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COMPUTED TOMOGRAPHY AND RADIOGRAPHIC SEMIOTICS OF ORGANIZING PNEUMONIA IN CHILDREN
E.S. Petryaikina, N.I. Kolganova, D.Yu. Ovsyannikov, V.V. Gorev, I.I. Zakirov, I.R. Zinnatullin, M.A. Karpenko, E.E. Petryaikina, F.A. Petryaikin

Summary. Organizing pneumonia (OP) is a non-infectious lung disease clinically similar to bacterial pneumonia. Computed tomography is the most informative study for the diagnosis of OP and its differentiation from other lung lesions in the presence of a typical clinical picture. This article presents generalized data on computed tomography and radiographic semiotics of OP in children, obtained from clinical cases described in the world literature, as well as from their 19 own observations.
Keywords: organizing pneumonia, bronchiolitis obliterans organizing pneumonia, computed tomography, radiography, children

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MODERN POSSIBILITIES OF IRRIGATION THERAPY IN PEDIATRIC PRACTICE
E.P. Karpova, V.A.Belov, A.I. Asmanov, D.A.Tulupov

Summary. In childhood, inflammatory diseases of the upper respiratory tract remain one of the most common diseases. The physiological processes occurring in the structures of the upper respiratory tract ensure the maintenance of rhinospiratory homeostasis. However, the effect of external damaging factors on the background of violation of protective processes leads to the occurrence of acute and progression of chronic diseases of the upper respiratory tract. Irrigation therapy is actively used for the prevention and treatment of diseases of the upper respiratory tract, the purpose of which is to provide hydration and purification of the nasal mucosa from pathological secretions, crusts, pathogenic biological agents, inflammatory mediators, as well as antigens responsible for inflammatory reactions. Recently, drugs have been developed based on the water of salty relict (residual) lakes, which have found wide application in pediatric otorhinolaryngology.
Keywords: irrigation therapy, brine, relict lakes, children, upper respiratory tract, rhinitis, sinusitis, adenoiditis

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CURRENT ASPECTS OF THE USE OF INTERFERON-BASED MEDICINES IN PEDIATRICIAN'S PRACTICE (BASED ON THE MATERIALS OF PUBLICATIONS 2023–2024)
I.M. Osmanov, L.N. Mazankova, E.R. Samitova, S.N. Borzakova, A.V. Vinokurov

Summary. The article is an update of a review of scientific works published at the beginning of 2023 on the main areas of the use of interferons for the treatment of various pathologies in children – based on materials from publications in 2023–2024. Information important for practical application is provided on the molecular mechanisms of action of interferons, methods of their industrial production, development of drugs based on them, new concepts for their use, current results of clinical trials and successful clinical experience of use, including pediatric practice. Data on clinical trials of drugs developed on the basis of various types of interferons and used in children, conducted in the Russian Federation, are reviewed. Recent publications on the use of one of the most common interferon α-2b preparations, Viferon^®, are discussed. Current problems in improving the treatment of interferon drugs in children are considered, as well as promising directions for the modification and development of drugs based on interferons using molecular biology methods.
Keywords: interferons, cytokines, INFα, INFβ, INFλ pegylated interferons, interferon α-2b, Viferon^®, COVID-19, children

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CONGENITAL PATHOLOGY OF THE THORACIC AORTA IN PEDIATRIC PRACTICE
A.S. Sharykin, M.A. Abramyan, I.I. Trunina, A.N. Grishkin

Summary. Diseases of the thoracic aorta manifest primarily in its dilation at various levels and carry the threat of developing life-threatening complications (rupture, dissection). Certain algorithms for monitoring adult patients with aortic dilation have been formed and set out in the relevant consensus recommendations. However, in pediatric practice, the determination of aortic diameters, which can be considered thresholds for aneurysmal changes, patient monitoring tactics, therapeutic algorithms and indications for surgery remain insufficiently studied. In this regard, we have undertaken a review of publications on aortic dilation in children and adolescents.
Keywords: thoracic aorta, aortic size, aortic dissection, syndromes

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A CLINICAL CASE OF CONGENITAL BILATERAL HOAN ATRESIA IN A NEWBORN CHILD WITH MULTIPLE MALFORMATIONS
D.A. Morozov, A.I.Asmanov, N.D. Pivneva, A.K. Fedorov

