Introduction. The prevalence of bronchopulmonary dysplasia development as the outcome of respiratory distress syndrome in premature infants is high. However, not all infants with serious risk factors develop this pathology. The aim. To develop a prediction model and improve a comprehensive approach to the management of infants with bronchopulmonary dysplasia (BPD) based on the identified clinical, laboratory, and molecular genetic predictors of its development.

Materials and methods. The study included 309 premature infants: premature infants in the neonatal period with respiratory distress syndrome over the active stage (n = 63); premature infants with bronchopulmonary dysplasia (n = 176); premature infants aged 29 days and older without bronchopulmonary dysplasia, but diagnosed respiratory distress syndrome in the neonatal period (n = 70). In the study, clinical and anamnestic parameters were analyzed, and the concentration of angiogenesis biomarkers in the serum in 204 children was determined using enzyme-linked immunosorbent assay. Genetic testing was also performed on 170 patients.

Results. When studying the genetic characteristics, the representation of the nucleotide variant rs45488997 in the CCN2 gene was observed to be higher in BPD patients (p = 0.023). At the same time, the nucleotide variant rs12489516 in the CPA3 gene was significantly more common in patients without BPD (p = 0.03). Clinical and biochemical parameters of premature infants were also assessed. The most important ones for the development of BPD were identified. Based on the data obtained, two prognostic models were formed. The first is characterized by the use of the identified clinical indicators to assess the risk of BPD development. These include gestational age, birth weight, and duration of general respiratory support. The second model evaluates biochemical markers. It analyzes serum concentrations of VEGF-A, ANGPT2, ANGPT1, PDGF-BB, and PECAM-1.

Conclusion. The development of modern prognostic models and early prevention of BPD is a promising method for effective care of premature infants.

Contribution:
Basargina M.A. — study concept and design;
Basargina M.A., Illarionova M.S., Zhanin I.S., Snovskaya M.A., Zhuzhula A.A. — data collection and processing;
Savostyanov K.V. — statistical processing of the material;
Basargina M.A. — writing the text;
Basargina M.A., Savostyanov K.V., Semikina E.L. — editing the text.
All co-authors approved the final version of the article and are responsible 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: October 31, 2025
Accepted: November 27, 2025
Published: December 25, 2025

Introduction. Currently, there are frequent cases of both underestimation of the importance of prescribing additional nutrition to a breastfed child by medical personnel, and unjustified introduction of infant formula, especially during the early neonatal period. The reason obviously lies in the lack of clear criteria for assessing the adequacy of lactation in a nursing mother and medical indications for the introduction of supplementary feeding in current recommendations. The aim of this publication was to analyze the existing literature on the presence of transient conditions in newborns over the early neonatal period associated with insufficient consumption of breast milk and to develop a methodology for their correction through the timely introduction of supplementary feeding with infant formula followed by its discontinuation.

Materials and methods. Implementation of the “Supplemental Feeding for Full-Term Breastfed Newborns” checklist at a perinatal center. Retrospective analysis of medical records.

Results. The introduction of a checklist into the perinatal center’s work, with the registration of the rationale for the introduction and withdrawal of supplementary feeding in medical records, allows, on the one hand, eliminating the unjustified prescription of supplementary feeding to newborns. On the other hand, to promptly identify infants who need of additional nutrition, select the optimal amount, monitor the condition of the newborn and the trend in his body weight and ensure the timely cancellation of supplementary feeding, which contributes to the creation of an effective model for supporting breastfeeding among newborns.

Conclusion. During the neonatal period, there are various conditions, that may require supplemental feeding in the newborn due to insufficient maternal milk. The developed checklist for the purpose of supplementary feeding is a modern technology for maintaining breastfeeding and an important practical step in supporting it from the first day of the life.

