Breastfeeding (BrF) provides significant health benefits for both the baby and the mother. At the same time, it is known that suboptimal nutrition of a woman during lactation can affect the health of children both in the short and long term, as well as shorten the duration of breastfeeding. In this regard, a set of measures to support breastfeeding should include raising women’s awareness of nutrition issues during lactation, and for the formation of a full-fledged balanced diet. It is advisable to use specialized products for nursing mothers, which is especially important in hypogalactia or suspected hypogalactia.

Materials and methods. The analysis included the results of a survey of women and medical records of children of one hundred eighty one mother-child couple. The questionnaires were completed by women who used the electronic version of the dietary re­commendations during breastfeeding. Depending on the rate of weekly weight gain in infants, lactating women were divided into 2 groups: women with sufficient lactation (n = 114); women with hypogalactia or suspected hypogalactia (n = 67). In addition to the recommendations of a set of measures to stimulate lactation, given to women, the use of a specialized product for lactating women of domestic production was recommended to correct the diets of women with suspected hypogalactia or its presence. To assess the quality of life of women, a short version of the WHO quality of life questionnaire — WHOQOL-BREF was used.

Results. 96.1% of female respondents rated the recommendations as useful and effective. After 30 days from the start of comply the recommendations, the number of women who highly assess their level of knowledge on nutrition during lactation increased from 38.7% to 63%. In 82.9% of cases, women were able to successfully adjust the diet, and in 81.2% of cases — to expand it. Upon repeated questioning after 30 days breastfeeding was revealed to preserve in 96.7% of cases in general among both surveyed groups. In both groups, the duration of crying and the volume of regurgitation in infants significantly decreased, which may be due to the correction of the mothers’ diet.

Conclusion. An integrated approach to lactation support with the provision of an electronic version of information materials on the nutrition of nursing women, as well as the inclusion of a specialized product for lactating mothers in the diet of nursing women, made it possible to preserve breastfeeding and improve the quality of life in terms of “Physical and psychological well-being”, including women with hypogalactia.

Contribution:
Butskaya T.V., Fisenko A.P., Makarova S.G. — concept and design of the study;
Ladodo O.B., Lebedeva A.M., Galitskaya M.G., Moshkina N.A. — collection and processing of the material;
Yasakov D.S. — statistical processing of the material;
Butskaya T.V., Ladodo O.B., Lebedeva A.M., Galitskaya M.G. — writing the text;
Fisenko A.P., Makarova S.G. — 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: May 25, 2023
Accepted: June 20, 2023
Published: August 31, 2023

Introduction. Lymphatic malformations (LM) are a congenital pathology of lymphatic vessels that arose during embryogenesis. The relevance of the research topic is due to the rarity, variety of clinical manifestations, and the lack of clinical recommendations for treatment. Aim. To evaluate our experience of surgical and conservative treatment of LM in the surgical department for newborns and infants.

Materials and methods. We performed a retrospective analysis of infants with various forms of LM treated at our department from 2017 to 2022. The study protocol was approved by the local ethics committee. The patients’ parents gave written voluntary informed consent to participate in the study.

Results. Depending on the form of a LM, the infants underwent conservative therapy, sclerotherapy or surgical resection of the LM.

Conclusions. Genetic tests for the spectrum of overgrowth syndromes are necessary for all LM patients to clarify the etiology of the process, prevent recurrence and complications.

Contribution:
Gurskaya A.S. — concept and design of the study;
Sulavko M.A., Nakovkin O.N., Karnuta I.V., Bayazitov R.R., Ekimovskaya E.V., Khagurov R.A., Sagoyan G.B. — collection and processing of material;
Gurskaya A.S., Sulavko M.A., Ekimovskaya E.V., Fisenko A.P. — writing and 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: May 19, 2023
Accepted: June 20, 2023
Published: August 31, 2023

Introduction. Inflammatory bowel diseases (IBD) including Crohn’s disease (CD) and ulcerative colitis (UC) are chronic inflammatory diseases with an autoimmune attack on the gastrointestinal tract. Insufficient knowledge of the pathogenesis and the lack of reliable biomarkers of the severity of the condition in IBD dictates the need to search for new prognostic markers to assess the condition and effectiveness of therapy in IBD patients during remission and exacerbation of diseases.

