year to 3 years of age from health groups I and II based on questionnaires developed by the researchers.

Results. The data of the study demonstrated significant differences in the opinions of pediatricians and parents on the adequacy of nutrition in young children (p < 0.001). A significantly high frequency of overweight/obesity was revealed in Stavropol (39%) compared to Cherkessk (22%), iron deficiency conditions, including anemia: 30%, 52%, 21%, respectively, while in Stavropol it was more common compared to Nalchik and Cherkessk (p < 0.001), as well as rickets: Stavropol — 39% versus Nalchik — 37% and Cherkessk — 20% (p = 0.029). A significant increase in the consumption of “unhealthy” food products by children over the third year of life in Cherkessk (p = 0.015) and Stavropol (p < 0.001) was revealed, as well as a direct effect of the level of mothers’ education on the consumption of such “harmful” products for children as carbonated sweet drinks (p < 0.001) and sausages (p = 0.013).

Conclusion. The identified violations in the nutrition of young children living in the North Caucasus region can be the cause of a high frequency of alimentary-dependent conditions, which requires increased attention to educational work in primary outpatient care using popular information materials available to the population to introduce the principles of healthy nutrition for children into practice and form correct eating behavior in them.

Contribution:
Bushueva T.V., Borovik T.E., Skvortsova V.A. — concept and design of the study;
Khubieva M.U., Lukoyanova O.L., Guseva I.M., Chernikov V.V., Komarova O.V. — collection and processing of the material;
Bushueva T.V., Khubieva M.U., Chernikov V.V. — statistical processing of the material;
Bushueva T.V., Borovik T.E., Khubieva M.U. — 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: August 11, 2025
Accepted: October 02, 2025
Published: October 30, 2025

Aim. To evaluate the association of the irritable bowel syndrome (IBS) with risk factors in school-aged children.

Materials and methods. A cross-sectional study included 1,296 schoolchildren aged of 7–17 years. IBS was diagnosed according to the Rome IV criteria, and subjects were divided into two groups based on the presence of the syndrome (64 children with IBS and 1,232 children without IBS). Anamnestic data that may contribute to the development of IBS were also obtained. The relative risk of their influence on the development of IBS was analyzed using odds ratios and 95% confidence intervals. The statistical significance of differences between variables was assessed using the Pearson chi-square test. A p value of < 0.05 was considered statistically significant.

Results. Among demographic factors, being girl and living in mononuclear families (living without an older generation) were significant in the development of IBS. A risk of IBS has been established in schoolchildren born by cesarean section and in children who have suffered certain illnesses (frequent acute respiratory infections, parasitic infections, chemical and food poisoning). A family history of digestive diseases, including gastritis, gallbladder disease, pancreatic disease, stomach cancer, and duodenal ulcers, adversely impacts to the development of IBS.

Conclusion. Thus, it is clear that rehabilitation of children with IBS should be based not only on symptom management but also on normalizing pathophysiological processes and eliminating the factors that led to the development of the disease. Further, a more comprehensive study of risk factors is advisable. This will help ensure a personalized approach and optimize the treatment and rehabilitation of IBS children.

Contribution:
Polivanova T.V., Manchuk V.T. — concept and design of the study;
Polivanova T.V., Manchuk V.T., Vshivkov V.A. — data collection and processing;
Vshivkov V.A. — statistical processing of the data;
Polivanova T.V. — writing the text;
Polivanova T.V., Manchuk V.T., Vshivkov V.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: September 17, 2025
Accepted: October 02, 2025
Published: October 30, 2025

Introduction. Neuroimaging is an essential part of the diagnostic process and monitoring of patients with hemorrhagic stroke (HS). Its role is to recognize and localize the hemorrhage site and to determine its etiology. Advances in neuroimaging have increased the capabilities and improved the diagnosis and treatment of stroke in children. In this regard, magnetic resonance imaging (MRI) has made significant progress in recent years, achieving significant advances in the assessment of brain physiology, function, and metabolism, which have not previously been routinely assessed in the clinical setting. Purpose. To determine the potential contribution of different MRI techniques to the identification and characterization of hemorrhagic stroke in children.

