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Introduction: In the late 1960s, probable cases of eosinophilic esophagitis (EoE) emerged, initially linked to esophageal rings and congenital causes or gastroesophageal reflux disease (GERD). Doubts about the GERD association arose due to poor responses to antisecretory therapy. EoE is now a significant pediatric health concern, impacting 1 to 7 cases per 10,000 children. Purpose of the Study: This study aims to comprehensively explore EoE's epidemiology, etiology, subtypes, clinical manifestations, diagnostic methods, and treatment modalities. Materials and Methods: The study employs a cross-sectional analysis of pediatric EoE patients, utilizing endoscopic evaluation and histological assessment. Three distinct EoE subtypes are identified based on pathogenic characteristics. Clinical manifestations, diagnostic methods, and treatments, including endoscopy, are examined. Results: Clinical manifestations span a broad spectrum in the pediatric population. Diagnostic methods include endoscopy, esophageal manometry, impedance-pH monitoring, capsule endoscopy, and string tests. Three distinct EoE subtypes are identified with unique characteristics. Treatment modalities involve dietary management, proton pump inhibitors, topical corticosteroids, biologic therapies, allergen immunotherapy, and endoscopic interventions. Conclusion: Formerly associated with GERD, EoE is now a significant pediatric health concern. The study underscores the importance of comprehensive diagnostic approaches and diverse treatment modalities, including promising biologic therapies and allergen immunotherapy. Understanding these aspects is crucial for effective management and improved outcomes in patients.

Purpose of the study. Was to analyze our experience of surgical treatment of retroperitoneal neuroblastoma in children and the influence of radical surgical treatment on the disease outcomes.Materials and methods. The study included 35 patients (14 girls and 21 boys, mean age 3.3 years) receiving treatment for retroperitoneal neuroblastoma at the Department of Pediatric Oncology, National Medical Research Centre for Oncology, in 2016–2018. 32 patients underwent surgical treatment. The disease progression during neoadjuvant polychemotherapy was registered in 3 patients. Initially, surgery was performed in 5 patients; the rest of the patients underwent percutaneous trepan biopsy with immunohistochemical testing and subsequent neoadjuvant polychemotherapy. No patients developed complications in the early postoperative period. In the article, we present our experience in the surgical treatment of pediatric patients with retroperitoneal neuroblastomas.Results. Patients have been observed during 12 to 24 months. 23 of 28 radically operated patients are alive and have no signs of the disease recurrence or progression. 2 patients developed tumor recurrence and received anti-recurrence PCT and DGT. Currently the patients are in remission. 3 patients showed systemic progression due to primarily advanced disease.Conclusion. Administration of modern surgical techniques and instrumentation allows radical surgical treatment for a large percentage of patients with locally advanced neuroblastoma.

Computed tomography is associated with high patient doses. CT is actively used for pediatric, however, currently there is no reliable data on the pediatric patient doses in the Russian Federation. The current study presents the data on the anthropometric characteristics of 5, 10 and 15-year-old pediatric patients, as well as the results of a comparative assessment of the effective doses of these patients during CT-examinations of chest, considering their anthropometric data. The effective doses were calculated using three methods: based on the actual guidelines (MU 2.6.1.3584-19) using the age specific conversion coefficients; using the conversion coefficients considered patient body mass and effective diameter; using a specialized software NCICT 3.0. The difference between effective doses according to actual guidelines and considering patient body mass and effective diameter was about 7.1 % (max-65 %). High deviations were observed in patients with abnormally large or abnormally low body mass. Effective doses calculated using NCICT 3.0 were higher compared to doses calculated according to actual guidelines on average by 18 % (max — 53 %). Such differences are explained by the fact that in MU 2.6.1.3584-19 conversion coefficients are presented for the most common CT-scan parameters of protocols, and in NCICT 3.0 the calculation considers individual scan parameters for each patient. The difference between effective doses according to NCICT 3.0 and considering patient body mass and effective diameter was about 32 % (max-70 %). This difference can be explained by the differences in the anthropometric data of some patients, and by the use of different types of phantoms: a stylized phantom (Golikov et al) and a voxel phantom in NCICT 3.0.

Retinoblastoma (RB) is a malignant tumor of the embryonic nerve retina.Purpose. To determine the effectiveness of retrobulbar blockade (RbB) with ropivacaine 0.5% for intra- and postoperative analgesia, as well as for the prevention of oculocardial reflex (OCR), postoperative nausea and vomiting (PONV) during enucleation.Material and methods. A prospective randomized controlled clinical trial was performed. Eighty patients aged 0 to 10 years were included, who were randomly assigned to the RbB group (retrobulbar blockade with ropivacaine 0.5% with general anesthesia) (n=40) and the GA control group (general anesthesia) (n=40).Results. There were no complications in the RbB group caused by the methodology. In the intraoperative period, the average dose of fentanyl in the RbB group was 4.7±0.7 μg/kg, which is significantly lower than in the OA group of 10.1±1.9 μg/kg (p

