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This article presents data on the epidemiology, pathogenesis, modern classification and the main clinical manifestations of Gaucher disease in children. The criteria for differential diagnosis with other diseases are given. It has been shown that the only effective method of treating Gaucher disease is pathogenetic enzyme replacement therapy, which relieves the main clinical manifestations of the disease, improving the quality of life of patients and without having pronounced side effects. The main errors of diagnosis and management of patients, as well as unjustified prescriptions for the treatment of this disease, are indicated.

Background. Even though mild cognitive impairments are common in patients with attention deficit hyperactivity disorder (ADHD), there are no studies of morphometric brain parameters in children with ADHD and comorbid mild cognitive impairments. Objective. The aim of the study is to determine and perform comparative analysis of MR-morphometric brain parameters in children with ADHD depending on the presence or absence of comorbid mild cognitive impairments. Methods. Participants are children aged from 7 to 8 years with ADHD without comorbid pathology (CP), ADHD with mild cognitive impairment (MCI), MCI without ADHD, and healthy children. All participants underwent brain magnetic resonance imaging followed by morphometry to obtain quantitative parameters of large brain structures, cerebral cortex gyri, basal ganglia, cerebellum, and lateral ventricles. Results. 90 children were examined. ADHD with MCI group has shown significant decrease in the volumes of caudate nuclei bilaterally and hippocampus on the right, as well as decrease in the volumes of right superior parietal gyrus, supramarginal gyrus, and frontal cortex. ADHD without CP group has shown different changes: decrease in the volume of putamen on both sides and thalamus on the left, increase in the volume of six and decrease in the volume of the cortex of four gyri, cortex thinning of four gyri with cortex thickening of one gyrus, volume increase of four cerebellar lobules. MCI without ADHD group has shown bilateral enlargement of lateral ventricles, decrease in the volume of right pallidum and seven gyri cortex, mostly on the right side, as well as decrease in the volume of four cerebellar lobules. Direct comparison between the two ADHD groups has shown significant differences up to lower total cortex volume with 5 gyri of left hemisphere and 7 gyri of right hemisphere in the ADHD with MCI group. Participants of ADHD groups compared to healthy individuals and the MCI without ADHD group did not show any age-related dynamic decrease in the volumes of cerebral cortex. Conclusion. ADHD is characterized by parallel presence of two pathogenetic processes: cerebral cortex hypoplasia and delayed age-related changes in other areas. Significant differences in morphometric parameters were revealed between ADHD without CP and ADHD with MCI. It suggests individual treatment for such patients and revision of approaches to morphometric brain studies in patients with ADHD. Enlargement of lateral ventricles in MCI may indicate the effect of perinatal pathology on these conditions’ etiology.

Mucopolysaccharidosis type II (Hunter syndrome, MPS II) is a rare hereditary disease from the group of hereditary metabolic diseases. There are neuropathic and non-neuropathic forms of this disease. The neuropathic form is most common and leads to severe cognitive impairment and progressive damage of central nervous system. Nowadays, early diagnosis and timely initiation of pathogenetic therapy in patients with orphan diseases is the crucial problem of modern pediatrics. Intracerebroventricular administration of idursulfase beta is one of the promising treatment options in patients with neuropathic form of MPS II as it prevents severe complications development. The study of new pathogenetic therapy methods for rare hereditary diseases will help doctors of pediatric specialties to route patient correctly in timely manner to receive all the necessary treatment.

Psoriasis is the second most common skin disease after atopic dermatitis in childhood. There are factors affecting both the manifestation and aggravation of this inflammatory skin process. The leading role in the psoriasis pathogenesis is currently associated with key cytokines. However, infectious diseases could be the triggers for psoriasis.Nowadays, the approach to psoriasis management in children has been revised due to emerging of new knowledge about the clinical manifestations and the role of numerous comorbid conditions in psoriasis course. Risk factors assessment, as well as evaluation of potential comorbidities signs and symptoms, is crucial part in patient management to create a prognostic model of the disease progression and the aggravation development (with underlying associated inflammatory processes included).

