Children In Russia Research Articles

Level of tryptophan signaling molecules in children with different dynamics of obesity development

The high incidence of obesity in children is an extremely pressing problem in the modern health care system of many countries. There is an increase in the incidence of obesity in children in Russia, which is dangerous not only due to the development of somatic concomitant pathologies, but also to a violation of the social adaptation of children. Without a doubt, the search for early biochemical indicators of stabilization and progress of obesity in older age is very important for the formation of a risk group and timely prevention of the development of obesity and its complications. Our study showed that when assessing the various dynamics of obesity development, it is necessary to take into account the gender of the child, which is ignored in many cases. A decrease in serum serotonin concentrations may be considered as an indicator associated with the stabilization or progression of obesity in girls. Whereas in boys prone to stabilization and/or progression of obesity, a reduced serum level of indole-3-acrylate may act as a predictor marker.

Rehabilitation and habilitation of disabled children: A review

The article presents approaches to the habilitation/rehabilitation of disabled children in Russia and in the countries of the European Union. The areas of rehabilitation, rehabilitation/habilitation activities that disabled children in the Russian Federation need are shown, and the legislative framework is presented. The data on the need for children with disabilities in rehabilitation are given. Research into pediatric rehabilitation care is essential to develop proper policies, programs, guidelines and resource allocation. The lack of evidence-based data comparing different national health systems is a major barrier to decision making in various European countries. To solve this problem, paediatricians and other healthcare professionals need to collect experimental and evidence-based data on the quality of rehabilitation care throughout Europe.

Развитие системы поддержки одаренных детей в СССР и в России: направления и перспективы

The article examines the work with gifted children in Russia within the context of the historical development of the Russian education system. The aim of the research is to identify the characteristics, directions, and prospects for working with gifted children in Russia within the framework of extensive and intensive development paths. The research involved exploring legislative acts, projects related to working with children, pedagogical papers on the issue of giftedness; methods of analysis and generalization were applied. The scientific novelty of the research lies in predicting possible directions for the development of the Olympiad system, considering its system-forming function. As a result, it can be said that after the collapse of the USSR, the Russian system of additional education has outlined a vector of transition from an extensive to an intensive approach in working with gifted children through regional centers for identifying and supporting such children. At the same time, the system of working with gifted children retains its historical characteristics of an extensive approach in all directions, while the scale of working with gifted children increases: (1) in the Olympiad system, (2) in additional education, and also (3) in the in-depth study of subjects in general education institutions for gifted children. Among the possible directions and prospects are the improvement of the “triangle” of support for gifted children (Olympiads – schools – additional education) in the humanities, for example, by clarifying the status of general education organizations with in-depth study of socio-humanitarian subjects in relation to working with gifted children and realizing the possibilities of a variable nature of the current Olympiad system, which allows children to demonstrate their giftedness in a wide range of activities and academic subjects.

Replacement of extended ureteral strictures in children: a multicenter experience with appendicoplasty

Introduction. The first description of ureteral appendicoplasty was provided by the Italian surgeon Giannettasio in 1901, followed by two German surgeons, Franke and Rydygier. Their work was later included in a review by Melnikoff in 1912. However, it is Melnikoff who is often erroneously credited with performing the first appendicoplasty in the literature. The first ureteral appendicoplasty operation on a 1.5-year-old child in Russia was performed by Soloviev in 1976.Objective. To report the results of performing operations on replacement of ureteral defects by ureteral appendicoplasty in children.Materials & Methods. Between 2009 and 2023, a total of 11 surgeries were conducted to replace extended ureteral defects using the appendix technique in four clinics in Russia and the Republic of Belarus. The follow-up included six boys and five girls with an average age of 79 months (ranging from 18 months to 16 years). Six operations were performed by laparoscopic access (mean operative time 356 minutes). Five operations were performed by open access (mean operative time 257 minutes).Results. Long-term results were assessed between 18 and 192 months in all patients. Urinary tract patency was evaluated based on the results of micturition cystography (in one case, vesicoureteral reflux was recorded) and intravenous urography (one case of stenosis of the distal anastomosis, which was corrected by endoscopic dissection of the stricture site using a fiberoureteroscope). In patients who underwent renoscintigraphy, no progression of renal function decline was observed. In all patients, long-term follow-up showed satisfactory urine passage.Conclusion. The results of the surgical interventions performed by us are assessed as good. In all 11 cases, the replacement of the extended ureteral stricture using an appendix allowed for the restoration of urinary flow. Furthermore, any complications that arose did not necessitate repeated reconstruction of the urinary tract. Nevertheless, it is important to note that, in our opinion, this technique cannot be considered the method of choice. Rather, it represents a last resort for patients who have undergone multiple previous operations due to severe trauma or oncological diseases. In cases involving ureteral strictures, priority should always be given to an operation involving anastomosis with sufficient ureteral length and minimal tissue tension. We firmly believe that this approach offers the best chance for a successful outcome.