Materials and methods. Data from one hundred five children with clinical manifestations of stroke who underwent MRI in the radiology department were analyzed. MRI was performed on a Philips Achieva dStream 3 T scanner using the following pulse sequences: axial T2-WI SE, T2 FLAIR, diffusion-weighted images (DWI), SWI, 3D T1 WI, and MR angiography.

Results. HS most often occurred in the carotid basin in 93 (88.6%) patients, including 30 (28.6%) with a mixed blood supply basin, while only 14 (14.6%) patients localized them in the vertebrobasilar basin. Most often, HS occurs in the blood supply basin of the proximal and distal parts of the middle cerebral artery (MCA). In addition to intracerebral hematomas, subarachnoid hemorrhages (SAH) and intraventricular hemorrhages (IVH) were detected in 54 (51.7%) cases. Several hemorrhagic foci were detected in 26 (24.7%) patients. Hematomas were detected in 7 (6.7%) children — HS of paraneoblastic genesis — hemorrhages into the tumor.

Conclusion. MRI using standardized protocols is currently the optimal standard for the diagnosis of hemorrhagic stroke in children. The introduction of shortened algorithms for severe patients and the widespread expansion of the availability of modern neuroimaging techniques can reduce the time to diagnosis and improve outcomes. HS mimics, including seizures, tumor, infection and other acute neurological conditions should be differentiated using neuroimaging.

Contribution:
Akhadov T.A., Bozhko O.V., Kanshina D.S. — study concept and design;
Bozhko O.V. — study implementation;
Ublinsky M.V., Bozhko O.V., Yakovlev A.N. — data collection and processing;
Ublinsky M.V., Khusainova D.N. — statistical processing;
Akhadov T.A. — writing the text;
Akhadov T.A., Bozhko O.V., Ublinsky M.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: September 12, 2025

Accepted: October 02, 2025

Published: October 30, 2025

Background. Meniscal injuries in children and adolescents are being reported with increasing frequency, which is associated with the growth of sports activity and advances in imaging techniques. Current treatment strategies focus on maximal preservation of the meniscus. The “all-inside” technique enables posterior horn repair without additional incisions; however, its use is limited by the high cost of disposable imported devices. Aim of the study. To improve the effectiveness and safety of posterior horn meniscus repair in children using a reusable guide.

Materials and methods. A retrospective comparison was conducted in one hundred patients aged of 5–17 years with posterior horn meniscus tears. Group 1 (n = 50) underwent “all-inside” repair with commercial anchor systems, while group 2 (n = 50) was treated using the original “Reverse” technique with a reusable instrument. The mean follow-up period was of 17–18 months.

Results. The recurrence rate was 2% in the “Reverse” group and 4% in the standard repair group (p = 1.0). No significant differences in complications were observed between groups. The “Reverse” technique allowed placing of a greater number of vertically oriented sutures without increasing the cost of surgery.

Conclusion. Arthroscopic posterior horn meniscus repair in children using the “Reverse” reusable guide demonstrated comparable outcomes to commercial all-inside systems at short-term follow-up. Economic accessibility and the ability to place anatomically stable vertical sutures make the technique a promising option for clinical practice.

Contribution:
Basargin D.Yu., Chelpachenko O.B. — concept and design of the study;
Basargin D.Yu., Vorobiev D.A., Lushnikov A.M. — collection and processing of material;
Basargin D.Yu., Lushnikov A.M. — statistical processing of material;
Basargin D.Yu., Chelpachenko O.B. — 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: September 17, 2025
Accepted: October 02, 2025
Published: October 30, 2025

Relevance. Rectal prolapse (RP) is one of the most frequent complications after correction of anorectal malformations (ARM), occurring in 15–40% of children and significantly impairing patients’ quality of life. In this patient population, the classic Delorme procedure often yields suboptimal outcomes: recurrence rates reach 25–35%, and continence function remains poor. This is attributable to the inherently abnormal pelvic floor anatomy and neuromuscular dysfunction of the anorectal region in ARM children.

Aim: to evaluate the efficacy and safety of a modified Delorme procedure, developed at the Research Institute of Pediatric Surgery, National Medical Research Center for Children’s Health, in children with rectal prolapse following correction of anorectal malformations.