Background. The COVID-19 pandemic is a global challenge to States and health systems. The pandemic and its consequences can have a devastating impact on the health and development of children, especially those in vulnerable situations — children with disabilities.The aim of the study is a medical and social assessment of the effect of the COVID—19 pandemic and its consequences on families with children with disabilities.Methods. A descriptive study using the Google forms platform was conducted using the cross-sectional method. Two groups of parents of children aged 0–17 years with disabilities (group 1) and without disabilities (group 2) who apply to a medical organization for preventive examinations were interviewed.Results and discussion. A total of 175 electronic questionnaires were received. Parents from 46 regions of Russia participated in the survey. A significant majority of respondents were women — 172 people (98%), 3 men (2%). More than half of the respondents are residents of the megalopolis. The study showed that the COVID-19 pandemic had a negative impact on the health and education of children and on the lifestyle and families welfare in general. It was revealed that the financial situation of many families who took part in the study worsened, which affected the living conditions of children. During the COVID-19 pandemic, the health care system was being rebuilt taking into account new tasks to counteract dangerous infection, which was reflected in changes in the provision of medical care to children, and in some cases this led to a deterioration of their health. A significant number of parents who participated in the study believe that changes in the organization of medical care during the pandemic had a negative impact on their child’s health. Among the main health problems, parents highlight delays and cancellations of medical consultations, difficulties in obtaining urgent care and problems with drug provision. Among the main health problems, parents highlight delays and cancellations of medical consultations, difficulties in obtaining emergency care and problems with drug provision. The study shows that families with disabled children have been affected by the COVID-19 pandemic to a greater extent than families raising children without chronic health problems. If the deterioration of the financial situation is almost equally revealed in both groups, then problems related to medical care and education have a more noticeable impact on families with a child with a disability. The obtained results should be taken into account in times of new challenges when developing measures of state support for families with children, especially with children with disabilities. At the same time, it is important to pay primary attention to the organization of medical care for children (continuity of planned medical care for the child population and rehabilitation actions) and educational services (providing online learning opportunities for the child, taking into account individual ones).Conclusion. The COVID-19 pandemic and its consequences have had a negative impact on the standard and quality of life of people, especially families with children. The pandemic has had a significant adverse impact on the health and development of children, especially children with disabilities. The study showed a decrease in the financial situation of families, problems with children receiving medical care, difficulties in education, especially with regard to specialized pedagogical classes with disabled children, during the pandemic. According to the study, in order to prevent the negative impact of the pandemic, it is proposed not only to provide financial support to families, but also to maintain access to the educational process with the provision of the required devices, as well as the possibility of receiving medical care for children, especially children with disabilities, including planned.

Background. Recurrent upper respiratory diseases in children are an urgent and common issue in pediatrics. Comorbidities often lead to prolonged, complicated, or chronic course of the inflammatory process in the upper airways.Objective. The aim of the study — scientific evidence and complex technology development for the management of children with recurrent upper respiratory diseases according to implemented multidisciplinary personalized approach, complex of modern methods for diagnosing and health monitoring to achieve long-term remission.Materials and methods. The study included 115 children aged from 2 years 6 months to 17 years 11 months with recurrent upper respiratory diseases. Examination included: nasal cavity, nasopharynx and larynx endoscopy, abdomen ultrasound with aqueous-siphon test, tympanometry, and laboratory tests (total and specific IgE levels, antistreptolysin-O, microbiological study of nasopharynx and oropharynx discharge, enzyme-linked immunosorbent assay of feces on Helicobacter pylori.Results. The study has revealed high prevalence of associated allergic pathology in children with recurrent upper respiratory diseases. Allergic rhinitis was the most common (55 (48%) children). There was also a high prevalence of gastroesophageal reflux disease (GERD) (37 (32%) children). Clinical signs of GERD were revealed in patients with chronic diseases significantly more often than in children with acute ENT pathology (27 (38%) and 10 (23%) children, respectively). It confirms the role of this comorbid condition in the development and course of chronic inflammatory process of the upper airways. Obtained data analysis has shown high prevalence of allergic and gastrointestinal pathology in children with recurrent upper respiratory diseases. Diagnostic and management algorithm for patients with recurrent upper respiratory diseases as well as practical guidelines were prepared based on the study data. This algorithm will allow to implement the personalized multidisciplinary approach for the management of prior and comorbid diseases via modern informative diagnostic methods. The complex approach to timely physical examination and pathogenetic treatment will ensure control of the patient’s condition and prevent the development of chronic ENT organ pathology in children.