Doctor, teacher and mentor — Peter Frantsevich Lesgaft

The article presents new information about Pyotr Frantsevich Lesgaft — a pedagogue and mentor, a follower of the traditions of his favorite teachers and professors of the Imperial Medico-Surgical Academy, his contribution to the development of the system of pedagogical upbringing and education of children in Russia.

PARENTS' ASSESSMENTS OF THE ORGANIZATION AND QUALITY OF RECREATION OF CHILDREN OF VULNERABLE CATEGORIES

Creating conditions for recreation and health improvement for children in Russia is a priority area of social policy. Special attention is paid to creating conditions for recreation for certain categories of children in difficult life situations and providing them with preferential vouchers. The article analyses the assessments of parents of children of privileged categories who have spent their holidays in children's recreation and health improvement institutions over the past two years. The results of a nationwide survey conducted by the Russian State Social University in 2023 were used for the analysis. Parents who indicated that their family belonged to the preferential category took part in the survey (N = 973). Based on the survey data, the authors distinguish groups of problems related to awareness of the opportunities to receive preferential vouchers, preparation for recreation, its organization, and the quality of services. The identified problems indicate the need to develop national projects for recreation and health improvement for children in privileged categories and take additional measures to improve the quality of recreation and implement state guarantees for this category of children. On the basis of parents' opinions, the authors have compiled a modal portrait of families of privileged categories that are most dissatisfied with their children's recreation. The results obtained can be used to improve measures related to the implementation of state policy in the field of children's recreation.

Genetic Diversity of the Human Adenovirus C Isolated from Hospitalized Children in Russia (2019-2022).

The human adenovirus (HAdV) is a common pathogen in children that can cause acute respiratory virus infection (ARVI). However, the molecular epidemiological and clinical information relating to HAdV among hospitalized children with ARVI is rarely reported in Russia. A 4-year longitudinal (2019-2022) study among hospitalized children (0-17 years old) with ARVI in Novosibirsk, Russia, was conducted to evaluate the epidemiological and molecular characteristics of HAdV. Statistically significant differences in the detection rates of epidemiological and virological data of all positive viral detections of HAdV were analyzed using a two-tailed Chi-square test. The incidence of HAdV and other respiratory viruses such as human influenza A and B viruses, respiratory syncytial virus, coronavirus, parainfluenza virus, metapneumovirus, rhinovirus, bocavirus, and SARS-CoV-2 was investigated among 3190 hospitalized children using real-time polymerase chain reaction. At least one of these respiratory viruses was detected in 74.4% of hospitalized cases, among which HAdV accounted for 4%. A total of 1.3% co-infections with HAdV were also registered. We obtained full-genome sequences of 12 HAdVs, which were isolated in cell cultures. Genetic analysis revealed the circulation of adenovirus of genotypes C1, C2, C5, C89, and 108 among hospitalized children in the period from 2019-2022.

The role of the gut microbiota in the genesis of gallstone formation in childhood