Contribution:
Belousova T.V., Skvortsova V.A. — research concept and design;
Lukoyanova O.L., Andryushina I.V., Borovik T.E., Malyutina L.V., Zakharova N.I. — collection and processing of material;
Belousova T.V., Skvortsova V.A., Andryushina I.V., Lukoyanova O.L. — writing the text;
Belousova T.V., Skvortsova 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: November 01, 2025
Accepted: November 27, 2025
Published: December 25, 2025

Introduction. The emergence of a wide range of genetically engineered biological products (GEBP) opens up opportunities for a personalized approach in the treatment of immune-dependent diseases. The development of methods for predicting the effectiveness of biological therapy for timely treatment correction is of particular relevance. Laboratory and clinical biomarkers are being studied.

Materials and methods. A laboratory examination was conducted on 486 children aged of 3.5 to 18 years with inflammatory bowel diseases (IBD), 182 children with psoriasis (PS), and 147 children with multiple sclerosis (MS). The study included a set of quantitative and functional indicators: the content of basic (T, B, NK cells) and small populations of lymphocytes (Th17 lymphocytes, regulatory T cells (Treg), activated T helper cells), populations of memory T cells, populations of myeloid suppressor cells (MDSCs), Treg with CD39 ectonucleotidase expression, succinate dehydrogenase (SDH) activity in lymphocyte populations, and nuclear factor kB (NF-kB) activity in lymphocyte populations. The comparison group consisted of 100 conditionally healthy children of comparable age. The diagnostic and prognostic significance of immunological parameters and the level of threshold values (cut-off) were evaluated using the method of characteristic curves (ROC analysis).

Results. A high probability of predicting (> 70%) the effect of GIBP therapy was obtained for the Th17/Treg index, regardless of the form of pathology and duration of therapy; for the absolute content of regulatory cells (Treg and MDSCs), regardless of the form of pathology during the maintenance course of GIBP; the activity of ADHD in Treg — in IBD and PS, regardless of the duration of therapy; the combination of ADHD activity in Treg and the Th17/Treg index in IBD, PS and MS, regardless of the duration of therapy; memory T cell subpopulations in IBD, PS and MS during the maintenance course; the relative Treg content with ectonucleotidase CD39 expression in IBD and MS after the induction course. Exceeding the threshold values for NF-κB levels in NK cells has been shown to predicts the activation of the inflammatory process in children with IBD, PS, and MS with a high probability (> 70%).

Conclusion. A 2-stage algorithm for immunological examination of children with IBD, PS, and MS has been developed based on informative immunological indicators, which allow for a high probability of predicting the effect of biological therapy and the activity of the inflammatory process before the administration of GIBPs and during the maintenance course.

Contribution:
Radygina T.V., Petrichuk S.V. — research concept and design;
Radygina T.V., Petrichuk S.V., Kuptsova D.G., Kurbatova O.V., Anushenko A.O., Opryatin L.A., Abdullaeva L.M., Freidlin E.V. — collection and processing of material;
Radygina T.V., Petrichuk S.V. — writing the text;
Fisenko A.P., Potapov A.S., Murashkin N.N., Kuzenkova L.M. — 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 was supported by a state assignment from the Russian Ministry of Health, № 119013090093-2, 122040800220-9.

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

Received: November 10, 2025
Accepted: November 27, 2025
Published: December 25, 2025

Introduction. Multiple hereditary exostatic chondrodysplasia (MHEC) is an orphan disease that requires constant orthopedic support for patients during the growth process. More than 35% of MHEC children require surgical treatment for progressive ulnar clubhand (UC). Guided-growth technology makes it possible to correct deformity without crossing the bone. The aim of the work: to increase the effectiveness of surgical treatment of ulnar clubhand in MHEC children by optimizing the choice of tactics between the method of hemiepiphysiodesis of the radius and various variants of osteotomies of the forearm bones.