Background. The role of recently discovered neurospecific peptides in the pathogenesis of acute and progressive neurologic disorders, their neuroprotective features, and possibilities to use them as markers for the course and prognosis of certain diseases have been actively studied in recent decades. However, neurospecific peptides are almost not studied in chronic residual diseases. In our study we measured the levels of neurospecific peptides and some other markers to achieve understanding of general neurophysiological trends in congenital and acquired chronic non-progressive brain pathology with reference to the selection of relevant groups — study objects. Objective. The aim of the study is to study patterns of neurospecific peptides, neurotransmitters and neuroreceptor markers distribution in the serum of children with various pathogenetic variants of chronic neuropathology. Methods. The study included children from 3 to 16 years old with different pathologies. The sample was divided into groups by pathology type: no sensory and neurological disorders, congenital sensory deficit due to mutation of genes expressed and not expressed in the brain, early acquired sensory deficit of multifactorial nature, congenital mild and severe organic disorders of central nervous system (CNS) in residual stage without baseline sensory deficit, acquired functional CNS disorders without baseline organic defect and sensory deficit. The following laboratory data (neurophysiological components) was studied: nerve growth factor, brain-derived neurotropic factor, neurotrophin-3, neurotrophin-4, neuregulin-1-beta-1, beta-secretase, sirtuin-1, synaptophysin, neuronal nitric oxide synthase, and anti-NR2 glutamate receptor antibodies. The parameters of cognitive activity, sense of vision, sense of smell, and acoustic sense were also evaluated. Results. The study included 274 participants. Neuropeptides and markers have shown a variable degree and range in the group spectrum of differences from normal levels. The most variable in the examined sample was NO-synthase, as well as levels of both neurotrophins, beta-secretase, and glutamate receptor marker. All visual deficits were associated with increased NO-synthase levels (p < 0.001). Neuroplasticity peptides (beta-secretase, neurotrophin-3 and 4) have been activated in all pathological conditions. Nerve growth factor and brain-derived neurotropic factor were specifically activated in mild organic CNS lesions (mild cognitive impairments), while neuregulin — in congenital genetically determined visual deficits. There was no specific activation of neuropeptides and NO-synthase level tended to decrease in cases of severe CNS lesions. Conclusion. The study results suggest that all types of early visual impairment are associated with increased physiological neuronal activity, and non-organic neurological functional disorders — mainly with increased physiological synaptic activity. General neuroplasticity processes were activated in all cases of visual deficits but more specific. However, more specific and well-studied processes were activated in mild organic CNS lesions, and neuroplasticity processes did not activate adequately in severe organic CNS lesions probably due to the limited neuronal and synaptic resources.

Epidemiological surveillance of preventive vaccinations implementation is the most crucial component in the immunoprophylaxis organization. Assessment of documented vaccination coverage indicators allows to determine the quality of routine preventive vaccination and indirectly evaluate the possible state of population immunity to vaccine preventable diseases. Continuous quality control of routine vaccination, therefore, is a component of the system for epidemic management of infectious diseases. Specific decisions should be based on its results to improve preventive vaccination quality.Сomparative analysis of the vaccination history in adolescents (studying in schools in large cities of different federal districts of Russian Federation) and recommended national immunisation schedule allowed to identify widespread systemic mistakes of vaccination status. These issues led to the uprise and spread of vaccine preventable diseases. The study results confirmed the topicality of awareness-raising activities among medical staff working on preventive vaccination. Moreover, long-standing need of vaccination schemes correction is also important through development of medical technology aimed on improvement of catch-up vaccination approach.

