The article is devoted to the founder of Russian neonatology, one of the initiators and active builders of the Soviet system of maternity and infancy care, the manager and head of the first domestic research institution in the field of pediatrics, George Nestorovich Speransky. There are consistently described stages of G.N. Speransky multifaceted activity on the management of the national system of maternity and infancy care, the creation of neonatology as a scientific discipline, the education and advanced training of pediatricians and neonato­logists, the introduction of a new system of specialized training of pediatricians at pediatric faculties, the activation of scientific societies of pediatricians. The ways of the further development of domestic pediatrics, new horizons in the creation and implementation of domestic and global pediatric projects aimed at improving the quality of life and timely comprehensive medical care for children are indicated.

Contribution: study conception and design, drafting of the manuscript, critical revision — Fisenko A.P. The author is responsible for the integrity of all parts of the article.

Funding. This research did not receive any specific funding.

Conflict of interests. The author confirms that there is no conflict of interest.

Received: December 29, 2022
Accepted: January 17, 2023
Published: February 28, 2023

The progression of lung failure in children with cystic fibrosis (CF) is associated with chronic lung infection (Staphylococcus aureus, Pseudomonas aeruginosa, Achromobacter spp., etc.). Functional pulmonary tests (PFTs), spirometry and body plethysmography, computed tomography (CT) of the lungs and analysis of the lung microbiota are used for monitoring of lung condition of CF patients. Several studies have been devoted to assessing the correlation of structural changes in CT and pulmonary function tests (PFT), but at the moment there is not enough data on the relationship of these indicators and their differences depending on the respiratory microbiota in CF children in the Russian population.

Materials and methods. Data was collected for CF 8–17.9 years children patients. We retrospectively analyzed genotype, body mass index, results of PFTs and CT scan of the chest (score by the Brody scale), deep throat cultures in all patients, and the capillary blood gas — in 56 children.

Results. Significant correlations between functional tests and structural changes in the lungs were found. A trend towards impairment of PFTs and CT scores with age due to infectious pathogens was shown, and the most significant negative impact was exerted by the mucoid species Pseudomonas aeruginosa and, especially, Achromobacter spp. The last one was associated with the worst lung parameters in CF children.

Conclusion. Pirometry, body plethysmography, and CT of the lungs are necessary for a comprehensive assessment of the lung condition, and a study of the lung microbiome due to its influence on structural and function changes in patients with CF.

Contribution:
Bystrova S.G., Simonova O.I. — research concept and design of the study;
Bystrova S.G., Kustova O.V., Akhmedova E.E. — collection and processing of material;
Bystrova S.G. — statistical processing;
Bystrova S.G., Lazareva A.V. — writing the text;
Simonova O.I. — 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: December 06, 2022
Accepted: January 17, 2023
Published: February 28, 2023

Among all hospitalizations of children with acute enteral infection (AEI), 20 to 60% are associated with rotavirus infection (RVI). The high intensity of the spread of the epidemic process and mortality from RVI indicates to the need for vaccination.

Aim: to assess the state of vaccination and study the clinical and etiological structure of RVI in children in-patients in the city of Krasnodar.

Materials and methods. There was performed the single-stage retrospective analysis of 505 case histories of acute AEI 0–18 years children (boys/girls: 267/238) admitted to the Children’s City Clinical Hospital in Krasnodar (2020). The state of vaccination (2013–2020) was studied on the base of the vaccination center in the Children’s City Clinical Hospital in Krasnodar.

Results. The number of immunized 6552 increased from 10 (2013) to 1460 (2020). Vaccination coverage in 2020 was 5.9% of the target cohort. Less than 1% of adverse events after immunization have been reported. In the AEI structure, 140 cases of RVI (27.7%) were registered: mono-RVI 50 (35.7%), mixed-RVI 90 (64.3%). Mixed-RVI included noro-RVI (67.9% cases), noro-adeno-RVI (17.8%), adeno-RVI (3.3%), salmonella-noro-RVI (3.3%), salmonella-RVI, salmonella-noro-adeno-RVI, campylobacteria-noro-RVI (2.2%) and escherichio-RVI (1.1%). The age structure of the Republic of Ingushetia was dominated by children under 1 year — 59.3%, 1–3 years old — 21.4%, 4–6 years old — 7.2%, 7–18 years old — 12.1%. Mono-RVI occurred in the form of gastroenteritis in moderate (78%) and severe (22%) forms with varying degrees of dehydration (stage I — 74%, stage II — 4%, stage III — 22%). Mixed RVI occurred in the form of gastroenteritis 80 (88.9%) and enterocolitis 10 (11.1%) in moderate (81%) and severe (19%) forms with stage I exsicosis (63%), II Art. (18%), III Art. (19%). Among all hospitalized children, none were as vaccinated against RVI.