Cholelithiasis has been and remains a frequent socially significant public health problem worldwide. The pathomorphosis of the disease has also undergone significant changes, which has significantly rejuvenated, occurring not only at a young age, but also in childhood. More than 175,000 cholecystectomies are performed annually for cholelithiasis. Cholelithiasis affects 10-20% of the adult population in our country. At the same time, cholecystectomy came in second place after appendectomy. There are no official statistics on the prevalence of GCD in the general population of children in Russia. In the Krasnodar Territory, the incidence of cholelithiasis in childhood, according to the data of circulation, is 1.8-3.3%. Over the past decade, a number of studies have been conducted confirming the role of the microbiota in various parts of the gastrointestinal tract as a new link in the etiopathogenesis of GI. Intestinal bacteria (Clostridium, Bifidobacterium, Peptostreptococcus, Bacteroides, Eubacterium, Escherichia coli), involved in the oxidation and epimerization of bile acids, can disrupt enterohepatic circulation and lead to the formation of gallstones. At the same time, cholecystectomy leads to further transformation of the microbiota composition in various parts of the gastrointestinal tract, increasing the risk of developing stomach cancer and colorectal cancer. Further research is needed to determine the possibility of using the assessment of the composition of the gastrointestinal microbiota as a marker for the early diagnosis of various gastroenterological diseases of cholelithiasis in particular. The purpose of the study: To determine the role of the intestinal microbiota in the development of metabolic disorders in children with cholelithiasis in order to predict the complicated course of the disease. Material and methods. The work was carried out on the basis of the children’s city polyclinic No. 122 Moscow`s Health Department (chief physician - A.I. Bragin), 194 children with housing and communal services were under supervision. The control group consisted of 78 practically healthy children of the I Health group. The study groups were comparable in gender and age. Criteria for inclusion in the study: children with an established diagnosis of cholelithiasis, asymptomatic course at the age of 3 to 15 years. Exclusion criteria from the study: refusal of the child’s legal representative from the study, the presence of diagnosed acute diseases in the child during the last month, chronic somatic diseases, taking antibiotics and probiotics in the last 6 months, catamnestic observation for less than 12 months. General clinical studies were conducted: questionnaires, health assessment, anthropometry, biochemical examination of blood serum, including lipidogram, ultrasound examination of the abdominal cavity and gallbladder. To assess the intestinal microbiome, the following methods were used: standard bacteriological analysis of feces (method of sowing feces on liquid agarized nutrient media); complex coprological examination with the determination of pancreatic elastase (ELISA method) and fecal carbohydrates (Benedict method); biochemical examination of feces with the determination of short-chain fatty acids (SCFCS) (gas-liquid chromatography method); The Shannon index was adopted as a measure of intestinal dysbiosis. Statistical analysis was performed using the software package Statistica8.0 and MS OfficeExcel 2010/ The results of the study and the conclusion. The biotransformation of the bile acid pool mediated by the gut microbiota regulates the metabolism of bile, glucose and lipids. In children with GI, the number of bacteria representing the indigenous microbiota is generally lower, the intensity of colonization of the intestinal mucosa by them is significantly less, the species diversity of opportunistic and pathogenic bacteria is significantly higher compared with those in practically healthy children. There is an unstable and poor-quality system of interrelation with the macroorganism, disparate metabolic pathways. MK is not able to qualitatively maintain homeostasis within its own consortium. All this creates conditions for disruption of bile acid metabolism and the formation of lithogenic bile. The presence of intestinal dysbiosis in children with GI can cause not only the formation of gallstones, but also negatively affect the further growth and development of children, including the formation of metabolic complications and inflammatory processes.

Традиции и новаторство горьковской стратегии книгоиздания для детей

Book publishing for children in Russia has a long and glorious history. In the first half of the 1920s, children’s literature was regularly published by two specialized publishing houses: Raduga and G. Mirimanov. Maxim Gorky, as an experienced book publisher, initiator and organizer of various publishing projects, adhered to traditions in the book business and introduced innovative approaches to children’s book publishing. The book for Gorky, a supporter of active and productive reading, has always been a work of culture and art capable of elevating a person, being an instrument of education and enlightenment. Gorky’s strategy included the preservation and enhancement of publishing experience. Gorky practiced publishing principles suitable for children’s literature in 1912 when editing Italian Fairy Tales translated by M. Andreeva. In 1917, he participated as an author and editor in the creation of a collection for children Christmas Tree in the Pams publishing house. In 1918, together with the publisher I.R. Belopolsky, the writer organized the first “pre-pioneer” Soviet magazine Severnoe siyanie. In 1933, Gorky was puzzled by the creation of a specialized children’s publishing house, for which he formed a special communicative field: he included his correspondents in the discussion of the plans of Detgiz. He turned for help in creating new children’s literature to K.I. Chukovsky, S.Ya. Marshak, M. Ilyin, S.T. Grigoriev, M. Prishvin, B. Zhitkov, Vs. Ivanov, Yu. Olesha, M. Zoshchenko, artist V. Lebedev, and others. Gorky’s appeal to children in the summer of 1933 with the question of what they read and what books they want to get was a truly innovative method of studying young readers, unique in its simplicity and effectiveness. This unique publishing strategy yielded significant results: Gorky and all those responsible for publishing books for children received reliable, truthful answers from young readers, learned the true interests and requests of Soviet children. Thus, thanks to Gorky, the interests of children began to determine the tasks and directions of the children’s publishing house, as well as the methods and forms of work of its editorial staff. In addition, involving children in discussing the problems of children’s publishing solved the problem of involving children and adolescents in reading. Gorky’s competent strategy - clear ideas about the mission, goals, objectives, orientation of the publishing house, a clear orientation to the target audience - in organizing the state children’s publishing house Detgiz, which still exists today, contributed to the formation of a special Soviet cultural space and to the change of the conceptual activity guidelines of the publishing house for children. The author declares no conflicts of interests.