Background. Nasal and nasopharyngeal pathology is one of the most important and widespread challenge in pediatrics and pediatric otorhinolaryngology. Prolonged nasal breathing difficulty can be caused by various diseases and their combinations. It requires multidisciplinary approach to diagnosis with the involvement of modern examination methods and pathogenetic treatment. Objective. The aim of the study is to develop complex technology for the management of children with nasal and nasopharyngeal pathologies. Methods. The study included 240 children aged from 6 to 18 years. All patients were divided into 3 groups, comparable by sex and age: Group 1 – 85 patients with confirmed ENT-organ disease, Group 2 — 104 patients with confirmed allergic disease, control group — 51 somatically healthy patients who did not have any ENT-organ or allergic diseases. Examination procedures: diagnostic nasopharyngeal endoscopy, rhinomanometry (RMM), rhinoresistometry (RRM), olfactometry. Results. The obtained results (RRM, RMM) have shown that air flow rate in nasal cavity increased due to nasal resistance decrease. Nasal resistance was higher and air flow rate was lower in all children with various ENT-organs or allergic diseases compared to the control group. Nasal resistance decreased in all study groups (significantly in children with aggravation of allergic diseases of airways and ENT-organs diseases) as well as air flow rate increased in all study groups (significantly in Group 1 and 2) after anemisation of nasal mucosa with decongestants. Apparently, it can be associated not only with anatomical features (nasal septum deviation), but also with inflammatory features of nasal cavity and nasopharynx (adenoid hypertrophy and inflammation, persistent swelling of nasal mucosa at allergic rhinitis). We would like to present the algorithm for diagnosis of children with nasal and nasopharyngeal pathologies according to the study results. The following practical guidelines have been proposed: 1) all patients with complaints on prolonged nasal breathing difficulties require not only otorhinolaryngologist examination, but also diagnostic endoscopy of nasal cavity and nasopharynx; 2) in case of nasal septum deviation and complaints on prolonged nasal breathing difficulties, it is necessary to perform functional methods for nasal breathing evaluating (RRM, RMM) to choose adequate treatment method; 3) the use of RRM, RMM would help to choose the optimal treatment approach in children with complaints on prolonged nasal breathing difficulties and confirmed diagnosis of allergic disease (allergic rhinitis, hay fever, etc.), also associated with adenoid hypertrophy and/or nasal cavity and nasopharynx inflammatory diseases; 4) all patients with confirmed chronic diseases of ENT-organs should be examined by allergist, and, if necessary, should undergo comprehensive allergological examination. Conclusion. The developed complex approach to the management of children with nasal cavity and nasopharynx pathology is innovative and represents the technology of personalized use of modern, objective methods for diagnosing the nasal cavity and nasopharynx state. The presented diagnostic algorithm and practical guidelines allow us to establish diagnosis and choose the treatment tactics within a short time. The use of these studies in clinical practice will allow to monitor the therapy efficacy (including various pharmacotherapeutic strategies) for nasal cavity and nasopharynx diseases in children. Timely examination and pathogenetic treatment will allow to prevent the chronization of pathological process in ENT-organs. This is especially crucial in childhood as it provides children with the best chance of healthy growth and development.