Materials and methods. We conducted a prospective analysis of outcomes after the odified Delorme procedure in thirty two patients aged of 4 to 14 years with full-thickness rectal prolapse of grade III–IV according to the Altemeier classification. All patients had a history of surgical correction of various types of ARM. Among them, 8 patients had recurrent prolapse after unsuccessful prior operations. The modified technique included a gentle circumferential mucosectomy with preservation of the submucosal vascular plexus, multilevel three-stage plication of the muscular layer, formation of a muscular cuff with additional fixation to pelvic floor structures, and creation of a submucosal bulwark. The postoperative follow-up period was up to 10 months.

Results. The mean operative time was 82 ± 15 min. Postoperative complications (anal canal stenosis) occurred in 3 patients, compared to 20–35% reported in the literature for the classic technique. Functional outcomes showed a marked improvement in continence scores from a baseline of 3.4 ± 1.1 to 8.1 ± 1.3 ball at 6 months on the Krickenbeck scale, versus 6.2 ± 1.4 ball for the classic Delorme procedure. During the follow-up of up to 10 months, no recurrences of rectal prolapse were observed in any patient, compared to 10–17% within the first year with the classic technique.

Conclusion. Preliminary results demonstrate high efficacy and safety of the modified Delorme procedure in children with rectal prolapse after ARM correction. The method shows significant advantages over the classic technique and may be recommended for the use in specialized centers. Further research is required to assess long-term outcomes.

Contribution:
Gusev A.A., Okulov E.A. — study concept and design;
Gusev A.A., Okulov E.A., Khvorostov I.N., Dyakonova E.Yu., Shchukina A.A., Bekin A.S., Romanova E.A., Tarzyan A.O., Evgenova N.N., Myagkov A.E. — data collection and surgical treatment;
Gusev A.A. — data analysis and statistical processing.
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: September 15, 2025
Accepted: October 02, 2025
Published: October 30, 2025

Introduction. Equino-plano-valgus deformity (EPVD) is one of the most common orthopedic pathologies in children with cerebral palsy. During surgical correction of such deformities, supination of the anterior section (elevation of the first metatarsal bone) may occur, which contributes to the loss of support of the head of the first metatarsal bone. Aim: to analyze the effectiveness of osteotomy modeling the forefoot in surgical treatment of EPVD in children with spastic diplegia associated with cerebral palsy.

Materials and methods. There were examined thirty two 8 to 18 years children (64 feet) with the diagnosis of EPVD against the background of cerebral palsy, spastic diplegia, II-III level according to GMFCS, surgically treated at the National Medical Research Center of Children’s Health. The study group consisted of 15 children (30 feet) who underwent surgical treatment of EPVD using techniques that lower the first metatarsal bone. The control group consisted of 17 children (34 feet) who underwent surgical treatment of EPVD using standard techniques without intervention on the forefoot. Statistical analysis of the studied indices was based on the search for statistical differences in the groups and was performed in the STATTECH software (Stattech, Russia).

Results. After surgical correction of foot deformities, the degree of elevation of the first metatarsal bone decreased by 30.6 ± 6.2%, and the intermetatarsal angle decreased by 5 ± 2° (p = 0.003), indicating the effectiveness of wedge-shaped bone osteotomy in correcting these parameters in patients with cerebral palsy.

Conclusion. Osteotomy of the medial cuneiform bone is an effective way to eliminate the elevation of the first metatarsal bone after correction of EPVDS in children with cerebral palsy.

Contribution:
Zubkov P.A., Zherdev K.V. — research concept and design of the study;
Zubkov P.A., Petel’guzov A.A. — collection and processing of material;
Zubkov P.A. — statistical processing;
Zubkov P.A., Petel’guzov A.A., Chelpachenko O.B. — writing the text;
Zherdev K.V., Butenko A.S., Pimburskiy I.P., Timofeev I.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: September 10, 2025
Accepted: October 02, 2025
Published: October 30, 2025

Introduction. The epiphyseal plate of the distal tibia is involved in the growth formation of 45% of the entire lower limb. Ossification of this area takes place between 12 and 14 years of age. Damage to the epiphyseal plate can lead to premature closure of the growth zone, deformation of the bone. and a significant limb length discrepency. Thus, the choice of surgical tactics should be carefully considered in case of fractures in the epiphyseal plate of the distal tibia in children because of growth zones in these bones. Objective. To assess the clinical effectiveness of biodegradable screws in type II metaepiphyseal fractures by the Salter–Harris classification after long-term catamnestic observation.