The aim of the work was to evaluate the protein profile, the amount of ischemia-modified albumin (IMA) and the content of 3-nitrotyrosine (3-NT) in the blood serum in IBD children.

Materials and methods. In the blood serum of twenty two children in accordance with the pediatric indices of PCDAI/PUC disease activity in remission and exacerbation of IBD, electrophoretic separation of serum proteins was performed on the Hydrases 2 scan focusing device (Sebia). The content of IMA was determined by colorimetric method, 3-NT — by enzyme immunoassay (Hycult-Biotech, USA).

Results. The article presents data on the content of fractions of albumin (A) and globulins, IMA, and 3-NT in the blood serum in children with different severity of IBD (CD and UC), corresponding to remission and exacerbation of diseases. It was shown that the more severe the condition, the more pronounced the decrease in A with an increase in the fraction of acute phase proteins and a decrease in the albumin/globulin index (A/G). Simultaneously with a decrease in the level of A, the content of IMA and 3-NT indicators of oxidative and nitrosative stress increases.

Conclusion. The results obtained indicate modifications of serum proteins and the presence of oxidative and nitrosative stress in children with severe IBD. Due to the fact that such changes are typical for hypoxic brain damage and hyperstimulation of glutamate receptors (GluRc) of neurons, it is suggested that the indicators of oxidative and nitrosative stress in IBD children are associated with the possible development of disorders in the brain through GluRc activation.

Contribution:
Sorokina E.G., Reutov V.P. — the concept and writing of the text;
Radygina T.V., Petrichuk S.V., Afanasyeva S.A. — collection and processing of the material;
Bakaeva Z.V. — statistics;
Smirnov I.E., Potapov A.S. — 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: June 08, 2023
Accepted: June 20, 2023
Published: August 31, 2023

Introduction. Peutz–Jeghers syndrome (PJS) and juvenile polyposis (JP) are congenital, inherited polyposis of the gastrointestinal tract. Both diseases are rare and characterized by the development of polyps in the small intestine, which can cause small intestine intussusception, obstruction of the gastrointestinal tract, and perforation of the intestinal wall. The main method of treatment is surgical. Polyps are formed throughout the life, and most patients undergo many surgical interventions, but despite this, there is currently no unequivocal opinion on the effectiveness of diagnostic and monitoring methods.

The purpose of this study is to determine the effectiveness of balloon enteroscopy, ultrasound examination of the abdominal cavity and video capsule enteroscopy as methods for diagnosing hamartoma polyps of the deep sections of the small intestine in children with Peutz–Jeghers syndrome and juvenile polyposis.

Materials and methods. Twenty seven SPE and JP patients were examined. Over the period from 2018 to 2022, this group of patients was hospitalized 67 times. Each hospitalization was assessed as a separate case. The average age at the first visit to medical care was 11 years 3 months. (min — 3 years, 6 months, max — 17 years 10 months). All patients underwent abdominal ultrasound and balloon enteroscopy (BE), 7 patients underwent video capsule enteroscopy (VCE).

Results. In 24 cases, ultrasound revealed intussusception of the small intestine. BE revealed 236 polyps in the small intestine, including 29 giant ones. 7 VCE revealed 57 polyps, while BE revealed 30 polyps in the same patients.

Conclusion. Ultrasound of the abdominal cavity does not reveal polyps of the small intestine, but is able to determine the presence of intussusceptum. VCE is the most effective method for detecting polyps, however, BE allows not only searching, but also radical removing.

Contribution:
Korolev G.A., Lokhmatov M.M., Dyakonova E.Yu. — the concept and design of the study;
Korolev G.A., Budkina T.N., Oldakovskiy V.I., Tupylenko A.V., Khazykova D.V., Bekin A.S. — collection and processing of material, writing the text, editing the text.
All co-authors — approval of the final version of the article, responsibility for the integrity of all parts of the article.

Acknowledgment. The study had no sponsorship.