Summary. The most common congenital malformations that lead to impaired nasal breathing include choanal atresia. Bilateral choanal atresia in a newborn requires urgent measures such as mechanical ventilation or even tracheostomy. Children with congenital choanal atresia should undergo comprehensive examination by various specialists. It is recommended to proceed with surgical intervention in multidisciplinary hospitals. In this clinical case, an example of congenital bilateral complete choanal atresia in a 20-day old newborn is described. The peculiarity of this clinical case is the presence of severe concomitant heart defect, the absence of tracheostomy, low weight. The use of the surgical treatment method such as endoscopic bilateral endonasal choanal atresia repair with transeptal approach with septal flaps and fibrin glue to prevent restenosis of the choana in postoperative period is demonstrated.
Keywords: congenital сhoanal atresia, endoscopy, transnasal endoscopic choanal atresia repair, invasive candidiasis, children

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NASAL VASOCONSTRICTORS IN THE TREATMENT OF ACUTE INFLAMMATORY PATHOLOGY OF THE RHINOSINUSOTUBAR COMPLEX IN CHILDREN
E.P. Karpova, D.A. Tulupov, O.G. Naumov, L.V. Toropchina, V.A. Belov

Summary. The pathogenesis of the development of a number of acute inflammatory diseases of the ENT organs is based on swelling of the mucous membrane of the upper respiratory tract. When the mucous membrane of the nasal cavity is involved in the process and the production of gland secretions increases, nasal obstruction syndrome is formed, which triggers the blocking of natural anastomoses and the development of complications, primarily acute otitis media. The similarity in the development of pathophysiological processes in the area of the rhinosinusotubar complex often leads to the simultaneous development of inflammation of the mucous membrane in the nasal cavity, paranasal sinuses, auditory tube and tympanic cavity. Due to the key role of nasal obstruction in the development of acute inflammatory pathology of the rhinosinusotubar complex, the main goal is to restore/improve nasal breathing function. To quickly eliminate swelling of the nasal mucosa and restore the drainage function of the anastomosis, nasal decongestants are traditionally used.
Existing consensus and regulatory documents in Russia on the treatment of a number of acute respiratory infections support the use of nasal vasoconstrictor drugs as the first line of symptomatic treatment of nasal obstruction in acute respiratory tract infections and as an element of improving passage therapy in the complex treatment of acute rhinosinusitis and acute otitis media.
Keywords: rhinosinusotubar complex, children, nasal decongestants, acute otitis media, Nasivin^®

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SEVERE COURSE OF CUTANEOUS MASTOCYTOSIS IN A CHILD: CLINICAL OBSERVATION
V.G. Potapenko, C.R. Talypov

Summary. Mastocytosis is a disease of the blood system with the accumulation of clonal mast cells in one or more organs. Patients usually need minimal symptomatic therapy, since in the vast majority of patients it regresses on its own, regardless of the severity of manifestations. Case report: the disease was diagnosed in a boy after birth. Masocytosis manifested with severe typical urticular and vesicular rash, daily hot flashes, itching, histamine crises, itching, and abdominal pain. The main provoking factors were temperature changes, hot water, emotion, hot food intake, rubbing of clothing, and acute infectious diseases. No signs of an aggressive course of mastocytosis were found. Symptomatic treatment with antihistamines and short courses of glucocorticosteroids was carried out. The disease started to resolve at 4 months: hot flashes were passed, abdominal pain, rash, itching and the need for pharmacotherapy decreased. At 2 years and 9 months, the child was radically operated on for osteoblastoma. Remission was achieved. Currently, moderate skin itching persists, the child grows and develops in age, takes antihistamines only occasionally. Clinical observation demonstrates self-limited course of the disease even in severe cases.
Keywords: mast cells, mastocytosis, urticaria pigmentosa, tryptase, C-KIT

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COVID-19 AND CHILDHOOD OBESITY: ANALYSIS OF 17 CASES OF NEW CORONAVIRUS INFECTION IN OBESE CHILDREN AND CLINICAL OBSERVATION
T.A. Gutyrchik, A.B. Malakhov, E.R. Samitova, P.V. Berezhansky, I.M. Osmanov, V.V. Gorev, I.V. Ozerskaya

Summary. The article presents an analysis of 17 clinical cases of a new coronavirus infection in obese children, as well as a detailed description of a clinical case of COVID-19 in a 16-year-old obese child. The importance of the presented clinical cases is due to the novelty of the disease itself, the complexity of its treatment, the combination of viral and bacterial inflammation of the lower respiratory tract with the development of severe respiratory failure.
Keywords: novel coronavirus infection, COVID-19, children, obesity, viral lung damage

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STRUCTURE OF INFECTIONS OF THE URINARY SYSTEM IN COMPARISON WITH VESICO-URETERAL REFLUX IN CHILDREN
V.I. Kirillov, N.A. Bogdanova, N.B. Serebrovskaya,S.Yu. Nikitina