Materials and methods. Thirty UC children were examined against the background of MHEC, which were observed in the neuro-orthopaedic department from 2018 to 2025. All patients were divided into 2 groups according to surgical treatment methods: group 1 consisted of 15 children (19 forearms) treated with guided growth technology, group 2 consisted of 15 patients (15 forearms) treated with osteotomies. All parameters were evaluated before and 21 ± 6 months after surgery.

Results. In patients of the controlled growth group, all parameters showed statistically significant changes before and after surgery (p < 0.01). When comparing the results of operations between groups of patients, the key parameter was the wrist joint angle (difference 7.75°; p < 0.0001), which showed greater importance in children of the controlled growth group. The remaining postoperative parameters did not differ significantly in patients of different groups.

Conclusion. The use of controlled growth technology makes it possible to correct both axial deformity and the difference in the length of the forearm bones in patients, which prevents the formation of severe deformities and reduces the need for osteotomies in the future. Performing osteotomies with various types of internal and external fixation is certainly the method of choice for correcting severe deformities with dislocation of the head of the radius.

Contribution:
Petel’guzov A.A., Zubkov P.A. — concept and design of the study;
Petelguzov A.A., Zubkov P.A. — collection and processing of the material;
Zubkov P.A., Pimbursky I.P. — statistical processing of the material;
Petel’guzov A.A., Zubkov P.A., Zherdev K.V., Chelpachenko O.B. — writing the text;
Zherdev K.V., Butenko A.S., Chelpachenko O.B., Pimbursky I.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: October 14, 2025
Accepted: November 27, 2025
Published: December 25, 2025

Introduction. Hypospadias remains a relevant and challenging problem for surgeons. The rate of complications is still considerably high, with many authors reporting figures ranging from 10% to 50% or even more. Urinary tract infection (UTI) and surgical site infection (SSI) in the postoperative period are among the causes of long-term complications following hypospadias repair. However, according to a number of authors, SSI in hypospadias surgery is relatively rare. Consequently, with the recent increase in antibiotic resistance, the necessity of perioperative antibiotic prophylaxis for distal forms of hypospadias in children has been called into question. Objective: To evaluate the efficacy and advisability of perioperative antibiotic prophylaxis in the surgical treatment of distal hypospadias in children.

Materials and methods. A prospective randomized study was conducted from 2023 to 2025, involving 122 boys aged 1 to 3 years with distal hypospadias. The patients were divided into two equal groups of 61 patients each. Patients in group 1 received perioperative antibiotic prophylaxis for 3–5 days. Patients in group 2 did not receive antibiotic prophylaxis. All patients underwent urethroplasty using one of three techniques: MAGPI, Mathieu, or TIP. The primary outcome of the study was the presence of a SSI, defined as erythema, pronounced edema, or purulent discharge from the surgical wound, as well as UTI, manifested as pyuria and bacteriuria. The secondary outcome was the incidence of late postoperative complications (urethral fistula, meatal stenosis, wound dehiscence, urethral diverticulum). All patients were followed up for at least 6 months postoperatively.

Results. The following results were obtained. In group 1, UTI was observed in 5 patients (8.2%), compared to 13 patients (21.3%) in group 2. SSI was noted in 2 (3.3%) patients in group 1 and in 6 (9.8%) patients in group 2. When assessing long-term postoperative complications over six or more months, meatal stenosis was observed in 2 (3.3%) patients in group 1 and in 1 (1.6%) patient in group 2. Urethral fistulas developed in 3 (4.9%) patients in group 1 and in 4 (6.6%) patients in group 2. A urethral diverticulum was noted in 1 (1.6%) patient with meatal stenosis in group 1. Wound dehiscence occurred in one boy (1.6%) from group 1 and in 2 (3.3%) patients from group 2. The total complication rate in both groups was 11.5%.

Conclusions. The use of antibiotic prophylaxis reduces the incidence of SSI and UTI in the surgical treatment of distal hypospadias but does not lead to improved long-term outcomes. The benefit of prophylactic antibiotic administration in this context is questionable.