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

Received: May 24, 2023
Accepted: June 20, 2023
Published: August 31, 2023

Introduction. Currently, despite the rapid development of pediatric cardiac surgery, there is a problem of postoperative dysfunction of the gastrointestinal tract (GIT) in patients. Necrotizing enterocolitis (NEC) remains the most complex and least studied problem in pediatrics, including cardiac surgery. In pediatric cardiac surgery, the decrease in perfusion of the internal organs of the abdominal cavity is due to low perfusion pressure during cardiopulmonary bypass, low cardiac output in the postoperative period, aggravation of sympathetic vasoconstriction due to the stress response to surgery, and the introduction of exogenous catecholamines. Objective: analysis of the features of the development of NEC in cardiac surgery children patients.

Materials and methods. A prospective analysis of thirty cardiac surgery children patients with the development of gastrointestinal dysfunction after surgery was performed. All children underwent standard research methods.

Results. In 63.3% of cases, children showed signs of dynamic intestinal obstruction; 36.7% of newborns have signs of necrotizing enterocolitis of varying degrees. The features of the bacteriological landscape, clinical manifestations and X-ray picture depending on the type of intestinal function disorder are presented. The role of hypoxia, hypoperfusion during cardiopulmonary bypass, the functioning of the open ductus arteriosus in “blue” patients in the formation of the risks of developing necrotizing enterocolitis is shown. Among the studied patients, according to the age structure, there were newborns — 18 (60%) patients, children under 6 months — 10 (33,3%); older than 1 year — 2 (96,6%). An analysis of clinical manifestations in children in the preoperative and postoperative periods showed 19 cases (63.3%) to have signs of dynamic intestinal obstruction. This group of children consisted of 8 newborns (36.8%) and 12 patients of the postnatal period. All patients were after heart surgery (2 patients after narrowing of the pulmonary artery and 10 cases cc were operated on under cardiopulmonary bypass). The most difficult and severe group of patients after heart and vascular surgery were children with congenital heart defects, who developed signs of NEC — 11 patients (36.6%). 10 children were neonates, 1 patient was ovet 5 years. It is shown that the development of such complications including infectious and hypoxic causes, heart failure, the duration of cardiopulmonary bypass and diastolic stealing of vessels is of decisive importance.

Conclusions. Dysfunction of the gastrointestinal tract after heart surgery in children is one of the urgent problems of cardiac surgery. In the group of severe sick patients undergoing prolonged ventilation, morphine infusion, muscle relaxants, with signs of anasarca, the interpretation of the X-ray picture and the clinic of acute surgical pathology in the abdominal cavity may be difficult. NEC, occurred in newborns over the postoperative period, is often not recognized in a timely manner and leads to an unfavourable outcome.

Contribution:
Sarsenbayeva G.I. — concept and design of the study, writing the text;
Kim A.I. — editing and consulting;
Berdibekov A.B. — collection and processing of the material.
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: May 30, 2023
Accepted: June 20, 2023
Published: August 31, 2023

Introduction. Cholelithiasis in children is a rare disease. Making a decision on cholecystectomy in children is an urgent problem due to the lack of consensus on the tactics of managing children with cholelithiasis. Aim: determine the indications for surgical treatment of cholelithiasis in children based on laboratory and instrumental examination methods.

Materials and methods. The study analyzed twenty seven patients operated on for cholelithiasis from 2018 to 2023.

Results. Me = 18.7 months elapsed from the moment of diagnosis of cholelithiasis to surgery. In the prospective part of the work, 27 patients were studied, of which 26 were operated on. In 7 (26%) — the disease proceeded without symptoms, in 20 (74%) — pain syndrome was observed, in 4 — dyspeptic disorders were observed in the form of nausea and vomiting associated with food intake, in 2 — biliary sludge. According to the study, there was no statistically significant change in the level of C-reactive protein (p = 0.4). Analyzing the ESR data before and after surgical treatment, there was no statistically significant difference in the dynamics of this indicator (p = 0.223). In the trend in laboratory parameters, a statistically significant change in the parameters of leukocytes (p = 0.023) and neutrophils (p = 0.014) was revealed in the general blood test before and after surgical treatment.

Conclusion. In children diagnosed with uncomplicated cholelithiasis, changes in laboratory parameters before and after surgery are uninformative and unreliable. In children with uncomplicated cholelithiasis, medical treatment was ineffective, as a result of which surgical treatment was indicated. The ineffectiveness of drug treatment and the deterioration of the general condition of the child are indications for surgical treatment. As a minimally invasive surgical intervention, laparoscopic CE is recommended.