Background. Speech development impairment is urgent and common problem in pediatric neurology. Transcranial magnetic stimulation (TMS) is one of the promising treatment variants for children with speech disorders. Objective. The aim of the study is to evaluate efficacy and safety of the developed approaches to TMS usage in the management of children with speech disorders. Methods. It was non-randomized controlled study. It included 46 children with speech disorders aged from 3 to 6.5 years. All children were divided into two groups comparable by gender and age: 26 children of the treatment group received TMS course, 20 children of the control group received treatment with hopantenic acid. All patients with speech disorders underwent psychological and pedagogical evaluation of speech and cognitive development, electroencephalography (EEG) before and after treatment. Moreover, comparative analysis of TMS and nootropic therapy efficacy was carried out. Specialized examination of speech and cognitive development was also performed via E.A. Strebeleva method for psychological and pedagogical diagnosis of children development. Furthermore, we carried out side reactions / adverse events registration according to patients and/or their parents complaints confirmed by physical examination, patient’s behavior observation, data from specially developed questionnaire for assessing child’s behavior and well-being (filled up by parents). Finally, we evaluated brain bioelectric activity recorded by EEG. Results. The study results have shown that it is possible to achieve significant positive dynamics in cognitive and speech development in preschool children with speech disorders in both groups (TMS course and medical treatment). But hereby, TMS treatment has demonstrated significantly higher positive dynamics in two out of the three evaluated parameters. There were no cases of adverse events in TMS group leading to early course discontinuation. Conclusion. TMS is non-invasive and safe method for treatment of children with speech disorders. This study has demonstrated the efficacy of the method in the field of personalized management of children with impaired speech and cognitive development.

The issue of recurrent upper respiratory tract diseases in children is common and relevant. Commonly this pathology is associated with other diseases that lead to the prolonged, complicated, or chronic course of the inflammatory process in the upper respiratory tract. Objective. The aim of the study is to improve management principles for children with recurrent upper respiratory tract diseases according to the developed multidisciplinary and personalized approach (modern methods of diagnosis and health monitoring) for achieving long-term remission. Methods. The study included 65 children aged from 3 to 17 years 11 months with recurrent upper respiratory tract diseases. Examination: nasal, nasopharynx and larynx endoscopy, abdominal ultrasound with aqueous-siphon test, tympanometry, and laboratory tests (complete blood count, evaluation of total and specific IgE levels, antistreptolysin O, nasopharynx and oropharynx microbiological study, enzyme-linked immunosorbent fecal analysis for Helicobacter pylori). Results. 88% of examined children showed allergic pathology according to our study results. Clinical signs of gastroesophageal reflux disease (GERD) were revealed in 30% of children with chronic oropharynx inflammation. GERD signs were revealed both via abdominal ultrasound with aqueous-siphon test and via fiberoptic laryngoscopy and later confirmed by esophagogastroscopy in 8.7% of patients. Obtained data indicates high prevalence of allergic and gastroenterological pathology in children with recurrent upper respiratory tract diseases. Conclusion. Obtained results allow us to establish scientifically multidisciplinary and personalized approach for the management of children with recurrent upper respiratory tract disease. This approach shall include key diagnostic methods required for improvement of comorbid conditions revealing, and achieving and maintaining control over the disease symptoms. The study is currently ongoing.

Background. The study of digital activity correlation with cognitive-emotional features, as well as with other parameters of adolescents’ life-activity in non-capital regions of Russian Federation remains relevant.Objective. The aim of the study is to analyze the digital activity structure in adolescents and its correlation with cognitive-emotional features, school performance and social and age factors.Methods. Participants are secondary school students of the 8th–11th grades. Digital activity was examined via online survey among adolescents. We took into account the use of social media, information search, watching videos on the Internet, using of messengers, playing games with electronic devices. Cognitive features (memory, thinking, executive functions, sensory information procession, reading and speech, understanding of emotions, decision-making) and emotional state of adolescents (anxiety) were evaluated by clinical psychologists via various tests. School performance was determined by the recent results of the school quarters/semester finished by the time of the survey. Social and age factors included regular out-of-school physical activity and family structure (complete/ incomplete).Results. We have examined 438 teenagers. 53 (12%) respondents spend more than 5 hours a day with digital devices on weekdays, 133 (30%) — on weekends, 147 (34%) — during the holidays. Structure of digital activity during weekdays (≥ 1 hour) among adolescents was the following: activity in social media prevailed (63.5% of respondents), fewer teenagers searched for information or watched videos on the Internet (47.3 and 42.9%, respectively), about a third (34.9%) played via electronic devices. Structure of digital activity changed over the weekend and during the holidays. We have revealed differences between the information search activity and the volume of short-time memory, understanding the verbal messages, and verbal-logical operations level. Adolescents with different levels of computer gaming activity have shown diversity in sensomotor reaction speed, visuospatial memorization accuracy, number of errors in high-speed reading, reading pace, and understanding text basic meaning.Conclusion. The greater time of digital activity among 8th–11th grades students is associated with negative results of cognitive activity and school performance.

