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THE NEW CORONAVIRUS INFECTION (COVID-19) IN CHILDREN
I. M. Osmanov, L. N. Mazankova, E. R. Samitova, S. N. Borzakova, A.V. Vinokurov, A.V. Miroshina

Summary. In the world scientific literature, you can find a large number of publications devoted to the provision of inpatient medical care to adult patients with COVID-19. However, data on the course of this infection in children of different ages and the features of the diagnostic process when this category of patients is admitted to the hospital are not fully presented.
Since the beginning of the pandemic, a COVID - 19 study has been conducted in Moscow on the basis of the Z. A. Bashlyaeva Children's City Clinical Hospital, the largest COVID center in Moscow.
The article presents the preliminary results of the analysis of clinical data of 3148 patients with a confirmed diagnosis of COVID-19, while in 17.2% of cases, patients had concomitant pathology. The children were hospitalized between March 2020 and June 2021.
Based on the data obtained, the criteria for diagnosing and assessing the severity of the course of various forms of COVID-19 in children were formed, approaches to conducting a diagnostic search in comorbid patients were optimized.
Keywords: coronavirus, COVID-19, children, diagnosis, symptoms

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MODERN METHODS OF TUBERCULOSIS SCREENING
A. A. Novak

Summary. The article describes the main modern aspects of early detection of tuberculosis. The advantages and disadvantages of screening methods for diagnosis of tuberculosis (Mantoux test, Diaskintest and T-SPOT.TB method) are considered. Taking into account current clinical guidelines, the T-SPOT.TB is considered as an alternative method for early diagnosis of tuberculosis.
Keywords: tuberculosis, children, diagnosis, Mantoux test, Diaskintest, T-SPOT.TB, screening

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HEREDITARY AND ACQUIRED RISK FACTORS FOR THE DEVELOPMENT OF UROLITHIASIS IN CHILDREN
E. A. Yuryeva, I. M. Osmanov, V. V. Dlin, E. S. Vozdvizhenskaya, E. I. Shabelnikova

Summary. The main risk factors for urolithiasis are described - primary (genetic and congenital anomalies) and secondary (stress hormone dysfunction, immobilization, climatic features and eating habits). Special attention is paid to the delay in the maturation of the mechanisms of regulation of calcium and phosphorus metabolism in children. The main methods of treatment and prevention of urolithiasis are listed.
Keywords: risk factors, urolithiasis, children, Сanephron® N

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MENINGOCOCCAL INFECTION IN CHILDREN - NEW CHALLENGES
L. N. Mazankova, A.V. Tebenkov, A. L. Rossina

Summary. Meningococcal infection is a serious public health problem due to the predominant affection of children and adolescents. Of particular importance are patients with a generalized form of infection, as well as a high proportion of disability after infection and deaths. This article highlights modern data on meningococcal infection, presents an analysis of a clinical case of meningococcal infection with a lethal outcome.
Keywords: meningococcal infection, children, clinical characteristics, vaccination

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ON THE PROCEDURE FOR IDENTIFYING AND RECORDING CASES OF PHYSICAL OR MENTAL VIOLENCE AND OTHER EXPLOITATION AGAINST MINORS
A. N. Makarova

Summary. The article describes the algorithm of actions of employees of medical organizations when they receive minor patients for whom there are sufficient grounds to believe that harm to their health was caused as a result of illegal actions. The regulatory and legal justification for this is given. The signs of causing harm to health as a result of committing illegal actions are listed. Examples from judicial practice are given.
Keywords: children, abuse, rights of minors, health protection, family problems, social problems, illegal actions, protection of children's rights

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DIAGNOSTIC POSSIBILITIES OF USING TROPONIN I IN CHILDREN WITH CARDIOMYOPATHIES OF NON-INFLAMMATORY ORIGIN
D. V. Zamaraeva, I. I. Trunina, A. S. Sharykin