Conclusion. The high intensity of the spread of the epidemic process in RVI indicates the need for vaccination.

Contribution:
Sutovskaya D.V., Burlutskaya A.V. — the concept and design of the study;
Sutovskaya D.V., Tetenkova A.A., Litvinskaya M.A., Naumenko G.V. — collection and processing of material;
Sutovskaya D.V., Epinetova A.A. — statistical processing;
Sutovskaya D.V., Krylova D.R. — writing the text;
Sutovskaya D.V., Burlutskaya A.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: December 19, 2022
Accepted: January 17, 2023
Published: February 28, 2023

Introduction. To date, Рalivizumab is the only approved monoclonal antibody preparation used to prevent the development of respiratory syncytial virus (RSV) infection. The aim of the work is to evaluate the benefits of immunization with Palivizumab in premature infants with bronchopulmonary dysplasia in a day hospital of the Federal Center.

Materials and methods. One hundred seven infants of different gestational age at birth were immunized with Palivizumab in the day patient department of hospital-replacing technologies. The preparation was administered to infants at risk for the formation of severe consequences of an RSV infection.

Results. Of the 107 children hospitalized in the day hospital, 74 premature babies were diagnosed with bronchopulmonary dysplasia (69%). Before immunization all infants were consulted by pediatrician, pulmonologist, and if necessary, other specialists. Discussion. The length of stay of children in a day hospital ranged from 2 to 3.5 hours on average. Each child stayed with their parents in a separate room. During this time period, the patient received the full range of the services associated with immunization.

Conclusion. Thus, immunization with Palivizumab in a day hospital of the Federal Center allows implementing a comprehensive multidisciplinary and individual approach to each infant, without exposing him to an undesirable risk of infection, in compliance with the principle of staged nursing of premature infants for patients with a new form of bronchopulmonary dysplasia who need a long follow-up observation.

Contribution:
Kharitonova N.A., Davydova I.V. — concept and design of the study;
Kharitonova N.A., Nesterovich M.I., Illarionova M.S., Seliverstova A.A., Potekhina T.V., Bondar V.A. — collection and processing of the material;
Kharitonova N.A., Mitish M.D. — statistical processing;
Basargina M.A., Zimina E.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: December 14, 2022
Accepted: January 17, 2023
Published: February 28, 2023

Aim of the study is to show the possibilities of multiplanar reformation and 3D reconstructions of computed tomography in the diagnosis of skull base fractures in young children.

Materials and methods. In one thousand three hundred thirty four children under 3 years of age with traumatic brain injury (TBI) CT was performed on a 128-slice Philips Ingenuity CT scanner; in 707 (53%) in the first 6 hours, in 254 (19%) — after 6 hours, but during the first 24 hours, in 205 (15%) children within 3 days and in 168 (13%) children later on 3 days after injury. Scanning of the area of interest (head + cervical spine) was made with the maximum possible reduction in parameters to minimize the radiation dose. Contrast was not used in children from 0 to 3 years of age with TBI. Post-processing included isotropic multi-planar reformatted (MPR) and 3D images.

Results. Of the 1334 children examined, 730 were boys and 604 were girls. In 448 (33.58%) children, fractures of the skull bones were diagnosed, in 366 (81.7%) of them, fractures were combined with intracranial injuries. Fractures of the skull base were in 83 (18.52%) of 448 children. In 65% (n = 54) of cases, basal fractures were combined with fractures of the temporal bones, 31.5% (n = 17) of these children had liquorrhea. Fractures of the anterior fossa (12% of the total number of fractures of the base of the skull) of the base of the skull or fronto-basal fractures were accompanied by additional fractures of the orbits and/or other bones of the facial skull in 56.6% of cases. Fractures of the middle cranial fossa were diagnosed in 54 (65%) children. Fractures of the posterior cranial fossa were found in 19 (23%) of 83 children. In addition to fractures of the bones of the base of the skull, 32 (38.6%) children were diagnosed with fractures of the bones of the vault and intracranial injuries.