Contribution:
Dyakonova E.Yu., Gusev A.A. — concept and design of the study;
De Cassia Vaz Amanda, Bekin A.S., Tishkin G.V. — collection, processing of material and 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: June 04, 2023
Accepted: June 20, 2023
Published: August 31, 2023

Aim: to identify medical and social features of children of different age groups who suffered from COVID-19.

Materials and methods. A survey of legal representatives of minors was conducted during 2020–2022. Eleven thousand twenty five 1 year to 17 years children were included in the study. Study design: single-center, non-randomized, uncontrolled study.

Results. Among chronic pathology over all time periods, diseases of the respiratory system (allergic rhinitis and bronchial asthma), endocrine system (diabetes mellitus, overweight and obesity), and skin and subcutaneous tissue (atopic dermatitis) occupied the first places. The vast majority of COVID-19 children showed a variety of symptoms, the most common being fever over 38°C, runny nose, sore throat, headache, and cough. Most parents believed that their child had a full recovery from COVID-19, which most often occurred after 1–2 weeks or 6 months or more. At the same time, most indicators of children’s functioning remained unchanged. Negative dynamics was observed in such signs as appetite, physical activity and performance. The most widespread specific consequences of the previous infection were impaired lung function, asthenic syndrome, and decreased psychophysical functioning.

Conclusion. The identified specific and non-specific consequences of COVID-19 determine the need to manage comprehensive rehabilitation for children. Along with medical rehabilitation measures, the rehabilitation program should include psychological and pedagogical assistance to optimize the regime of psychophysical load and the implementation of relaxation classes aimed at stabilizing the emotional state, increasing the dynamic characteristics of higher mental functions.

Contribution of authors:
Fisenko A.P., Lazurenko S.B., Timofeeva A.G. — concept and design of the study;
Sviridova T.V., Makarova S.G. — collection and processing of material;
Terletskaya R.N., Sviridova T.V. — statistical processing;
Lazurenko S.B., Terletskaya R.N. — writing the text;
Lazurenko S.B., Makarova S.G. — editing the text.
All co-authors — approval of the final version of the article, responsibility for the integrity of all parts of the article.

Financing. The study had no sponsor support. Performed within the framework of the State Assignment to the Russian Academy of Education No. 075-00693-23-00 dated 27.12.2022.

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

Received: June 14, 2023
Accepted: June 20, 2023
Published: August 31, 2023

Breastfeeding (BF) is generally accepted to provide significant health benefits both for the infant and mother. In this regard, the creation of a favourable environment for breastfeeding being of great social importance is supported by a number of measures at the state level. This review focuses on various social aspects of managing and supporting BF and raising women’s awareness of breastfeeding and nutrition during lactation. The results of recent studies have shown suboptimal nutrition during pregnancy and lactation in the context of changing nutrients to need significantly affects gene expression, which can affect the health of children both in the short and long term. In the context of constant “information noise”, it is important to implement scientific knowledge into sources available to pregnant and lactating women. For a targeted policy of healthy and long-lasting BF, government institutions need to build up marketing methods for promoting BF, using modern types of communication.

Contribution: collection and processing of material, writing the text, editing the text.  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 author declares no conflict of interest.

Received: May 29, 2023
Accepted: June 20, 2023
Published: August 31, 2023

There are described various variants of the clinical manifestations of coronavirus infection, reflecting the severity of the course of the disease from mild forms to severe acute respiratory syndrome, the development of a multisystem hyperinflammatory syndrome with a high probability of death. There is an understanding that, along with a viral infection, COVID-19 is a cardiorespiratory disease. With the defeat of the respiratory system, violations of the functioning of the cardiovascular system are often recorded. Heart lesions detected in 17–75% of cases are associated with myocardial damage by the SARS-CoV-2 virus.  An informative and accessible method of examination for COVID-19 in children is electrocardiography (ECG), used in combination with telemedicine technologies. Long-lasting changes in the structure and function of the heart during convalescence require an individual approach to rehabilitation. The review presents the analysis and interpretation of data on ECG changes in COVID-19 children, discusses the patterns of electrophysiological disorders in COVID-19 children and adults.