Оториноларингологическая помощь детям с хроническим риносинуситом

Chronic rhinosinusitis (CRS) is a common disease that has a significant impact on the health and life quality of children. CRS occurs when the disease lasts for more than 12 weeks and it can lead to serious complications. Specialized ENT care is crucial for the diagnosis, treatment and rehabilitation of patients with CRS. This review presents the system of providing specialized ENT care to children in Russia, as well as the organization of medical and social support for children with CRS. Special attention is paid to the prevention of CRS exacerbations in children, including the prevention and timely treatment of acute and recurrent respiratory viral infections, reduction of bacterial load, improvement of mucociliary clearance and follow-up. It is also noted that the formation of a Health School for children with CRS will help teach children to recognize the signs of CRS exacerbations and take action at the first deterioration signs. KEYWORDS: specialized ENT care, chronic rhinosinusitis in children, Health School, medical and social support for children, respiratory viral infection FOR CITATION: Dvornikova T.A., Alexandrova O.Yu. ENT care for children with chronic rhinosinusitis. Russian Medical Inquiry. 2024;8(8):499–504 (in Russ.). DOI: 10.32364/2587-6821-2024-8-8-9.

Конституционно-правовые гарантии защиты прав нерожденного ребенка в России

The article discusses the realization of the right to human life from the moment of conception. The article is based on the consideration of normative legal acts, scientific literature and court decisions. In the course of the research, traditional methods of scientific cognition were used: analysis, synthesis, induction, deduction, comparative legal, system methods. Dialectical and logical methods were also used in the work, which created the basis for a comprehensive study of optimal mechanisms for protecting human life from the moment of conception. The use of the system-structural method made it possible to investigate the problem of protecting the constitutional right to life of unborn children in connection with the constitutional guarantee of health protection of citizens in the Russian Federation, to assess the constitutional goals of restricting human rights when recognizing the right to life from the moment of conception. The comparative legal method made it possible to analyze the regulations protecting the lives of unborn children in foreign countries. The authors found that the right to life from the moment of conception, despite the fact that it is not fixed in Russia, is recognized by the state indirectly and is provided by the legal regulation of the medical care system for the human embryo and fetus, a developed system of specialized medical care. The constitutional right to the life of a child from the moment of conception in Russia is not absolute, since every woman up to 12 weeks of pregnancy has the right to terminate it at will, and also due to the fact that the protection of fetal life in the health care system, in case of threats to its development and health, is carried out with the consent of a pregnant woman. The legal asymmetry of protecting the life of unborn children has been revealed: doctors are obliged to protect it from the moment a woman applies to a medical organization, from the moment a pregnant woman is registered in a women's clinic, while the duties of a pregnant woman to preserve the life of an unborn child are not established by Russian legislation. The terms of the intrauterine development of the child, at which it is possible to bring to criminal responsibility for the death of an unborn child in Russia, have been determined. Doctors are criminally responsible for the death of a child at 22 weeks of gestation, and at 37 weeks – women who killed a newborn child, which contradicts the constitutional principle of equality of all before the law and the court. The article provides evidence of the expediency of further legal protection of the life and health of unborn children in Russian legislation, taking into account the most appropriate norms of the legislation of foreign countries, allowing to minimize the negative impact of harmful psychoactive substances on the health and life of the child.