BACKGROUND Benign vascular lesions of the skin, hemangiomas and pyogenic granulomas are quite common in pediatric patients, which are complicated with bleeding in 7.5% of cases.MATERIAL AND METHODS In 2016–2018, 17 children with cavernous hemangiomas and pyogenic granulomas complicated with bleeding were operated on an emergency basis at the Research Institute of Emergency Children’s Surgery and Traumatology. Surgical intervention for all patients was performed using the method of interstitial selective laser photodestruction developed by the RIECST, which took out the utility patent. This method was implemented using two wave laser surgical device IPG “IRE-Polus” (Russia), generating two wavelengths of laser radiation of 0.97 μm and 1.56 μm.RESULTS The analysis of the long-term results of treatment in 17 pediatric patients who were operated on an emergency basis for hemangioma and pyogenic granuloma complicated by bleeding showed that all 17 patients (100%) had a good clinical and aesthetic result. The method of interstitial selective laser photodestruction provided a radical removal with guaranteed hemostasis of the indicated benign vascular lesions of the skin complicated with bleeding illustrate the effectiveness of this method in clinical practice, as well as the possibility of its use in inpatient and outpatient conditions.CONCLUSION To prevent the large blood loss in hemangiomas complicated by bleeding and pyogenic granulomas of the skin in children, emergency surgical treatment has been performed using interstitial selective laser photodestruction. This method ensures the radical photodestruction of tissues of a pathological vascular formation and reliable hemostasis, which guarantees the achievement of a good clinical and aesthetic result of treatment in inpatient and outpatient conditions in all cases.

In this article the current state of the legal regulation of age restriction for using of medicines in children in Russian Federation has been analyzed. The ways for addressing legal uncertainties between the register of the standard labels of the interchangeable medicines and labels of concrete medicines, approved at their state registration, have been offered. The necessity of development of the list of data for compulsory including in the register of the standard labels of the interchangeable medicines have been proved. The prospects of the using of the register of the standard labels of the interchangeable medicines to improve of drug supply of pediatric patients have been studied.

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Early diagnosis of acute inflammatory demyelinating polyneuropathy (AIDP) is of fundamental importance for the timely prescription of therapy. The conventionally used techniques of electrophysiological diagnosis are not sensitive enough at early stages of development of the condition. The objective of this work was to assess the applicability of studying H-reflex as a tool for early diagnosis of AIDP in children. Materials and Methods. A total of 57 children were examined: 20 healthy children (range: 714 years; mean age 12 years) and 37 patients diagnosed with AIDP (range: 8-13 years; mean age 11 years). Electroneuromyography (ENMG) was performed on day 37 after the first symptoms had emerged. The velocity of impulse conduction along motor fibers, the amplitude of M responses during stimulation of nn. tibialis, ulnaris and medianus, as well as latency and threshold of M response and H-reflex during stimulation of m. soleus, was evaluated. Results. No significant intergroup differences in amplitudes of motor responses and the velocity of impulse conduction were recorded, while the residual latency of M-response was significantly higher in the AIDP group. In individuals in the control group, the H-reflex was recorded in 100% of cases, while being recorded only in 2 (5.4%) patients in the AIDP group. In both patients, examination was performed as early as possible (day 3) after the onset of the first symptoms among the entire group examined. Conclusions. In pediatric patients with AIDP, which develops on day 37 after the onset of the first symptoms, no H-reflex was recorded in 94.6% of cases. Investigation of the H-reflex at the early stage of AIDP in children can be used as an additional criterion for diagnosing the disease.

Purpose: to assess early and long-term results of the pediatric hand reconstructions with posterior interosseous flap, including those in children younger than 3 years old. Materials and methods: results of the hand reconstructions with posterior interosseous artery reverse flap were studied in 10 children (4 males and 6 females) aged from 1 year and 1 month to 13 years old. In 4 cases flap coverage were performed due to acquired posttraumatic hand deformity, in 6 cases reconstruction was assumed for congenital hand deformities. Combined procedures consisted of posterior interosseous artery flap coverage and other types of microsurgical reconstructions were suggested in 4 patients. Preoperative color doppler visualization of the posterior interosseous vessels were mandatory. All flaps were risen under 3.5x-4.5x magnification. Results: all flaps survived completely in 3 weeks postoperatively. There were no postoperative complications such as flap’s arterial or venous insufficiency, deep infection, or posterior interosseous nerve palsy. Nearly whole group (9 of 10) of patients and/or their parents were satisfied with the esthetic view of the reconstructed hand and donor site of the forearm 1 year postoperatively. Conclusion: posterior interosseous flap is a reliable and versatile option in pediatric hand reconstructions, providing excellent skin coverage with good color match and texture. Preservation of major vascular bundles of the forearm (radial and ulnar arteries) during flap harvest gives a possibility to perform a simultaneous microsurgical reconstructions of the hand (e.g. free toe transfer).

The authors have summarized their experience of surgical treatment of cardiac and mediastinal neoplasms in 24 pediatric patients who were operated and followed up from 1967 to 2012. Rapid malignization was observed in one third of patients with thymus tumors. The authors conclude that surgery should be done as soon as possible after detection of a neoplasm, despite the absence of clinical signs and symptoms indicative of involvement of chest organs.