The description of new promising method of functional neuroimaging, functional near-infrared spectroscopy (fNIRS), is presented. General information on functional tomography and its features in children are given. Brief description on the history of fNIRS development, the method itself, its advantages and disadvantages are covered. fNIRS implementation areas in science and clinical practice are clarified. fNIRS features are described, and the role of this method among others in functional tomography is determined. It was noted that fNIRS significantly complements other research and diagnostic methods, including functional magnetic resonance imaging, electroencephalography, induced potentials, thereby expanding the range of scientific and clinical issues that can be solved by functional neuroimaging.

Background. For now, there is little data on sensitivity features to specific allergen antigens in infants with initial allergy manifestations.Objective. The aim of the study is to determine the features of the primary molecular sensitisation profile in infants with risk of atopic disease according to their postnatal age.Methods. Full-term infants with burdened familial allergic history and/or skin/gastrointestinal allergy symptoms were examined: Group 1 — 50 children, age — 2.0 [1.0–3.0] months; Group 2 — 35 children, age — 9.0 [8.0–11.0] months.Results. The hereditary atopy risk was observed in 74% of cases (37/50) in Group 1 and in 71% of cases (25/35) in Group 2. 38% of children (19/50) in Group 1 were breastfed, in Group 2 — 60% of children (21/35). Supplemental feeding was implemented in 5.5 [5.0–6.0] months. Sensitisation was reported in 10% and 37% of children. Children of Group 1 were sensitised to food allergen antigens: cow's milk/meat (Bos d 6, Bos d 8), egg-white (Gal d 1, Gal d 2, Gal d 3), soybeans (Gly m 6), shrimps (Pen m 4); airborne allergens: house dust mite (Blo t 5, Der h 10), Anisakidae (Ani s 3), cockroach (Bla g 7). Children of Group 2 were sensitised to food allergen antigens: cow's milk (Bos d 6), egg-white (Gal d 1, Gal d 2), soybeans (Gly m 6), peanut (Ara h 1, Ara h 2, Ara h 6), kiwi (Act d 1), corn (Tri a 19); airborne allergens: cat (Fel d 1, Fel d 4), birch pollen (Bet v 1). Polyvalent sensitisation was revealed in 4% and 6% of cases, respectively.Conclusion. Infants have much wider range of allergens to which they are sensitive than it is commonly believed. Beside obligate food allergens, sensitisation can be caused by airborne allergens: house dust mites, epidermal, birch pollen; crossreactive component — tropomyosin.

Dyslexia (disturbance of reading) and dysgraphia (disturbance of writing) are a common problem of teaching children in secondary schools. Information on the prevalence of these conditions is ambiguous, the data presented in the Russian speech therapy literature differ from the results of a few foreign works, and therefore population studies are becoming particularly relevant. The review of the domestic methodological base with the prospect of application in population research and international approaches to population screening are presented.