First results of long-term follow-up of children in Russia after gene therapy for hereditary retinal dystrophies associated with biallelic mutations in the RPE65 gene

Purpose: to evaluate the results of gene therapy by the recombinant adeno-associated viral vector voretigene neparvovec (VN) in children with follow-up periods of 1, 3, 6, and 12 months.Material and methods. The study included 6 children (12 eyes) aged 5 to 15 with a confirmed biallelic mutation in the RPE65 gene, treated with VN (Luxturna, USA). Treatment efficacy was assessed by surveying which included questions on spatial orientation under various types of illumination, Goldman perimetry, microperimetry, best corrected visual acuity (BCVA), electroretinogram (ERG), and visual evoked potentials (VEP). To assess the structure of the retina, the central retinal thickness (CRT) was evaluated by optical coherence tomography.Results. All children showed subjective changes in visual perception, including improved orientation in the dark and twilight, and improved contrast. In one case, the child with initially low visual acuity showed improved visual fixation. In 4 patients out of 6 (8 eyes), an expansion of the visual fields was noted, including 2 cases who displayed significant expansion thereof. In 2 patients (4 eyes), the visual fields were not narrowed and remained so throughout the entire observation period. Mean light sensitivity of the retina in 3 patients and fixation indices in 1 patient improved significantly as shown by microperimetry. BCVA remained stable throughout the study or changed insignificantly. Initially, ERG could not be detected in 8 eyes, but after an VN injection, 6 eyes demonstrated a partial recovery at different times — from 1 to 12 months. An increase in the amplitude of the P1 component to pattern VEP and P2 component to flash VEP was observed in all patients, which indicates an enhanced activity in the projection of the visual cortex after the restoration of the visual cycle. No significant changes were revealed in CRT (p = 0.9). Complications and adverse events were noted in 9 eyes (75 %): chorioretinal dystrophy at the injection site in 3 patients (5 eyes), multifocal nummular dystrophy in 2 patients (4 eyes), local episcleritis in 1 eye, transient increase in intraocular pressure in 2 patients (3 eyes).Conclusion. The results of a one-year post VN treatment follow-up of Russian patients with RPE65-associated inherited retinal disease demonstrate stabilization and improvement of visual functions, which is especially important for otherwise incurable patients with a progressive course of the disease.

Only daughters caring for their aging mothers in Ufa, Russia

Russia is not the only country in the world that relies heavily on informal caregiving, but what makes Russia unique is the number of single-parent one-child families. With the collapse of the Soviet Union and the transition from state socialism to market capitalism, little has changed in terms of the social protection of older adults. Unaffordable home care services, low pensions, bifurcation of the formerly free healthcare into state and private sectors, the invisibility of people with disabilities, and the absence of quality nursing homes, have left adult children in Russia no choice but to bear the full burden of caregiving for their aging parents completely alone. Given the scarcity of research that examines informal caregiving in Russia in general and in provincial cities in particular, this study addresses this gap by centering on previously unheard voices of a unique group of women: only children of single mothers from Ufa, a metropolitan city in the Ural Mountains. Twenty middle-aged (M = 40.75, SD = 3.43), college-educated women participated in a two-hour, semi-structured interview. Inductive thematic analysis revealed three themes: incongruence with the microenvironment, aging in the “cement box,” and distrust of outsiders. The findings suggest material and cultural constraints that female caregivers face as they negotiate the mothers’ discordance with the microenvironment of Khrushchev-era apartments.

To the 200th anniversary of the beginning of pediatric education in the Republic of Tatarstan: pages of the life of the outstanding pediatrician Pyotr Mikhailovich Argutinsky-Dolgorukov

The paper describes the main milestones in the life of one of the founders of the pediatric school in Kazan Professor P.M. Argutinsky-Dolgorukov. He made a lot of efforts to organize the teaching of pediatrics at the Kazan Imperial University, was one of the initiators of the construction of a new children's clinic on the Arsk field in 1900. Professor P.M. Argutinsky-Dolgorukov connected mainly with the study of infectious pathology. His students Professor V.K. Menshikov, E.M. Lepsky, A.A. Agafonov later became well-known pediatricians and infectious disease specialists who took an active part in the creation of pediatric and infectious diseases services in the Republic of Tatarstan. P.M. Argutinsky-Dolgorukov was the founder of the study of malaria in children in Russia. Under the guidance of the professor, progressive methods of diagnostics and treatment were introduced into clinical practice, in particular, the method of treating scarlet fever with Moser's serum, the study of the measles causative agent, and X-ray examinations at the patient's bedside.