Conclusion. The use of multiplanar reformation and 3D reconstruction increased the sensitivity and specificity of diagnosing skull base fractures in children compared to conventional axial CT. The essential advantages of using 3D reconstruction are the availability of the technique, the absence of additional scanning time and radiation exposure.

Contribution:
Zaitseva E.S., Akhadov T.A., Melnikov I.A. — research concept and design;
Zaitseva E.S., Mamatkulov A.D., Bozhko O.V., Dmitrenko D.M. — conducting research;
Zaitseva E.S., Mamatkulov A.D. — collection and analysis of data;
Ublinskiy M.V., Manzhurtsev A.V., Khusainova D.N. — statistical analysis;
Akhadov T.A. — writing text;
Zaitseva E.S., Bozhko O.V., Ublinskiy M.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: December 14, 2022
Accepted: January 17, 2023
Published: February 28, 2023

The goal is to assess the health of students studying according to adapted basic general education programs and the conditions of health saving in the educational institution.

Materials and methods. A monitoring research in some educational institutions that provide education according to adapted basic general education programs in eight federal districts of the Russian Federation. The factors influencing on the state of children’s health in the training process were as follows: management of medical, hygienic, psychological, and pedagogical and health saving procedures. To objectivize the experimental data, questionnaire survey of teaching staff and parents, qualitative and quantitative analysis were carried out.

Results. Currently, in educational institutions, regardless of the form of implementation of the educational process (in special or inclusive education), different categories of students are included in education. So far, education is carried out according to several versions of the basic general education curriculum. Such necessity is caused by the reduction of the number of children of one category and increase of another one. Education of children of different psychological and pedagogical categories in one educational institution requires creation of optimal educational conditions, taking into account the special educational needs of each student. The spatial environment that supports the health of students is created in most schools for children with musculoskeletal disorders, and less often in schools for children with hearing and vision disorders. Complete compliance of classrooms and special technical equipment of the educational process with the special educational needs of children occurred not in all educational institutions. Factor analysis has identified the most important components of a school health environment, and the data of the cluster analysis has formed its typological variants. Science-intensive health-saving technologies are used only for the correction of posture and the prevention of visual overexertion. The most acute gaps are insufficient educational and methodological equipment, material and technical condition of institutions, the volume and management of medical care for students. Existing legislative and normative legal documents do not fully regulate the management of health saving measures and technologies for students with special educational needs and children with disabilities, the process of health saving in the education system, which negatively affects their health status.

Conclusion. The problems identified in the activities of educational institutions, in which children with special educational needs and children with disabilities study, to create a health-saving environment should be taken into account when supplementing and improving the content of legislative acts.

Contribution:
Lazurenko S.B., Fisenko A.P. — concept and design of the study;
Terletskaya R.N. — statistical processing;
Konova S.R., Terletskaya R.N. — collection and processing of material, writing the text;
Lazurenko S.B. — text 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: December 08, 2022
Accepted: January 17, 2023
Published:  February 28, 2023

Introduction. The issues of increasing the effectiveness of the treatment of atopic dermatitis (AD) in young children remain extremely relevant. At the same time, insufficient attention is paid to such a socially controlled factor in treatment as the readiness of parents to comply with the recommendations of specialists.

Materials and methods. In the course of an observational cross-sectional study, there was made an analysis of medical and social data and the results of a survey of forty eight parents of children under the age of 2 years 11 months who were hospitalized in the Department of Dermatology of the National Medical Research Center for Children’s Health of the Ministry of Health of Russia with established severe AD. The author’s questionnaire «Attitude of parents of young AD children to recommendations», adapted by M. Rokich’s method «Value Orientations» was used.

Results. Despite the declared satisfactory adherence to treatment in more than 70% of cases parents of young AD children (94%) were established to experience one or a number of psychological problems that act as a subjective obstacle to the implementation of pediatrician’s prescriptions: lack of awareness or misinformation in regarding the treatment of the child, the lack of the habit of observing the principles of «healthy» nutrition, emotional and educational difficulties, the weak expression of the priority of «health» in the value system. According to the expert analysis of the answers of parents, a satisfactory readiness to comply with the recommendations was noted in only 11 (23%) cases, poor — in 37 (77%) cases.