Contribution:
Sukhodolsky A.A. — concept and design of the study;
Sukhodolsky A.A., Fedulov A.V., Sytkov V.V., Yanorova A.I., Anikeeva Yu.A., Mikhailov E.S., Nechay A.V. — collection and processing of the material;
Sukhodolsky A.A., Fedulov A.V. — writing the text;
Sukhodolsky A.A., Zorkin S.N., Poddubny I.V., Sytkov V.V., Chernukha M.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. This work was supported by the state budget-funded research program of the Moscow Region: “Study of the Efficacy of Perioperative Antibiotic Therapy in the Prevention of Surgical Site Infections in Children with Diseases of the Urinary System”.

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

Received: October 30, 2025
Accepted: November 27, 2025
Published: December 25, 2025

Introduction. Despite the effectiveness of various methods of reimplantation of the ureter in various forms of pathology of the ureterovesical segment in children, a number of patients require repeated reconstruction. At the same time, there are situations when the length of the mobilized ureter is insufficient for transverse ureterocystoneoimplantation with the formation of the ureteral mouth in the area of the Lieto triangle. The question remains about the choice of a technique for the formation of ureterocystoanastomosis in conditions of a deficit in the length of the ureter. The aim: to determine the effectiveness of various methods for repeated reimplantation of the ureter in children.

Materials and methods. In the department of urology and andrology, in the period from 2016 to 2025, repeated laparoscopic ureterocystoneoimplantation was performed in forty patients, on 45 ureters. The age of the children ranged from 10 months to 16 years (63.8 ± 45.7 months). The patients were divided into 2 groups. Group 1 included 12 children who underwent laparoscopic transverse extravesical reimplantation (14 reimplanted ureters). Group 2 included 28 patients who underwent laparoscopic longitudinal extra-intravesical ureterocystoneoimplantation (31 reimplanted ureters). The follow-up period is from 6 months to 9 years.

Results. In patients who underwent laparoscopic transverse extravesical ureterocystoneoimplantation, vesicoureteral reflux was detected in 5 out of 14 reimplanted ureters. Due to the loss of kidney function, two children underwent nephrectomy. In patients with laparoscopic longitudinal extra-intravesical ureterocystoneoimplantation, vesicoureteral reflux was detected in 4 out of 31 reimplanted ureters. Violations of the evacuation function of the vesicoureteral segment in the postoperative period were not detected in patients from both groups.

Conclusion. The high efficiency of laparoscopic longitudinal extra-intravesical ureterocystoneoimplantation in children with repeated interventions, including conditions of ureteral length deficiency, has been established.

Contribution:
Sharkov S.M. — concept and design of the study;
Margieva D.A., Shmyrov O.S., Kulaev A.V., Surov R.V., Lobach P.Yu. — collection and analysis of the material, writing the text;
Lazishvili M.N., Morozov K.D., Kovachich A.S., Lobach A.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: October 30, 2025
Accepted: November 27, 2025
Published: December 25, 2025

Introduction. A decrease in sleep duration, its significant variability and sleep breathing disorders (obstructive sleep apnea syndrome — OSA) are factors in the formation of obesity in children. The main cause of OSA in children is chronic pathology of the ENT organs, when combined with overweight and obesity, its most severe forms are recorded. The aim: to determine the features of sleep disorders and their association with obesity in children with chronic pathology of ENT organs.

Materials and methods. One hundred twenty seven children (75 boys and 52 girls) aged of 4–12 years (median 6 years) with chronic pathology of ENT organs were examined during 2016–2024. All children were examined with night polysomnography (PSG) using the Embla 7000 system (USA). A statistical analysis of quantitative PSG data was performed and their relationship to age, gender, and SDS index of the of body mass index (BMI) was determined.