Russian and Indian preschool educators’ beliefs about play activities: a comprehensive study

In this study, preschool teachers’ beliefs regarding play in preschool children in its various forms (role-play, rough-and-tumble play, digital play), and the process of its development in groups of children based on samples of Russian and Indian educators were examined. From Russia, 3,013 respondents (all women), aged 18–77 (M = 41.57; SD = 10.02) took part in the study, and 116 respondents (10.34% men), aged 23–50 (M = 36; SD = 9) from India also participated. An original questionnaire aimed at assessing attitudes toward different types of play in preschool educators was used. This instrument consisted of various sections which focused on the understanding of play and its place in the everyday routine of the child group, role-play patterns characteristics (i.e., preferred plots, play materials, course of the play), rough-and-tumble play practice, attitudes toward digital play, and educators’ play competence (self-assessment regarding difficulties with joining the play, suggesting a plot or materials for play, etc.). Our main finding was that although the vast majority of educators in both cultures recognize the value of play for child development, this belief does not find practical expression in the daily life of the child group. Our data showed that Indian educators are more likely to be mediators of children’s experience in play, while their Russian counterparts are more likely to be engaged in the role-play with the children. The content characteristics of play among children in Russia and India were also described. There are differences in attitudes toward digital play: more experienced teachers have a more positive attitude toward the activities of children with digital devices, they see opportunities for the development of a child in digital play. At the same time, teachers in whose groups children enter into digital play not only have a positive attitude toward this type of play but also evaluate themselves more positively in the process of playing with children.

Unemployment of parents — one of the poverty causes in families with children

Families with children in Russia are at high risk of poverty. The economic consequences of the coronavirus pandemic and the sanctions imposed in spring 2022 make social policy a priority. It is necessary to pay a stronger attention to groups of population at higher risk of poverty. In recent years the support for families with children has been strengthened and the circle of potential recipients of assistance expanded (raising the age of children, lifting restrictions on the type of family). Additional support measures provided to families with children to reduce the negative effects of the crisis helped to alleviate the severity of poverty but did not change the position of families with children on the welfare scale, they are still the largest group of the poor (according to Rosstat they make 80% of all poor households). It seems important to identify the main factors of poverty of families with children, which include, not least, the limited employment of parents. The main purpose of the study is to show, using the data of the statistical survey (HBS-2019), the scale of unemployment and its impact on families with children as well as gender characteristics of the phenomenon of unemployment. Financial assistance to families with children should be combined with work to activate the actions of families for self-sufficiency.

Molecular genetic characterization of the epstein–Barr Virus: a relationship with the clinical features of pediatric infectious mononucleosis

Introduction. Infectious mononucleosis (IM) is an high priority viral infection in children. Epstein-Barr virus (EBV) is the main etiological agent of IM. EBV is classified into two main types EBV-1 and EBV-2. In addition, different variants of the virus are isolated based on individual genes, among which the LMP-1 gene and the oncoprotein it encodes are the most well known. So far, the study of the clinical significance of EBV genetic diversity in EBV-IM in children in Russia has not been conducted. The aim of the study was to evaluate a relationship between EBV LMP-1 molecular genetic variants and clinical and laboratory manifestations of IM in children.
 Materials and methods. The material of the study was presented by blood leukocyte and saliva samples of children aged 117 years with EBV-IM (n = 69). A total of 132 EBV isolates were studied. For differential detection of EBV-1/EBV-2, we used a previously optimized one-round PCR variant with electrophoretic detection of amplification products in agarose gel. The nucleotide sequences of the C-terminal region of the LMP-1 gene were determined by Sanger sequencing followed by analysis of the obtained sequences using the MEGA X software. Multiple Factor Analysis was used to search for the relationship between LMP-1 variants and clinical and laboratory manifestations of IM (32 signs and 8 groups of signs).
 Results. It was established that only one type of virus, EBV-1, was identified in all children. At the same time, the severity of clinical manifestations of EBV-IM in children varied significantly (from 15.5 to 35.5 scores in total). Molecular genetic analysis of the sequences of the LMP-1 C-terminal region in Nizhny Novgorod region EBV isolates demonstrated a significant heterogeneity of the viral population, which was not limited only to their grouping according to known variants. According to the frequency of detection, B95-8 was the dominant variant of LMP-1 (60.66.0% of cases), other variants were less common (China 1, NC, Med and China 1+В95-8). It was found that EBV-IM proceeded more easily and with less severity of the intoxication syndrome in cases of infection with a virus having the molecular genetic profile of EBV-1/B95-8, in particular EBV-1/B95-8/E214D. Conversely, EBV-1/Med, as well as EBV-1/Med/L338S, EBV-1/Med/S229T, EBV-1/China 1/L338S and EBV-1/NC/S229T profiles were associated with more severe infection.
 Conclusion. For the first time, the influence of the genetic diversity of EBV on the clinical manifestations of IM in children was revealed. In the context of the tasks to be solved in this study, it is necessary to conduct a larger-scale and systemic studies in different territories of Russia.