Conclusion. To improve the effectiveness of treatment of children with severe AD, it is necessary to strengthen the motivation of parents to cooperate with specialists and increase their psychological readiness to follow the recommendations.

Contribution:
Makarova S.G., Sviridova T.V. — research concept and study design, editing;
Emelyashenkov E.E. — collection and processing of material, writing the text;
Murashkin N.N., Egorenkova O.S., Ereshko O.A. — editing.
All co-authors — approval of the final version of the article, responsibility for the integrity of all parts of the article.

Acknowledgment. The study had no sponsorship.

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

Received: December 09, 2022
Accepted: January 17, 2023
Published:  February 28, 2023

Introduction. The modern system of primary education dictates high requirements to children, which determines the relevance of the study of the child’s functional readiness for schooling. The child’s readiness for school provides an ability to fully satisfy conditions of systematic education and includes intellectual, emotional and social aspects. The emotional state of the child and the level of anxiety are important factors reflecting the adequacy of school adaptation during this period.

Objective: assessment of anxiety and functional readiness for being taugh tin first-graders.

Materials and methods. There were conducted survey and testing of sixty one 7–8 years first-graders, including 31 boys (50.8%) and 30 girls (49.2%). The children were taught in different classes: two classes with a separate form of education (only boys (19 students) and only girls (20 students)) and one class of joint education (together boys and girls — 22 students). Anxiety was assessed according to the method of “Scale of socio-situational anxiety” by O. Kondash (1973) adapted by V.V. Katunova (2020). The assessment of functional readiness for school was carried out using the Kern–Irasek orientation test of the school maturity.

Results. When analyzing school and self-assessment anxiety, a significant predominance of excessive calmness was noted among 62.3% and 65.6% of children, respectively (95% CI 50.1–74.5% and 53.7–77.5%). When assessing school anxiety, a significant prevalence of normal anxiety for girls studying in a separate form of education — 55% (95% CI 33,2–76.8) was revealed in comparison with children studying in a joint form of education — 13.6% (95% CI –0.7–8.0). When considering aggressiveness, a significant prevalence of a low level of aggressiveness among girls — 35% (95% CI 14.1–55.9), and a high level among boys — 68.4% (95% CI 47.5–89.3) in comparison with children studying in the joint form of education (4.5%; 95% CI –4.2–13.2 and 27.3%; 95% CI 8.7–45.9, respectively). Reliable risks of high interpersonal anxiety and a high level of aggressiveness for boys studying in a separate form of education have been identified, which, however, requires further research.

Conclusion. The data obtained make it possible to identify a risk group among children for the formation of school maladaptation and inadequate response to the academic load.

Contribution:
Chekalova S.A., Khramtsov P.I. — research concept and design of the study;
Berezina N.O., Karpovich E.I., Marinina A.O., Katunova V.V. — collection and processing of material;
Chekalova S.A., Kurgansky A.M. — statistical processing;
Chekalova S.A., Khramtsov P.I., Antonova E.V. — writing the text;
Chekalova S.A., Khramtsov P.I., Antonova E.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: December 20, 2022
Accepted: January 17, 2023
Published: February 28, 2023

Introduction. One of the urgent problems of modern pediatrics is the risk of developing vascular complications in children, among which thrombosis is not uncommon. For early diagnosis and thromboprophylaxis of strokes and other vascular complications, the identification of thrombogenic risk factors is indicated.

The purpose of the study. Based on the screening, to establish predictors of thrombogenic risk in children living in urban and rural areas of the Altai Territory for the timely prevention of vascular complications.

Materials and methods. The results of a screening study of two hundred seventeen aged 12–17 years children living in the city of Barnaul, Zarinsk and Klyuchevsk districts of the Altai Territory, were analyzed. Screening examination of children without signs of thrombosis and bleeding was carried out at an outpatient appointment with a pediatrician in random sampling. The questionnaire included questions to clarify the family thrombotic history, personal thrombotic history, background somatic diseases. Clinical examination was performed for all interviewed patients.

Results. According to the results of the study, it was revealed that in 65 (30%) of the 217 children surveyed, the closest relatives had thrombogenic risk factors, such as heart attacks, strokes, hypertension, coronary heart disease (CHD). After analyzing the personal thrombotic history, it was found that in the general group of patients, myocardial infarction was observed in 2 (0.9%) children. Strokes were noted in 5 (2.3%) respondents, and thrombosis and TIA in 2 (0.9%) subjects. When analyzing the results, it was found that a significant proportion of children had the following conditions, such as vegetative-vascular dystonia (VVD) of the hypertensive type, the presence of signs of undifferentiated connective tissue dysplasia (UCTD), smoking, obesity.