The other contributors confirmed the absence of a reportable conflict of interests The influence of dynamically changing habits associated with the use of digital devices (DD) on the child’s brain is one of the most topical issues of the last decade. Ambiguous or contradictory data on this issue indicate the need of systematizing all the results of scientific research. This analysis shows negative effect of large amount of screen time on the development of children at early age, their academic performance, and attention at older ages due to media absenteeism, as well as the correlation between the use of digital devices with delayed reward. It is necessary to update and to conduct qualitative research to understand the issue in more comprehensive way.

Speech disorders have the leading position among cognitive disorders and represent the urgent medical problem. The modern approach to the treatment of cognitive and behavioral disorders in children consists of the integrity of pharmacotherapeutic, correctional and psychotherapeutic, as well as non-invasive instrumental methods of brain neurostimulation. This article provides the overview of the currently available data on transcranial magnetic stimulation method as noninvasive treatment of various neuropsychiatric disorders in children and its difference from physiotherapeutic methods used in traditional Russian practice.

Modern approaches for the management of children with gastrointestinal pathologies include optimal nutritional support that makes it possible to replete energy failure and restore essential nutrients balance. The article presents key information on gastrointestinal diseases in which modern amino acid formulas can be used to regulate nutritional status. The authors have conducted the extensive analysis of all available for now evidence on the efficacy, safety and utility of using such innovative medical technology as special elemental formula in gastrointestinal tract pathological conditions. This material is the basis for guidlines on the use of amino acid formulas developed by expert specialists of the Union of Pediatricians of Russia in 2020.

The aim of the study is to estimate olfaction in post-COVID-19 children.Research methods. The study included 81 children, they were divided into two groups: those who had COVID-19 and those who had not.Survey procedures. Pediatrician, neurologist and otolaryngologists clinical examinations, cognitive status estimation, olfactometry were performed.Results. The olfaction perception threshold post-COVID-19 children and adolescents was higher than in children who have not undergone this infection. Changes in olfaction perception threshold did not depend on how participants and their parents informed about the sense of smell. The involvement of olfactory sensitivity in the pathological process does not depend on the infection severity itself or premorbid neurological lesion.Conclusion. It has been shown for the first time in the Russian sample that changes in sense of smell persist in children 3–4 weeks after recovery from COVID-19.

The article presents modern approaches to the use of balanced formulas for nutrition and diet correction in children with various forms of food allergies. The guidelines are based on all available up to date evidence on the efficacy, safety and utility of using such innovative medical technology as specialized amino acid formulas. This formula is the targeted medical intervention for food allergies and confirmed cow's milk protein allergy, and particularly for patients with reduced physical growth and development (growth rates included). The material is based on methodological guidelines on the amino acid formulas usage previously developed by specialist experts of the Union of pediatricians of Russia in 2020.

The Ministry of Health of the Russian Federation jointly with professional association and experts in the field of pediatrics, infectious diseases and resuscitation has revised guidelines “Clinical Features and Management of the Disease Caused by New Coronaviral Infection (COVID-19) in Children” in order to provide the child population with effective medical care during the pandemic of the new coronaviral infection. The practical experience of specialists from various countries was considered during the development of this document. Special attention should be given to the evidence base of the presented data, as well as to the efficiency and safety issues of medications used in treatment of coronaviral infection and its complications. The authors highlight the problems of prevention, diagnostics and management of pathological conditions caused by COVID-19 in the article according to the presented guidelines. Patient’s management is presented depending on the age and severity of the disease itself. The therapy is considered with regard to etiological, pathogenetic and symptom focus.

