[Risk factors and clinical features of the course of recurrent acute otitis media in children]. / Faktory riska i klinicheskie osobennosti techeniya retsidiviruyushchego srednego otita u detei.

This article discusses the problem of recurrent acute otitis media (RAOM) in children. OBJECTIVE: To study the risk factors and the clinical course of RAOM in children. MATERIAL AND METHODS: 148 children (81 boys and 67 girls) from 1 to 14 years old were examined with a diagnosis of recurrent otitis media. The work was carried out in the ENT departments of Pediatric Clinical Hospital No. 13 named after N.F. Filatov, Pediatric Clinical Hospital named after Z.A. Bashlyaeva. The average age of the children was 4.1±1.5 years.All children underwent a clinical study, a laboratory study on the content of the main metabolite of vitamin D - 25(OH)D3 (25-hydroxyvitamin D, or calcidiol) in blood serum. RESULTS: Our clinical examination of children with RAOM allows us to identify the main risk factors for this pathology. Thus, the most significant risk factors for the development of RAOM in children included in the study were: early visits by children to preschool institutions (50.6%), allergic history (39.1%), pathology during pregnancy (28.3%), mixed (38.5%) or artificial (27.7%) feeding in the first year of life, frequent upper respiratory tract diseases (41.2%), burdened heredity in close relatives according to RAOM (33.7%), smoking in the family of one of the parents (65.5%) presence in the family of one more child (34.4%). CONCLUSION: It was shown that the absolute number of children (96%) with RAOM is characterized by a reduced level of 25(OH) vitamin D in the blood serum, which can increase the likelihood of developing episodes of acute otitis media in children and requires therapeutic correction.

[All-Russian Consensus on Diagnosis and Treatment of Celiac Disease in Children and Adults]. / Vserossiiskii konsensus po diagnostike i lecheniyu tseliakii u detei i vzroslykh.

The paper presents the All-Russian consensus on the diagnosis and treatment of celiac disease in children and adults, which has been elaborated by leading experts, such as gastroenterologists and pediatricians of Russia on the basis of the existing Russian and international guidelines. The consensus approved at the 42nd Annual Scientific Session of the Central Research Institute of Gastroenterology on Principles of Evidence-Based Medicine into Clinical Practice (March 2-3, 2016). The consensus is intended for practitioners engaged in the management and treatment of patients with celiac disease. Evidence for the main provisions of the consensus was sought in electronic databases. In making recommendations, the main source was the publications included in the Cochrane Library, EMBASE, MEDLINE, and PubMed. The search depth was 10 years. Recommendations in the preliminary version were reviewed by independent experts. Voting was done by the Delphic polling system.

[Nutritional management of kidney diseases in children].

The prevalence of various kidney diseases in children remains high in recent decades. Adequate nutrition management can enhance the effectiveness of drug treatment, slow the frequency of relapses andprevent the progression of the disease. The article is devoted to modern approaches to diet therapy in various kidney diseases in children with the defeat of tubular and glomerular appa ratus. For the first time the therapeutic diets for children with various kidney diseases are presented. Particular attention is paid to diet therapy in nephrotic syndrome (steroid-responsive and steroid-refractory). Dietary approaches with modern formulas for enteral nutrition in cases of steroid therapy complications in children with renal insufficiency (in predialysis stage and on dialysis) are described. Differentiated nutritional approaches for patients with different types of crystalluria are separately presented.

Characteristics of the nutrition organization and nutrient consumption in toddlers' living in the Central Federal District, Russian Federation (Moscow, Ivanovo, Yaroslavl).

A multicenter cross-sectional study with the participation of 356 healthy children aged 1 to 3 years from the cities of the Central Federal District: Moscow (n=106), Ivanovo (n=126), Yaroslavl (n=124) has been carried out. Questionnaire method, the method of 24-hour diet recall for 3 days (2 weekdays and 1 weekend) and the method of diary recording of food intake were used. The average daily volumes of food were consistent with the recommended age norms only in 31.2% of the surveyed children; after 1 year of life children actively started to transfer to nutrition from the family table and only 51.7% of children continued to receive individually prepared for baby food. The recommended dietary allowances were inadequate in macro- and micronutrients: 48.6% of all children received excessive amounts of protein and fat, and 74.1% were less in carbohydrates. The consumption of vitamins D and A and minerals (calcium, iron and zinc) did not correspond to existing recommendations in the majority of cases: only 10-30% of the examined children received physiological norms of vitamins from food and 13-34% - some minerals and trace elements. These results indicate that the nutrition of young children living in the Central Federal District is imbalanced on daily caloric, macro- and micronutrient composition, does not fully meet the requirements of the balanced diet and needs serious optimization.