Results. Snoring, shortness of breath, and sleep disorders in children with chronic forms of ENT pathology are closely related to the indices of apnea/hypopnea (IAG) and desaturation (ID), which indicates the risk of developing chronic non-communicable diseases. In preschool children (4–6 years old), complaints of breathing disorders during sleep and objective signs of sleep disorders prevail. In these patients, despite severe forms of pathology of the ENT organs, overweight, obesity, and less pronounced forms of OSA are less often detected. Overweight and obesity are significantly more common in school-age children (7–12 years) with chronic pathology of the ENT organs, as well as their close correlations with complaints and objective PSG data indicating more pronounced sleep breathing disorders than in preschoolers.

Conclusion. In school-age children with chronic pathology of the ENT organs, objective signs of respiratory disorders during sleep are registered more often, are more pronounced and are associated with a frequently detected increased BMI, which requires an integrated approach in the treatment of children, taking into account behavioral factors, one of which is the child’s sleep.

Contribution:
Kozhevnikova O.V., Makarova S.G. — the concept and design of the study;
Tikhonovsky P.A., Lebedev V.V., Blazhievskaya T.O., Abashidze E.A. — collection and processing of the material;
Gordeeva I.G., Kustova E.A. — statistical analysis;
Kozhevnikova O.V., Tikhonovsky P.A., Rodionova A.M. — writing the text;
Fisenko A.P., Makarova S.G., Komarova 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: October 16, 2025
Accepted: November 27, 2025
Published: December 25, 2025

Introduction. Pneumococcal infection remains one of the leading causes of respiratory disease in children. Despite the widespread implementation of pneumococcal conjugate vaccines, the impact of vaccination status on the clinical course of bacterial respiratory infections remains relevant. In the context of increasing antibiotic resistance of Streptococcus pneumoniae, the evaluation of approaches to antibiotic therapy in pediatric patients is of particular importance. The aim of the study was to assess the clinical and laboratory characteristics of pneumococcal infections and patterns of antibiotic therapy in children with different vaccination status.

Materials and methods. A retrospective study included 128 children aged of from 6 months to 6 years who received treatment for pneumonia, acute otitis media, or acute rhinosinusitis at the National Medical Research Center for Children’s Health (Moscow, Russia). Patients were divided into those vaccinated against S. pneumoniae (Group 1; n = 48) and unvaccinated children (Group 2; n = 80). Clinical parameters (disease severity, level and duration of fever), laboratory markers (leukocyte count, C-reactive protein, procalcitonin), and characteristics of antibiotic therapy (route of administration, choice of agent, duration of treatment) were evaluated.

Results. Severe disease forms were significantly more common in children of Group 2 (28.8% vs. 12.5%; p = 0.033). C-reactive protein levels were higher in the Group 2 (48 mg/L vs. 33 mg/L; p = 0.003), while leukocyte counts did not differ significantly. Oral antibiotic therapy predominated in both groups (87.5% and 80.0%), and amoxicillin/clavulanate was the first-line agent. Children of the Group 1 demonstrated a trend toward faster fever resolution (95.3% vs. 85.3%; p = 0.09).

Conclusion. Vaccination against S. pneumoniae is associated with milder clinical course, reduced inflammatory response, and lower prevalence of severe disease in children. Effective use of oral antibiotics supports the feasibility of managing most patients without parenteral therapy and highlights the importance of rational antibiotic selection.

Contribution:
Alacheva Z.A., Bakradze M.D., Lazareva A.V. — concept and design of the study;
Alacheva Z.A., Poliakova A.S., Yasakov D.S. — data collection and processing;
Alacheva Z.A., Yasakov D.S. — statistical processing of the data, writing the text;
Bakradze M.D., Lazareva A.V., 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: November 10, 2025
Accepted: November 27, 2025
Published: December 25, 2025

Introduction. Staging of chronic kidney disease (CKD) is used in nephrology practice to assess the risk of kidney disease progression and determine the timing of renal replacement therapy (RRT). Infections, including vaccine-preventable ones, remain among the main causes of decreased overall and renal survival after kidney transplantation, necessitating monitoring of the complete implementation of preventive measures before initiating RRT. The aim: to determine the presence and persistence of post-vaccination immunity to whooping cough in children in the pre-transplant period at stages 3 and 5 of CKD.