Background. The number of people infected with SARS-CoV-2 causing COVID-19 is growing worldwide. It is necessary to study features of prevalence and clinical signs in pediatric population considering the fact that this disease is rather new.The aim of the study is to analyze the features of prevalence and clinical signs of pathologic process of COVID-19 in pediatric patients according to the results of practical experience of primary care medical facility (Children’s City Outpatients Clinic № 133) under the conditions of pandemia.Methods. Pediatricians of Children’s City Outpatient’s Clinic № 133 have examined certain categories of pediatric patients (especially who came from abroad or contacted with infection) for the presence of a new coronaviral infection in February 2020. Doctors have been examining children with catarrhal symptoms and hyperthermia since March 2020. The survey of children in February and March was carried out in accordance with algorithms (uniform for adults and children) approved by the Moscow City Health Department. Later, the survey was carried out in accordance with the guidelines for children prepared by the Ministry of Health of the Russian Federation. The throat and nose swabs on SARS-CoV-2 were performed for all patients on the 1st, 11th and 13th day of the disease.Results. 1,900 children (or 3.1% of total attached pediatric population) have been examined in our outpatient’s clinic with the polymerase chain reaction (PCR) method on the presence of the new coronavirus RNA since the beginning of the COVID-19 pandemic in Russia. The course of disease was analyzed in first 100 patients with the confirmed COVID-19 diagnosis: 58 (58%) boys and 42 (42%) girls. In 81% of cases we revealed the source of infection, in 19% – we did not. The disease was asymptomatic in 11 (11%) children examined after the contact with ill relatives; 89% had mild COVID-19 disease with light catarrhal signs. The most numerous group of patients who had COVID-19 consisted of children over 10 years of age (42%); in 20% of cases it was pupils from 7 to 10 years old. Smell disorders were reported in children over the age of 10 in 50% of all cases.Conclusion. New coronaviral infection COVID-19 in children is taking mild course, without complications, under the «mask» of common viral infection. Thus, it is unknown either those who have undergone COVID-19 asymptomatically remain healthy or they need special rehabilitation. The timely development of clear algorithm with step-by-step instructions for various situations for every health professional is crucial during these difficult times.

Background. Children’s body weight is the predictor of pathologic elevation of arterial blood pressure (ABP) in adult life. The aim of the study is to divide the data on body weight and ABP in adolescents and to find correlations between them. Methods. The randomised study of 11 and 15 years old pupils from general education institutions was carried out. The 16 months research was executed in 9 different regions of the country (one region from every federal district and 5 schools (with juniors and seniors) in each were randomly selected). In addition to measurement of ABP (three times by Korotkov’s method) and body weight (using general bathroom scales) all children were examined by the group of pediatric specialists (pediatrician, gastroenterologist, allergologist, otolaryngologist, ophthalmologist, neurologist, psychologist, cognitive specialist, orthopedic traumatologists, nephrologist, ultrasound and laboratory diagnostic specialist).Results. The study included 1911 teenagers. The correlation (p

Background. Physical development is one of the leading criteria for assessing the health status of children. The body mass index (BMI) is a reliable sign of physical development disorders. The possibility of diagnosing childhood obesity, a significant problem of modern healthcare service, is of particular value. Our aim was to assess the prevalence of obesity, overweight, and underweight in students aged 11 and 15 years attending educational institutions in the regions of the Russian Federation. Methods. The data is based on a prospective assessment of the screening of children. A total of 2,540 children were examined, the study included data of 2,023 schoolchildren of both sexes aged 11 and 15 years. The BMI calculation was assessed using SDS tables and centile scales (WHO, 2007). Results. When assessing the body mass index in 11-year-old boys in the regions of Russia according to SDS, obesity was determined in 18.6% of cases, overweight — in 15.4% of cases, and underweight — in 5.4% of cases. In 15-year-old boys, obesity was detected in 10% of cases, overweight — in 11.5% of cases, and underweight — in 8.5% of cases. In girls aged 11 and 15 years, obesity was detected in 9.2% and 3.6% of cases, overweight — in 14.3% and 10.5% of cases, underweight — in 10.5% and 8.9% of cases, respectively. Conclusion. In the Russian Federation, cases of underweight or overweight were detected, but these indicators do not exceed the number of children with normal parameters. A high proportion of obese boys is detected mainly due to 11-year-olds. More cases of obesity were registered in girls aged comparing with 15-year-old girls.