Summary. Troponin I (cTnI) is one of the most effective markers of myocardial injury detection determined by ischemic and non-ischemic causes, and also can be used in patients with cardiomyopathies (CM). The aim of this study was to evaluate cTnI level in children with various myocardial pathologies and to estimate correlations between cTnI and findings of clinical and instrumental examination. Materials and methods. The study involved 119 children aged 1 month to 18 year. The myocardial pathology group (n = 64) consisted of patients with non-inflammatory CM (dilated, hypertrophic and non-compaction of left ventricle). The control group included 55 healthy children without cardiovascular diseases. Quantitative serum cTnI level were measured for all children in our study by means of portable express-analyzer. Results. Patients with myocardial pathology had a significant cTnI increase compared with the control group (0.12 vs 0.03 ng/ml, p <0.01). The median cTnI level was significantly higher in patient with STT-changes on ECG (p <0.01) and with left ventricle ejection fraction <50% (p <0.05). Serum cTnI level were significantly higher in patients with heart failure (2B stage) (p = 0.03) and correlated with level of N-terminal proB-type natriuretic peptide (r = 0.55, p <0.05). The type of myocardial remodeling and the linear left ventricle size of the heart did not influence on cTnI level. Conclusion. Determine of myocardial injury in children with CM using cTnI plays an important role in detection of myocardial damage period in patients with CM and helps to provide more effective method of treatment and long-term observation.
Keywords: troponin, children, cardiomyopathies, myocardial injury

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PATHOGENETIC FEATURES ATHEROGENESIS WITH DELAY INTRAUTERINE DEVELOPMENT OF THE FETUS
E. V. Neudakhin, V. V. Derevtsov

Summary. Atherogenesis in childhood is one of the most urgent, debatable and poorly studied problems of medicine. Atherosclerosis is not a disease of an adult, not a nosological unit, but a multifactorial pathophysiological process that begins in the intrauterine period and ends with the death of a person. The life expectancy of a person largely depends on the activity of atherogenesis. With a burdened course of pregnancy, the fetus is in a state of chronic stress, as a result of which the processes of atherogenesis are intensified, diseases are programmed for the coming and distant years. The article discusses the pathogenesis of early atherogenic disorders in children, as well as their prevention.
Keywords: children with intrauterine development delay, fetal programming, atherogenesis, chronic stress, L-carnitine, Elkar®

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PROBIOTICS IN CLINICAL PRACTICE
S. V. Belmera

Summary. The idea of using microorganisms with a positive effect on the human body for the prevention and treatment of diseases arose a long time ago. The article analyzes the data of various studies devoted to evaluating the effectiveness and safety of probiotic products in acute intestinal infections, antibiotic-associated diarrhea, inflammatory bowel diseases, functional disorders of the motility of the small and large intestines, etc.
Keywords: probiotics, prebiotics, intestinal infections, diarrhea, constipation, inflammatory bowel diseases

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OBESITY IN ADOLESCENTS: THERAPY OPTIONS
I. M. Osmanov, S. N. Borzakova, A.V. Vinokurov

Summary. In order to update pediatricians with the modern therapeutic options in adolescents with obesity, a review of clinical guidelines and recent publications on this topic was carried out. Based on the results of the literature analysis, it can be concluded that the pathway of adolescent with obesity depends on its etiology. Behavioral therapy for lifestyle modification, dietary correction, and physical activity targeting are currently recommended to treat exogenously obese patients. Drug therapy (Orlistat, Liraglutide) may be suggested for comorbid patients who do not respond well to lifestyle interventions. In adolescents with morbid obesity, bariatric surgery is considered as a tertiary therapy. Therapy for obese adolescents should be individualized, comprehensive, comorbidity-adjusted, and long-term. Weight loss of even 5-10% allows prevention and relief of several obesity-related comorbidities, but long-term benefits depend on the sustainability of initial weight loss.
Keywords: obesity, overweight, adolescents, children, liraglutide, Saxenda, orlistat