Summary. Materials and methods. We examined 104 children aged 1 to 14 years who were admitted to the nephrology department with a symptom complex characteristic of urinary tract infection. In 46.1% of cases, pyelonephritis was diagnosed, which in most children was combined with cystitis. 43.3% of children has isolated cystitis, and a minority (10.6%) had asymptomatic urinary tract infection (UTI). The diagnosis of cystitis was based on the results of cystoscopy, which was accompanied by 2 modes of prevention of exacerbations of urinary infection. The first included the prescription of Canephron N (n = 50), the second – furasidin (n = 54). No development of these complications was noted in any regime. Results. Vesicoureteral reflux (VUR) was found in total in 39.4%, more often (62.5%) in pyelonephritis compared with cystitis (13.3%). In the combined group, reflux nephropathy was observed in one in ten, and in the presence of VUR in about a quarter of cases (24.4%). Special attention should be paid to patients with asymptomatic UTI due to the frequent occurrence of VUR (45.4%), and in two cases (18.2%), accompanied by reflux nephropathy. Conclusion. The presented data indicate the leading role of ascending infection in renal damage, especially in the presence of inflammation in the bladder and VUR. The question of involvement in the development and progression of nephrosclerosis requires further study.
Keywords: urinary tract infection, cystitis, pyelonephritis, vesicoureteral reflux, reflux nephropathy, Canephron^® N

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FEATURES OF THE CLINICAL PICTURE AND DIAGNOSIS OF BRUGADA SYNDROME IN CHILDREN AND ADOLESCENTS: LITERATURE REVIEW
A.P. Smirnova, B.A. Pavlikov, A.V. Eremeeva

Summary. Sudden cardiac death (SCD) among children is 0,7–6,4 cases per 100 000 population. The leading mechanism of SCD in this case is malignant arrhythmias. One of the conditions leading to their development is Brugada syndrome. Brugada syndrome is a genetically and phenotypically heterogeneous hereditary disease characterized by malignant clinical and electrographic arrhythmic syndrome, which manifests itself in the form of ST segment elevation in the right thoracic leads (V1 – V3) of a vaulted configuration (the so-called Brugada pattern type I), blockade of the right leg of the Gis bundle on an ECG and clinically in the form of recurrent syncope or episodes of sudden cardiac death due to polymorphic ventricular tachycardia or ventricular fibrillation. Despite the fact that significant progress has been made to date in understanding the pathophysiological processes of the disease and criteria for diagnosis and risk stratification for adult patients have been proposed, diagnosis of this disease in children is difficult due to the high frequency of asymptomatic course and imperfect interpretation of the electrocardiogram recording. According to a number of studies, the most common manifestations of this syndrome in children are a hereditary history and accidental ECG findings, syncopal conditions and arrhythmias at this age are recorded much less frequently. ECG recording can expand diagnostic capabilities during the action of factors provoking electrocardiographic changes, such as febrile temperature, medications and periods of high parasympathetic tone, which leads to great opportunities for diagnosing this syndrome in patients of infectious departments, provided that an ECG is recorded during fever and in patients who underwent daily ECG monitoring by Holter. Another important aspect in the stratification of risk for children is the conduct of a genetic study, since a higher incidence of malignant arrhythmias and their recurrence among patients with a confirmed mutation in the SCN5A gene was revealed than in adults.
Keywords: Brugada syndrome, sudden cardiac death, diagnosis, channelopathy

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A RARE CLINICAL CASE OF ACUTE BALANOPOSTHITIS COMPLICATED BY PARAPHIMOSIS
N.A. Parkhomenko, O.G. Sarkisyan, A.A. Cherepanova, O.E. Batyscheva, T.O. Sergienko, R.B. Gumer, T.D. Loseva, K.G. Zabaznov, I.V. Popov, I.A. Parkhomin

Summary. A clinical case of treatment of acute balanoposthitis complicated by paraphimosis in a patient who had previously undergone circumcision is presented. At the moment, this problem is relevant in the medical practice not only of the urologist-andrologist, but also of the surgeon, pediatrician, therapist, dermatologist. An analysis of the patient's outpatient chart is carried out. In this clinical case, the use of antibacterial, anti-inflammatory and antihistamine therapy in patients with acute balanoposthitis in the first hours of paraphimosis development was demonstrated and justified for patients who had previously undergone circumcision. It is shown, that an integrated approach and reactive therapy can cause rapid reversibility of the pathological process and thereby avoid irreversible changes.
Keywords: paraphimosis, balanoposthitis, inflammation, circumcision