[Functional digestive disorders in infants. Working protocol of diagnostic and treatment].

Functional digestive disorders in infants comprise a group of disorders characterized by several specific features. They are related to structural and physiological peculiarities of the gastrointestinal tract in children during lactotrophic period of nutrition, limited pharmacotherapeutic options and supremacy of dietary correction in this age group, and psychological discomfort that has a negative impact on the quality of life of the whole family. The working protocol "Functional gastrointestinal disorders in infants' was prepared by the Russian Society for Pediatric Gastroenterology, Hepatology, and Nutrition (RusPGHAN) based on the previously proposed European (ESPGHAN) and American (NASPGHAN) guidelines. The protocol includes detailed description of the current approaches to diagnosis and management of the functional digestive disorders in young children, as well as algorithm tables that can be used by pediatricians and familial physicians in routine clinical practice.

[Anthropometric measures of children in the period of clinical manifestation of celiac disease].

We have analyzed the data of children's physical development who have celiac disease. The purpose of the study is to analyze the interrelations of celiac patients' anthropometric data with the age of diagnostics and the disease duration. 186 children with morphologically verified celiac disease at the age of from 9 months to 16 years were included. It was shown that the patients of pre-preschool age have the deficiency of body weight much more often than the growth delay. As they grow older and when the disease duration increases first of all we meet with stunting, as the result a number of children with normal growth at school age decreases to 23, 3 %, and the frequency of somatogenic nanism exceeds 50%. We have revealed the negative correlation between the symptoms duration of the disease and the deviation of growth data. We have confirmed the point of view that the presence of strong deviations of data of physical development which children have is the indication for the screening for celiac disease.

[Metabolic syndrome and nonalcoholic fatty liver diseases in children].

The review of literature considers the problem of the metabolic syndrome and nonalcoholic fatty liver disease in children. It provides information about common pathogenesis of the metabolic syndrome and nonalcoholic fatty liver disease, the relationship of diagnosis and treatment.

[Prevention of antibiotic-associated diarrhea in children].

One of the most frequent complications of antibiotic therapy is a diarrheal syndrome, which may be related both to the direct toxic effects of antibiotics on the gastrointestinal tract, and the activation of conditionally pathogenic intestinal flora. Particular attention gets to present the problem of C. difficile-infection, which may be the consequence of the development of pseudomembranous colitis in both children and adults. The article presents current data on the prevalence, etiology, pathogenesis of antibiotic-associated diarrhea, as well as various clinical variants of klostridial infection. In the light of modern approaches to prevention and treatment of this pathology attention paid to the possibility of using probiotic preparations based on S. boulardii.

[Metabolic syndrome: a pediatrician view].

The review of literature considers the problem of metabolic syndrome in pediatric practice. The review discusses pathogenesis of metabolic syndrome and diagnosis for the children. A therapeutic algorithm and an approach to the principles of diet the therapy is presented.

[Changes in human monosynaptic H-reflex during altitude decompression]. / Izmeneniia monosinapticheskogo H-refleksa pri vysotnoi dekompressii u liudei

Test subjects exposed to altitude decompression without preliminary denitrogenization showed in 65-75% of cases stability or reduction of the amplitude of the H-response of a leg with subsequent painful sensations and in increase of the amplitude of the H-response in the other leg as long as they were raised to an altitude of 11,000 m. When bends developed in a leg the amplitude of the H-response in that leg decreased and in the opposite leg increased. During the descent and disappearance of painful sensations changes in the amplitude of the H-response were just the opposite. It is assumed that a decrease of the amplitude of the H-response during altitude decompression was associated with oxygen deficiency of nerve afferents and an increase--with the descending activating supraspinal effect.

[Value of extracorporeal radioimmunoassay in children with nephrotic syndrome]. / Znachenie ekstrakorporal'nykh radioimmunnykh issledovanii pri nefroticheskom sindrome u detei.

Extracorporeal radioimmune techniques were employed to study gonadotropic and sex hormones renin and beta 2-microglobulin in patients with nephrotic glomerulonephritis. The hypophyseal and gonadal system showed alterations which were dependent on the disease gravity. The level of renin and beta 2-microglobulin correlated first of all with renal function.