Conclusion. Effective methods for diagnosing heart lesions in children have not been defined, and the ECG and echocardiography used do not have specific markers for diagnosing cardiac pathology in COVID-19. Therefore, it is necessary to use the available knowledge to optimize the algorithms for the rehabilitation of children in the period of convalescence.

Contribution:
Kozhevnikova O.V. — concept and design of the study;
Blazhievskaya T.O., Rakhimova A.N., Akhmedova E.E., Abashidze E.A. — collection and processing of the material;
Kozhevnikova O.V., Blazhievskaya T.O. — writing the text;
Kozhevnikova O.V. — editing the text.
All co-authors — approval of the final version of the article, responsibility for the integrity of all parts of the article.

Acknowledgment. The study had no sponsorship.

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

Received: June 05, 2023
Accepted: June 20, 2023
Published: August 31, 2023

A clinical case of diagnosis of the onset of leukemia in an 8-year-old child, began with a bone-joint syndrome and was the only one at the beginning of the disease, is presented. This made it much more difficult to make a timely diagnosis. In addition to the severity of the articular syndrome at the onset of the disease, polymorphism of primary clinical manifestations was the reason for the examination of the child in children’s departments of various profiles. The diagnostic search took 4 months, since laboratory changes in the patient were observed later than clinical symptoms. It was the lack of effect from the ongoing therapy of the articular syndrome that made it necessary to exclude acute leukemia. The first manifestation of acute leukemia in this patient was osteoarticular syndrome caused by infiltration of the bone marrow and periosteum. The relative rarity of oncological diseases in children, about 95% of which are represented by acute leukemia, leads to a decrease in the alertness of doctors, both primary care and narrow specialists to these forms of pathology and determines the need for a differentiated approach not only to the existing syndromes, but also their combinations. A multidisciplinary approach to the diagnosis of acute leukemia with the implementation of a comprehensive assessment of the course of the disease allows the patient to be referred to a pediatric hematologist-oncologist in a timely manner.

Contribution:
Santalova G.V. — concept and design of a clinical case;
Plakhotnikova S.V., Santalova G.V. — collection and processing of material;
Plakhotnikova S.V., Santalova G.V. — writing the text;
Plakhotnikova S.V., Poretskova G.Yu. — editing the text.
All co-authors — approval of the final version of the article, responsibility for the integrity of all parts of the article.

Acknowledgment. The study had no sponsorship.

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

Received: May 29, 2023
Accepted: June 20, 2023
Published: August 31, 2023

Introduction. Ablepharon-macrostomia syndrome (AMS) — rare ectodermal dysplastic congenital disease. This syndrome ectodermal dysplasia due to genetic disorders includes malformations of skin, hair, nails, sweat glands, and teeth. AMS typical anomalies are mostly developed in the facial part of the skull and rarely in the internal organs. Characteristic lacks are or eyelid hypoplasia, oral defect (macrostomia), ear abnormalities, dry and rough skin, or excessive folds of skin, absence or sparse pieces of hair, delay intellectual and motor development, variable anomalies of mamillaae, genitalia, dactylion of the fingers and toes, short stature.

Aim: to consider, based on a clinical case, the effect of mutations in AMS on the formation of external genitalia.

Materials and methods. A description of a clinical case of AMS in a 10-year-old patient admitted to the gynecological department is presented. Since birth, the child has been diagnosed with AMS at the place of residence. The patient is observed by a neurologist, ophthalmologist, otolaryngologist, maxillofacial surgeon.

Results. Despite the characteristic clinical picture during external examination, difficulties may arise in the differential diagnosis for the gender due to the possible influence of mutations on the structure of the external genitalia.

Conclusion. It is quite difficult to diagnose this pathology. The clinical picture may be different, which is why it is so important to conduct genetic testing in doubtful cases. This method allows identifying point mutations.

Contributions:
Sibirskaya E.V., Sharkov S.M. — concept and design of the study;
Movsesian E.Kh., Kirillova Yu.A. — collection and processing of the material;
Movsesian E.Kh. — writing the text;
Sibirskaya 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: May 30, 2023
Accepted: June 20, 2023
Published: August 31, 2023