Materials and methods. A retrospective analysis of the medical records of 91 patient was conducted: 42 children with CKD stage 3 (group 1) and 49 children with CKD stage 5 (group 2), aged 7 to 17 years, with an assessment of the presence of protective IgG levels to the pertussis pathogen Bordetella pertussis (BP) after previous vaccination. The comparison group consisted of 25 children without chronic diseases.

Results. The average frequency of positive IgG levels in children in group 1 with stage 3 CKD was found to m be only 33.3%, while in children with CKD stage 5 it was 52.8%. Positive IgG levels to BP in both groups were higher in children with non-immune-mediated pathology (Alport syndrome, congenital renal malformations, polycystic disease, etc.) compared to patients with primary steroid-resistant nephrotic syndrome. Positive levels of specific antibodies were detected in children in both groups in the period after vaccination up to 5 years of age — in 57.2% of children in group 1 and 55.1% in group 2.

Conclusion. Analysis of our sample shows about half of the patients (67.7% of patients with stage 3 CKD and 47% of children with stage 5 CKD) to have negative IgG to BP, which significantly increases the risk of infection in this cohort of patients and requires mandatory immunization in the pre-transplant period.

Contribution:
Matsneva I.Yu., Komarova O.V. — concept;
Matsneva I.Yu. Konyashin M.V., Kushtysev E.A., Dergacheva Yu.S. — collection and processing of material;
Matsneva I.Yu. — writing the text;
Trofimova A.G., Kurbatova O.V., Tsygin A.N. — 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: October 28, 2025
Accepted: November 27, 2025
Published: December 25, 2025

Introduction. The state of posture and foot are basic characteristics of the health and well-being in children and adolescents. Forming a single biomechanical system of human support, movement and balance, they are in a certain relationship. It is of scientific and practical interest to study the effects of foot deformity in the form of flat feet on the formation of postural disorders, as this allows scientifically substantiating measures to prevent postural disorders by preventing foot deformities. The purpose of the work: to establish and assess the risks of flat feet affecting postural disorders in students from 5^th to 11^th grade using evidence-based medicine methodology.

Materials and methods. An online survey was conducted of sixteen thousand six hundred seventy one student in grades 5^th –11^th with a diagnosis of foot deformity in the form of flat feet and 42,663 students in the same classes who were not diagnosed with such a diagnosis. The distribution by class was approximately equal and amounted to 15–18%. The respondents answered the questions: “Did the doctors notice that you have flat feet?” and “Did the doctors notice a violation of your posture?”. The answers included the following options: “No”, “I don’t know”, “Yes”. The survey was voluntary and anonymous. The number of children with postural disorders, having a normal arch of the foot and flat feet was estimated. To assess the causation of postural disorders by flat feet, the relative risk (RR) and etiological proportion (EF) were calculated.

Results. Children with flat feet, compared with children with a normal arch of the foot, the incidence of postural disorders was found to be higher during the entire period of secondary and high school education. In the 5^th grade students with a normal arch of the foot, the incidence of posture disorders was 14.6% (95% CI 13.9–15.4), with flat feet — 41.5% (95% CI 39.6–43.5) (p < 0.05). In the 11^th grade students, posture disorders were more common in both normal arch of the foot and flat feet, respectively, in 31.4 (95% CI 29.6–33.2) and 58.8% (95% CI 56.2–61.3) students (p < 0.05). The values of RR = 2.928 (95% CI 2.739–3.131) and EF = 65.9% in the 5^th grade students indicate a high degree of conditioning of posture disorders by the influence of flat feet. In the 11^th grade students, RR = 1.840 (95% CI 1.719–1.969) and EF = 45.7% indicate the average degree of conditioning.