Materials and methods. There is presented a series of case reports of 14–15 years children with the damage to the growth zone (with closed metaepiphyseolysis of the distal tibia with type II displacement).

Results. The main advantages of biodegradable screws are sufficient strength and elasticity which are very important for maintaining stability of osteosynthesis in bone fragments. In addition, they have no any adverse effect at bone tissues in the meta-epiphyseal region, on intersection of the growth zone with the installed above metaphysical plate, thus reducing risks of displacement, non-fusion and premature closure of the growth zone in a young patient. The installed polylactate-glycolide (PLGA) implants do not require removal and repeated surgical intervention with general anesthetic support. Clinical cases analyzed in this trial have shown that in three years after the surgery screw bioresorption was not accompanied with any long-term consequences.

Conclusion. Based on the presented clinical observations and long-term results, bioresorbable screws based on PLGA have promising prospects for use in the surgical treatment of type II fractures of the distal metaepiphysis of the tibia according to the Salter–Harris classification. This is due to their ability to provide reliable stable osteosynthesis, a sufficient period of biodegradation, and the absence of adverse effects on surrounding soft and bone tissues. Additionally, there is no need for repeated surgery under anesthesia to remove the implant.

Contributions:
Serova N.Yu., Yatsyk S.P., Akhadov T.A., Chelpachenko O.B., Lushnikov A.M., Dmitrenko D.M., Kochetova N.A., Bykov V.M. — collection and processing of material;
Serova N.Yu., Chelpachenko O.B., Kochetova N.A., Bykov V.M. — writing the text;
Serova N.Yu., Chelpachenko O.B., Nikishov S.O. — editing the text.
Аll co-authors — аpproval 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: September 05, 2025
Accepted: October 02, 2025
Published: October 30, 2025

Neurofibromatosis is an orphan disease of the phakomatose group, the timely treatment of which helps to reduce the burden of pain and surgical interventions. Aim. To analyze the trend in the neurofibromatosis epidemic in children over the past decade in the context of timely diagnosis of the disease and early treatment initiation.

Materials and methods. The authors have analyzed official statistical data (federal statistical observation form No.12) for 2015–2024 for Russia as a whole and by urban and rural population, as well as by constituent entity of the Russian Federation.

Results. The prevalence of neurofibromatosis in 0–4 year children increased from 3.9 in 2016 to 7.1 per 100,000 children of the corresponding age in 2024; in children aged 5–9 years — from 5.3 to 9.4; and in children aged 10–14 years — from 11.7 to 18.2; The incidence in 0–14 years children aged increased from 7.8 in 2015 to 16.6 in 2024, and in children aged 15–17 years — from 5.8 to 12.1. There was an increase in the incidence rate in 0–14 year children – from 1.3 in 2015 to 1.8 in 2023. The incidence rate in adolescents changed statistically insignificantly, amounting to 0.8 per 100,000 children aged of 15–17 years in both 2015 and 2024. Only 3.5% of children are detected during preventive examinations. The incidence of neurofibromatosis in rural residents is significantly lower than in urban areas. The average 10-year prevalence rate of neurofibromatosis in children aged 0–17 years varies across regions from 0.3 to 27.2 per 100,000 population (the interquartile range equaled to 7.2); the incidence rate ranges from 0.0 to 5.1. The highest values ​​are associated with regions with an ethnic and genetic prevalence of the Finno-Ugric population.

Conclusion. The increase in the incidence of neurofibromatosis is associated with underdiagnosis of this disease and low detection rates during preventive examinations. Given the availability of treatments that can reduce the burden of pain syndrome and surgical interventions, it is advisable to realize measures to identify patients with neurofibromatosis in organized children’s groups, for example, periodic surveys of schoolchildren for the neurofibromatosis symptoms, using online tools.

