Introduction. The implementation of the Federal Project "Development of the Network of National Medical Research Centers and the Introduction of Innovative Medical Technologies" brought a structural transformation of the domestic health care system. The key tool of this model was the formation of a vertically integrated network of medical organizations, the central elements of which are the National medical centers and "anchor" medical organizations.

Aim: to assess the effectiveness of organizational and methodological support of regional children's medical organizations (3rd group), or medical organizations performing their function (hereinafter referring as "anchor" medical organizations) in the "Pediatrics" speciality for 2019‒2024, to identify the dynamics of key indicators, to determine stable trends and problem areas in the development of children's health care at the regional level.

Materials and methods. Results (analytical reports) of away organizational and methodological measures on the "Pediatrics" speciality in the supervised regions of the Central, South and North Caucasian federal districts of specialists of the National Medical Research Center for Children's Health. For the entire period of implementation of the federal project since 2019 year by 2024 year, more than 160 away events were held.

Results. The regulatory framework for routing has been updated in 30 of the 32 supervised regions, the diagnostic potential and material and technical base of "anchor" medical organizations have been significantly improved, the quality of medical care in pediatric departments, including specialized ones, has increased by more than 2 times, and system errors have decreased. In the leading regions (Krasnodar and Stavropol Territories, Lipetsk, Moscow, Oryol, Rostov Regions), new clinical standards have been successfully introduced.

Conclusion. The model of "anchor" medical organizations within the framework of the Federal Project has confirmed its effectiveness for creating a vertically integrated health care system. System organizational and methodological support from the National Medical Research Center for Children's Health is a key factor in achieving and ensuring the unification of standards and the transfer of innovations. The improvements achieved are sustainable, which allows us to recommend this model for preservation in the future, with increased attention to staffing, digitalization and the development of a quality management system in the industry.

Introduction. Family-centered and family-integrated care are increasingly regarded as important components of modern care for preterm infants. However, in Neonatal Intensive Care Units with traditionally closed policies, immediate implementation of continuous parental presence may be limited by organizational, infection-control, and staffing constraints. Therefore, evaluation of staged family involvement after clinical stabilization is of practical relevance.

Aim: to evaluate the clinical effectiveness of a combined care model including unaccompanied intensive care during the acute phase followed by staged parental participation in preterm infants.

Materials and methods. This single-center comparative study included 120 preterm infants admitted to the neonatal intensive care unit in 2021–2024. The study did not focus on a single nosological entity; rather, it evaluated a clinically heterogeneous cohort of preterm infants requiring treatment and care in the neonatal intensive care setting. The intervention group (n=60) received a combined model of unaccompanied care followed by staged family involvement, whereas the control group (n=60) received conventional unaccompanied care. Study measures included length of hospital stay, weight gain velocity, complications, breastfeeding at discharge, parental competence, parent-infant attachment, and age-appropriate growth/ development at 3 years. Parental competence and parent-infant attachment were assessed using local structured questionnaires with conversion of total scores to a 100-point scale. Mean differences (MD) and relative risks (RR) with 95% confidence intervals (95% CI) were additionally calculated.

Results. The combined model was associated with shorter hospitalization (29.8±5.6 vs 36.5±6.2 days; MD -6.70; 95% CI -8.84 to -4.56; p <0.001), higher weight gain velocity (19.5±3.1 vs 14.2±2.8 g/day; MD 5.30; 95% CI 4.23 to 6.37; p <0.001), lower complication rates (11.7% vs 28.3%; RR 0.41; 95% CI 0.18 to 0.92; p=0.022), and higher breastfeeding rates at discharge (81.7% vs 56.7%; RR 1.44; 95% CI 1.12 to 1.85; p=0.003). Parental competence, attachment, satisfaction, and the proportion of children with age-appropriate growth/development at 3 years were also higher in the intervention group.

Conclusion. A staged model combining controlled intensive care with family-integrated care may improve selected short-term hospital parameters and 3-year follow-up measures in preterm infants and can be considered a pragmatic pathway for Neonatal Intensive Care Units transitioning from closed policies to family-centered care.

Introduction. Parental literacy in matters of nutrition is a factor capable of significantly influencing eating behavior and, subsequently, the health of children.

Aim: to assess and compare knowledge of healthy nutrition with the implementation of healthy nutrition principles in the family by mothers of children of older preschool and school ages.

Materials and methods. A face-to-face survey of 319 mothers of children aged 6 to 17 was conducted in a comprehensive school and kindergarten in Moscow. The questionnaire included questions on socio-demographic characteristics, to assess knowledge of healthy nutrition and adherence to healthy eating habits. For the analysis, proportions and mean values were calculated and compared, and correlation coefficients were determined in SPSS.