Conclusion. The data obtained can be used in the development of preventive programs for the prevention of postural disorders and flat feet in students in educational institutions.

Contribution:
Khramtsov P.I., Berezina N.O. — concept and design of the study;
Razova E.V., Antonova E.V. — collection and processing of material;
Khramtsov P.I. — statistical processing and writing the text;
Komarova 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: October 22, 2025
Accepted: November 27, 2025
Published: December 25, 2025

Introduction. Physical education at school is an important area of health care due to its impact on the state of health, physical development, function capabilities of the body and the formation of vital skills in children. However, physical education lessons come with certain risks, including injuries of varying severity. The aim of the work — to assess the risks of the occurrence of injuries associated with flat feet in physical education for students in the grades 5^th–11^th.

Materials and methods. The study involved sixteen thousand 671 student from the grades 5^th–11^th who noted the presence of flat feet in an online questionnaire according to an orthopedic doctor and 42,663 students who were not diagnosed with such a diagnosis. The children also indicated the number of minor and serious injuries in physical education (PhE) over the past 12 months. The risks of flat feet influencing the occurrence of injuries in PhE were calculated using evidence-based medicine methods.

Results. In children with flat feet, compared with children with a normal arch of the foot, injuries were found to be more common, respectively, 33.1% and 29.4% (p < 0.05). This is true for both minor (29.4% and 27.0%, respectively; p < 0.05) and serious (3.7% and 2.4%, respectively; p < 0.05) injuries. The risk of flat feet influencing on the occurrence of minor injuries is low (EF = 3.6% in boys and EF = 13.9% in girls), and moderate in serious injuries (EF = 35.0% in boys and EF = 43.0% in girls). Serious injuries in boys were more often detected than in girls with both normal arch of the foot (2.8% and 2.1%, respectively; p < 0.05) and flat feet (3.9% and 3.5%, respectively; p < 0.05).

Conclusion. The data obtained can be used to substantiate a differentiated approach to the management of physical education classes for children with flat feet, the implementation of which will contribute to the prevention of injuries in PhE.

Contribution:
Khramtsov P.I. — concept and design of research, writing the text;
Berezina N.O. — processing and analysis of the material;
Razova E.V. — collection and processing of the material;
Komarova 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: October 31, 2025
Accepted: November 27, 2025
Published: December 25, 2025

Introduction. The steady increase in the prevalence and severity of allergic diseases worldwide necessitates the search for new pathogenetic mechanisms and preventive strategies. In addition to genetic predisposition, environmental factors, particularly the nature of nutrition during critical periods of early ontogenesis, have a significant impact on the development of the immune response and the risk for atopy. Polyunsaturated fatty acids (PUFAs) play a central role in this process, and the imbalance between the consumption of pro-inflammatory omega-6 and anti-inflammatory ω-3 PUFAs is considered a key factor in the epidemiology of allergic diseases. The aim. To systematize current data on the role and mechanisms of the effect of long-chain PUFA on the risk of development and course of allergic diseases, as well as to assess the potential for their use in prevention and therapy, taking into account genetic features of metabolism.

Materials and methods. The analysis of data from epidemiological, observational, and intervention studies, as well as systematic reviews, devoted to the study of the relationship between the consumption of PUFAs (both with food and in the form of supplements) during pregnancy, lactation, and early childhood with markers of immune response and clinical outcomes of allergic diseases. Special attention is paid to the role of polymorphisms of genes of the FADS cluster (FADS1, FADS2), encoding desaturase enzymes, in the modulation of the effects of PUFAs.