Conclusion. According to screening data in children, the main predisposing factors in the development of thrombosis, strokes and heart attacks are a burdened family, thrombotic history, the presence of some somatic diseases. The combination of these factors justifies the need for additional examination for the prevention of vascular thrombosis.

Contributions:
Skudarnov E.V., Strozenko L.A. — research concept and design;
Ponomarev V.S., Dorokhov N.A. — collection and processing of material, writing the text;
Malyuga O.M., Zenchenko O.A. — editing.
All co-authors — approval of the final version of the article, responsibility for the integrity of all parts of the article.

Acknowledgment. The work was not supported financially.

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

Received: December 21, 2022
Accepted: January 17, 2023
Published February 28, 2023

A systematic review of current data on the structure and functions of Helicobacter pylori (Hp), pathogenesis, diagnosis and treatment of Hp-infection is presented. The relevance of the topic of helicobacteriosis is due to the proven connection of this infection with chronic, widespread diseases of the digestive organs among the population. The review used materials from the databases including PubМed, Medline, EMBASE, Scopus, Google Scholar, RSCI. A systematic review based on studies with a high degree of evidence has shown significant progress in the diagnosis and treatment of Hp-infection in recent years in adults and children. Coordination of the scientific search for the regularities of the formation of Hp-associated forms of pathology, continuous improvement of diagnostic technologies and the search for new therapies, periodic well-organized international revisions of standard methods of Hp diagnosis and treatment contribute to the creation of effective methods of Hp eradication, preservation of the optimal composition of the microbiota of the gastrointestinal tract and prevention of antibiotic resistance. Of particular importance for the prevention of complications of Hp-infection are original diagnostic algorithms using specialized endoscopic and molecular technologies before and after Hp eradication with long-term follow-up and the determination of the leading factors correlating with a high risk of stomach cancer. The review indicates the emergence of potentially effective and promising areas for the diagnosis and treatment of Hp-infection, including genetic modification of the Hp genome to ensure its existence as a human symbiont and a significant reduction in its pathogenic properties. At the same time, sequencing of a new generation reveals mutations in Hp genes associated with its pathogenicity and antibiotic resistance, which contributes to the creation of new classes of drugs to increase the effectiveness of Hp eradication with a decrease in the proportion of antibiotics and an increase in pathogenetically significant inhibitors of its pathogenic factors for the prevention of side effects, a significant reduction in the empirical use of several antibiotics and increased compliance to treatment. 

Contributions:
Smirnova G.I., Korsunsky A.A. — concept and design of the study;
Smirnova G.I., Yakovleva N.V. — collection and processing of material, writing text;
Smirnova G.I., Korsunsky A.A. — editing.
All co-authors — approval of the final version of the article, responsibility for the stability of all parts of the article.

Acknowledgment. The study had no sponsorship.

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

Received: December 15, 2022
Accepted: January 17, 2023
Published: February 28, 2023

Enterocolitis syndrome induced by dietary proteins occupies a special place in the structure of allergic diseases in children of the first years of life. This is primarily due to the difficulties of diagnosing the syndrome, since there are currently no specific laboratory tests confirming the diagnosis, and the similarity of the clinical picture with the symptoms of other diseases of the gastrointestinal tract. Most often, the diagnosis is established according to the clinical picture and is confirmed by a positive provocative test with a suspected food trigger. The article briefly describes the enterocolitis syndrome induced by dietary proteins, and presents a clinical case of the syndrome in a child of 11 months. This syndrome was suspected at the first appointment of a nutritionist-allergist after analyzing the clinical picture of the disease and confirmed at a repeat appointment after 1 month. The significant role in the diagnosis by the provocative introduction of a causally significant product is shown, as well as the importance of prescribing an elimination diet to achieve remission of the disease.

Contribution:
Galitskaya M.G., Ereshko O.A., Makarova S.G. — research concept and design;
Galitskaya M.G. — collection and analysis of data;
Galitskaya M.G., Ereshko O.A., Lebedeva A.M. — writing the text;
Makarova S.G. — 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: December 08, 2022
Accepted: January 17, 2023
Published: February 28, 2023