Results. 230 (72.1%) mothers know the principles of healthy nutrition, 145 (45.5%) implement healthy eating behavior. The higher the level of maternal nutrition literacy, the more healthy eating habits she has (r=0.186; p <0.001). Mothers who reported higher family income have better nutrition literacy, demonstrate lower alcohol consumption, higher consumption of vegetables and protein, regular breakfast consumption, but higher consumption of fast carbohydrates (p <0.001).

Conclusion. It is relevant for medical workers of children’s educational institutions to initiate the assessment of mothers’ nutrition literacy and their adherence to the principles of healthy nutrition in the family.

Introduction. Lower urinary tract infections are a leading cause of morbidity in preschool-aged children. Standard solid dosage forms of furazidin (tablets, capsules) often reduce treatment adherence in children aged 3–7 years due to swallowing difficulties and a bitter taste.

Aim: of the work is a comparative assessment of the efficacy, safety and adherence to therapy when using the developed extemporaneous suspension of furazidin (50 mg/5 ml) in comparison with the tablet form in children with cystitis.

Materials and methods. A prospective, open, comparative study was conducted involving 60 children (3–7 years) with lower urinary tract infections who received outpatient treatment. Two groups were formed: the study group (n=30) received furazidin suspension; the comparison group (n=30) received furazidin tablets at a dose of 5 mg/kg/day for 7–10 days. The study assessed efficacy, the incidence of adverse reactions, and adherence to treatment.

Results. By day 3, dysuria relief was achieved in 90% of children in the treatment group versus 73.3% in the comparison group (p <0.05). Clinical recovery and pathogen eradication were 96.7% and 93.3%, respectively (p >0.05). Adherence to treatment (>80% of doses) in the suspension group was 100% versus 83.3% in the tablet group (p <0.01); parental willingness to use the formulation in the future was 96.7% versus 60% (p <0.01). Ease of use of the suspension was rated at 9.6±0.6 points. The overall incidence of adverse reactions (primarily nausea) was significantly lower in the suspension group―10% versus 40% (p <0.01). There were no discontinuations due to adverse reactions.

Conclusion. Furazidin suspension is an effective, safer, and more compliant dosage form for the treatment of uncomplicated urinary tract infections in children aged 3–7 years compared to tablets. It provides precise dosing, is easy to administer, and is less likely to cause dyspeptic symptoms. It can be recommended for wider use in pediatric practice.

Introduction. The search and scientific substantiation of technologies and conditions for the formation of students' body tolerance to educational loads is an urgent problem in the preventive field of school medicine.

Aim. The aim of the study was to evaluate the impact of sports activities in sports sections on the frequency of complaints among students in grades 5‒9 about weakness and fatigue after lessons.

Materials and methods. An online survey of 60,753 students in grades 5‒9 from 25 regions of Russia was conducted. The children answered questions about the frequency of complaints of weakness and fatigue after lessons, depending on whether they play sports or not. The relative risk (RR) and etiological proportion (EF) values were calculated to assess the causation of frequent complaints due to lack of exercise.

Results. It was found that 27.9% (95% CI: 33.9–34.6) of students often complain of weakness and fatigue after school, 37.9% (95% CI: 37.5–38.2)―sometimes and 34.3% (95% CI: 33.9–34.6)―never or very rarely. Among those who are not engaged and engaged in sports , the number of children with frequent complaints in the 5th grade was 20.7% (95% CI: 19.6‒21.7) and 16.2% (95% CI: 15.3–17.1) (p <0.05), respectively, in the 9th grade―37.3% (95% CI: 36.1–38.6) and 28.3% (95% CI: 27.2–29.5), respectively (p <0.05); 17.6% (95% CI: 17.2–18.0) of boys and 36.0% (95% CI: 35.5–36.5) of girls reported frequent complaints (p <0.05). The analysis of the values of RR and EF made it possible to establish the conditionality of increasing the resistance of the body of students to educational loads by playing sports in sports sections.

Conclusion. The data obtained indicate a higher level of resistance to the educational stresses of the body of students involved in sports sections. Further research in this area will make it possible to recommend to children with learning difficulties those sports that will contribute to the prevention of their health disorders in the educational process.