Contribution:
Vitkovskaya I.P. — concept and design of the study, writing the text;
Sterlikov S.A. — statistical analysis, writing the text;
Zelenova O.V. — management of scientific collaboration and coordination;
Oskov Yu.I. — collection of statistical material and methodological consulting;
Pankova Ya.Yu. — support for research planning, 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: September 15, 2025
Accepted: October 02, 2025
Published: October 30, 2025

Introduction. The placenta is a key organ that determines the conditions of fetal development and neuropsychological health. It performs endocrine, metabolic, and barrier functions, regulates the supply of oxygen, nutrients, and hormones and protects the fetus from xenobiotics and pathogens. The aim of this review is to determine the interactions between the placenta and the fetal nervous system and the potential impact of their disorders on the further neuropsychological development of the fetus. The literature search was conducted in the Embase, PubMed, Google Scholar, and Medline databases. Placental process disorders lead to hypoxia, inflammation, and endocrine imbalances, which are associated with fetal growth restriction, preterm birth, and central nervous system damage. Placental infection (chorioamnionitis) further increases cytokine exposure, causes epigenetic changes, and is associated with the risk of psychiatric disorders, including attention deficit hyperactivity disorder, autism, and schizophrenia. Placental insufficiency is accompanied by blood flow remodeling, mitochondrial dysfunction, and activation of inflammatory cascades, which contribute to the development of gliosis and impaired neuronal differentiation. The endocrine role of the placenta is manifested in the synthesis of neurosteroids (allopregnanolone, which plays a multifaceted role in the development of the central nervous system), the regulation of glucocorticoid levels, and the transport of thyroid hormones. These factors are critical for myelination, synaptic formation, and the emotional and cognitive stability of the fetus. Imbalances in these factors are associated with cortical thinning, impaired sensory processing, and behavioral disorders in the fetus. An additional mechanism of placental effect is the subcellular transport of microRNAs and extracellular vesicles involved in epigenetic regulation. These molecules are considered as promising biomarkers for early detection of cognitive and motor disorders in the fetus.

Contribution:
Sibirskaya E.V., Sharkov S.M., Ivannikov N.Yu. — study concept and design, data analysis, editing the text;
Aigistova N.M., Gorshkova D.V. — data collection, processing, analysis, writing the text;
Sibirskaya 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: September 10, 2025
Accepted: October 02, 2025
Published: October 30, 2025

Introduction. As a rule, the presence of an additional cervical rib is not accompanied by clinical manifestations, especially in childhood. However, in rare cases, when compression of large vessels by an additional rib occurs, the symptoms can seriously affect the patient’s quality of life. A thorough history collection, clarification of details and an individual approach to each patient with this pathology is extremely important. Goal. To present a description of the surgical treatment of a patient with an additional cervical rib and clinical manifestations associated with compression of the vertebral and subclavian arteries.

Materials and methods. This scientific publication includes clinical experience in the observation and treatment of a boy patient who had compression of two arteries, subclavian and vertebral, due to the presence of a cervical rib. A 16-year patient was comprehensively examined, the following diagnostic methods were investigated: magnetic resonance imaging of the brain and spinal cord, chest X-ray, computed tomography of the neck and chest, ultrasound examination of the vessels of the neck and left upper limb, 3-D modeling of pathology.

Results. According to the results of surgical treatment, it was possible to achieve a satisfactory clinical effect, confirmed by the absence of symptoms and an improvement in the patient’s quality of life in follow-up.

Conclusion. Patients with an additional cervical rib should cause increased alertness, regardless of age and the presence of clinical manifestations. In the described case, it was the integrated approach that made it possible to achieve a clinical effect.

Contribution:
Chelpachenko O.B., Alkhasov A.B. — concept, definition of surgical treatment tactics and operation, writing the text;
Portugal P.M., Strakhov D.A., Ratnikov S.A., Shmykova A.O., Zherdev K.V., Butenko A.S., Abdullayeva L.M. — collecting and processing 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: September 08, 2025
Accepted: October 02, 2025
Published: October 30, 2025