Air abrasion with additional water supply for sealing fissures of permanent teeth in children

Relevance. The prevalence of caries in permanent teeth of 6-year-old children in Russia reaches 13%. In view of tooth enamel mineralization completion within a few years after the eruption, the role of primary prevention is especially significant. Fissure sealing is one of the preventive measures. At the same time, the effectiveness of dental caries prevention in children within the first year after tooth eruption reaches sufficiently high rates.Material and methods. The study involved 58 children. The experimental group included 30 children (105 teeth) who had the fissures sealed by air abrasion with additional water supply using a "Rondoflex plus 360" handpiece ("KaVo", Germany). The control group included 28 children (89 teeth) who underwent standard non-invasive sealing. Sealing effectiveness was assessed in 3, 6, 12, 18, and 24 months using the E.M. Melnichenko formula modified by the authors. Statistical data were represented by percentage; the χ2 test identified inter-group differences.Results. The experimental group showed the best sealant retention (up to 76.19% after 24 months). In the control group, the percentage of retained sealant was 48.31% by the end of the follow-up period. After 1 and 2 years, the total sealant loss was 11.24% and 22.48%, respectively. This fact may be associated with the failure of the sealant adhesion to the tooth enamel under the influence of a constant chewing load.Conclusion. Analyzing two-year follow-up results, we found that caries developed in 3.81% of cases in the main group, and the control group revealed caries in 12.37%. Thus, the effectiveness of fissure sealing using air abrasion with additional water supply is 63.4% higher compared to the non-invasive technique (χ2 =16.638, p<0.001).

Ethnic variability of growth processes through the prism of sexual dimorphism of body dimensions (based on data of early and first childhood children)

The study deals with the process of forming of the level and vector of sex somatic differences through early and first childhood, specific peculiarities of sexual dimorphism at 3–6 years of age as compared to the sexual dimorphism of adults, ethnic heterogeneity of sexual dimorphism dynamics of main anthropometric dimensions (height, weight, chest girth); most adequate algorithms of analysis of data considering age peculiarities. Generali-zation of vast material on children of Russia and former USSR of 1950s–2010s (over 200 samples) allowed to describe convincing conformities of intergroup distribution of sex somatic dimorphism; different by sex vector of significant correlations of standardized levels of sexual dimorphism of dimensions with average population values of dimensions themselves — positive for boys , negative for girls, which may be interpreted as confirmation of the contribution of somatic variability of both sexes to forming of sexual differences. When analyzed of data locally, under greater enlargement, sexual dimorphism allowed to estimate inter-ethnic specificity of somatic growth dy-namics. In particular, definite sex synchrony of growth dynamics of Russian children regardless of the ecological niche of development through early and first childhood; similar synchrony for some groups of different ethnicity. To fix well known in age physiology effect of decreasing of growth activity before semigrowth spurt, which chrono-logical age differs between populations, for the case of more homogeneous groups. Thus, the results show the sensitivity of sexual dimorphism of body dimensions as the informative indicator of ethno-territorial diversity of somatic status and growth dynamics through early and first childhood.

РАННЯЯ ДИАГНОСТИКА В ДЕТСКОЙ ОНКОЛОГИИ/ГЕМАТОЛОГИИ

Late diagnostics of oncological diseases (OD) in children accounts for significant deaths in pediatric oncology. As a result of it the overall survival rate is decreasing and the level of complications is increasing. There are no effective screening programs for malignant neoplasms in children as yet. Programs intent to spread the early OD diagnostics require significant efforts in the fields of increasing of the oncological awareness among practitioners and optimization of routing. The Article provides up-to-date information on the importance of early diagnostics in pediatric oncology, various international campaigns to improve the early OD diagnostics and their effectiveness. The information about existing programs to improve the early OD diagnostics in children in Russia is provided as well.