Results. The biological effects of ω-6 (arachidonic acid, ArA) and ω-3 (eicosapentaenoic acid, EPA and docosahexaenoic acid, DHA) PUFA were established to be opposite. ARA metabolites (prostaglandins, leukotrienes) provoke and support allergic inflammation, promote the polarization of the Th2-type immune response and IgE synthesis. On the contrary, ω-3 PUFAs compete with arcs for enzymes, suppressing the synthesis of pro-inflammatory eicosanoids and promoting the formation of specialized resolving mediators (SRM) that resolve inflammation and promote the formation of immune tolerance. Taking ω-3 PUFA supplements during pregnancy and lactation has been shown to be associated with a reduced risk of atopic dermatitis, sensitization to food allergens (especially egg white) and bronchial asthma in children, and the effects can persist for many years. The enrichment of infant formula with PUFA brings their immunomodulatory properties closer to those of breast milk. The effectiveness of PUFA interventions significantly depends on the genetic profile. Carriers of minor alleles of polymorphisms of the FADS genes are characterized by reduced desaturase activity, which leads to lower baseline concentrations of PUFA (especially ARA) and, as a result, to a greater susceptibility to the positive effects of supplementation of ω-3 PUFA and to a potentially lower risk of developing allergies mediated by reduced synthesis of proinflammatory mediators. The “genotype-diet” interaction is a critical factor: dietary interventions (for example, breastfeeding, increased consumption of fish) demonstrate the most pronounced protective effect in carriers of certain genotypes. At the same time, the data from individual studies are contradictory, which may be due to differences in research design, dosages, initial nutritional status of participants and their genetic background.

Conclusion. Long-chain PUFA play a fundamental role in the modulation of immune processes underlying the pathogenesis of allergic diseases. ω-3 PUFA supplementation during the perinatal period and early childhood demonstrates significant potential for the primary prevention of atopy. However, further large-scale prospective studies are required to develop personalized recommendations, taking into account the genetic characteristics of PUFA metabolism (primarily, the FADS cluster polymorphisms), which will allow identifying target populations, optimal doses, timing, and duration of interventions to maximize their clinical effectiveness.

Contribution:
Mukhortykh V.A., Larkova I.A. — creation of the concept, construction of sections of the work;
Mukhortykh V.A., Larkova I.A., Tarmaeva N.A. — work with literature sources, analysis and generalization of the data obtained, writing the text;
Revyakina 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 research work on the preparation of the manuscript was carried out using funds from a subsidy for the implementation of a state assignment within the framework of the Fundamental Scientific Research Program (FGMF-2025-0003).

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

Received: November 06, 2025
Accepted: November 27, 2025
Published: December 25, 2025

Introduction. The need to identify risk factors and complications of esophageal plastic surgery in children remains significant in pediatric surgery. This is due to the fact common risk factors in esophageal surgery in children to be associated with various forms of esophageal atresia in newborns, issues of choosing a transplant as a rescue strategy for chemical burns and esophageal strictures, technical difficulties in the formation of anastomoses, recurrent and refractory strictures after the restoration of esophageal atresia. The aim: to identify significant risk factors and complications of esophageal plastic surgery in children with colon. Literature was searched in Embase, PubMed, Google Scholar, and Medline databases. Indications for plastic surgery of the esophagus in children include atresia of the esophagus with diastasis, which does not allow direct esophagoesophagoanastomosis; cicatricial post-burn and peptic stenosis of the esophagus, resistant to bougie; previously unsuccessful attempts to create an artificial esophagus and other rare forms of pathology. The optimal plastic material for plastic surgery of the esophagus in children is the colon. The choice of colon graft should be flexible and based on an assessment of its blood supply, required length and location. In this case, the left sections of the colon are most often used, due to the anatomical features of the vessels of this department. Complications of colon esophageal plastic surgery are mainly associated with impaired blood supply to the transplant. The use of endoscopic methods in the reconstruction of the esophagus in children can significantly improve the results of surgical treatment of such patients with mandatory timely correction of intraoperative risk factors.

Contribution:
Shmykova A.O., Alkhasov A.B. — study concept;
Shmykova A.O., Ratnikov S.A., Portugal P.M. — collecting and processing material, writing the text;
Alkhasov A.B. — 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: October 24, 2025
Accepted: November 27, 2025
Published: December 25, 2025