Adequate nutrition for infants and young children, as well as pregnant and lactating mothers, is one of the most important factors in ensuring the health of the world’s population. The formation and implementation of global plans in this area is supported by the world’s professional medical communities, including the World Health Organization (WHO). Currently, global initiatives aimed at preventing nutritional disorders in children are being implemented within the framework of the United Nations Decade for Action on Nutrition project. The Ministry of Health of the Russian Federation provides both the implementation of international initiatives on nutrition for children and mothers, and the development of domestic projects in this area. In the Russian Federation, the issues of baby food are traditionally in the focus of state attention. The main strategic objectives in this area are to increase the prevalence of exclusive breastfeeding, reduce the number of children born with low anthropometric indicators, combat childhood obesity and optimize nutritional support for children with various congenital pathological conditions. The development and implementation of a set of measures to combat obesity in children and adults and a set of measures aimed at implementing the principles of a healthy diet are included in the Plan for the implementation of the Strategy for the Development of Healthcare in the Russian Federation for the period up to 2030. To date, the Russian Federation continues to develop relevant clinical recommendations for optimizing the nutrition of healthy children and children with various pathological conditions, as well as the preparation and updating of regulations guaranteeing support for pregnant women and nursing mothers.

Gigantomastia in adolescence is a serious clinical problem that requires an interdisciplinary approach. The lack of clear etiopathogenetic criteria and predictors of recurrence makes it difficult to choose the optimal surgical approach to minimize complications and achieve a stable functional and aesthetic result. The aim of this review is to analyze current knowledge about the etiopathogenesis, classification, and surgical management of gigantomastia in adolescent girls to integrate this knowledge into clinical practice. The literature search for this literature review was conducted in the databases PubMed, eLibrary, Google Scholar, Embase, Сochrane library. The were found and analyzed three hundred forty seven sources. Literature route has shown that gigantomastia in adolescent girls is a polyetiological condition. The most studied theories of pathogenesis include hypersensitivity of target tissues to estrogens, as well as autoimmune mechanisms. In some cases, a link has been established with the use of medications. The clinical picture i s characterized by rapid, often bilateral, growth of the mammary glands, leading to physical and psychosocial disturbances. Conservative therapy is generally ineffective. Surgical reduction mammoplasty remains the method of choice, but there is no consensus on the optimal extent of resection or the type of surgery, and subcutaneous mastectomy is often used to prevent recurrence.
Despite its relative rarity, gigantomastia in adolescent girls is a clinically significant condition that radically reduces the quality of life. The rapid progression of the disease, the uncertainty of its pathogenic mechanisms, the variability of surgical approaches, and the risk of recurrence after surgery necessitate an in-depth analysis of existing diagnostic and treatment strategies.

In global and domestic pediatric palliative care, an epidemiological shift has occurred: from the prevalence of oncological pathology to severe neurological, orphan genetic diseases, and consequences of extreme prematurity. This dictates the need for long-term, high-tech support for technology-dependent patients at home. The traditional hospital-centric model demonstrates low efficiency, leading to the social blockage of intensive care beds, "opioidophobia" in primary care, and institutional gaps during the transition to the adult network.
To analyze the current organizational, regulatory, and clinical barriers of the pediatric palliative care system and assess the prospects for overcoming them using digital transformation.
In accordance with PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) guidelines, a systematic search of publications was conducted in PubMed, Scopus, Web of Science, The Cochrane Library, RSCI (eLibrary), and CyberLeninka databases for the period 2018–2026. Search queries included: "pediatric palliative care", "telemedicine", "Internet of Medical Things", "electronic patient-reported outcomes", "transition care". The review included 42 relevant sources. It was established that overcoming the growing personnel deficit, geographical dispersion, and legal collisions requires a paradigm shift from a reactive to a proactive model. The necessity of creating unified regional digital ecosystems is substantiated.
A viable direction for the industry's development is the integration of Internet of Things technologies in medicine, the use of gaming platforms to collect electronic patient-reported outcome measures (ePROMs), predictive smart registries, and hybrid telemedicine models.

Peutz‒Jeghers syndrome is a rare hereditary disorder characterized by hamartomatous gastrointestinal polyps and mucocutaneous pigmentation. In childhood, the most clinically significant complications are intussusception and chronic blood loss leading to anemia.
We present a case of a 12-year-old boy with clinically verified Peutz‒Jeghers syndrome, burdened family history, marked pigmentation of the lips and oral mucosa, multiple hamartomatous gastrointestinal polyps, and mild anemia. During planned hospitalization, despite the absence of clinical signs of acute intestinal obstruction, abdominal ultrasound revealed intussusception associated with a polyp. At the first stage, retrograde balloon enteroscopy and endoscopic polypectomy were performed. Follow-up ultrasound demonstrated persistent entero-enteric intussusception, which determined the need for urgent surgical treatment. Laparoscopic desinvagination, enterotomy and polypectomy without bowel resection were performed. Histological examination confirmed hamartomatous polyps. The postoperative period was uneventful. 
This case demonstrates that even in minimally symptomatic Peutz‒Jeghers syndrome, ultrasound monitoring plays a key role in detecting continuously recurring intussusception and in choosing a stage-based treatment strategy.