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The publication is devoted to the review of accumulated data on the relationship of respiratory allergopathology with neuropsychiatric disorders in childhood. The immediacy of the problem is due to the mutual influence of allergic and neuropsychiatric conditions combined in a child on the course of these diseases. According to research, the connection of respiratory allergic diseases with disorders of neurodevelopment, in particular with attention deficit and hyperactivity disorder and autism spectrum disorders, is clearly manifested, and the first publications on the connection with speech and other mild cognitive impairments have appeared. At the same time, the formation of depression, suicidal behavior, and anxiety disorders in respiratory allergopathology is being actively studied. It is assumed that the close relationship between nervous and immune regulation provides a high correlation of allergic and neuropsychiatric pathological conditions, although cause-and-effect relationships have not yet been precisely established. In this regard, it becomes relevant to introduce into clinical practice monitoring of cognitive status, neuropsychic development and possible symptoms of anxiety, depression and suicidal thoughts in the treatment of children with respiratory allergic diseases. Timely detection of violations will make it possible to provide specialized interventions at an early stage in order to achieve a favorable treatment result in the long term.

Background. The COVID-19 pandemic is a global challenge to States and health systems. The pandemic and its consequences can have a devastating impact on the health and development of children, especially those in vulnerable situations — children with disabilities.The aim of the study is a medical and social assessment of the effect of the COVID—19 pandemic and its consequences on families with children with disabilities.Methods. A descriptive study using the Google forms platform was conducted using the cross-sectional method. Two groups of parents of children aged 0–17 years with disabilities (group 1) and without disabilities (group 2) who apply to a medical organization for preventive examinations were interviewed.Results and discussion. A total of 175 electronic questionnaires were received. Parents from 46 regions of Russia participated in the survey. A significant majority of respondents were women — 172 people (98%), 3 men (2%). More than half of the respondents are residents of the megalopolis. The study showed that the COVID-19 pandemic had a negative impact on the health and education of children and on the lifestyle and families welfare in general. It was revealed that the financial situation of many families who took part in the study worsened, which affected the living conditions of children. During the COVID-19 pandemic, the health care system was being rebuilt taking into account new tasks to counteract dangerous infection, which was reflected in changes in the provision of medical care to children, and in some cases this led to a deterioration of their health. A significant number of parents who participated in the study believe that changes in the organization of medical care during the pandemic had a negative impact on their child’s health. Among the main health problems, parents highlight delays and cancellations of medical consultations, difficulties in obtaining urgent care and problems with drug provision. Among the main health problems, parents highlight delays and cancellations of medical consultations, difficulties in obtaining emergency care and problems with drug provision. The study shows that families with disabled children have been affected by the COVID-19 pandemic to a greater extent than families raising children without chronic health problems. If the deterioration of the financial situation is almost equally revealed in both groups, then problems related to medical care and education have a more noticeable impact on families with a child with a disability. The obtained results should be taken into account in times of new challenges when developing measures of state support for families with children, especially with children with disabilities. At the same time, it is important to pay primary attention to the organization of medical care for children (continuity of planned medical care for the child population and rehabilitation actions) and educational services (providing online learning opportunities for the child, taking into account individual ones).Conclusion. The COVID-19 pandemic and its consequences have had a negative impact on the standard and quality of life of people, especially families with children. The pandemic has had a significant adverse impact on the health and development of children, especially children with disabilities. The study showed a decrease in the financial situation of families, problems with children receiving medical care, difficulties in education, especially with regard to specialized pedagogical classes with disabled children, during the pandemic. According to the study, in order to prevent the negative impact of the pandemic, it is proposed not only to provide financial support to families, but also to maintain access to the educational process with the provision of the required devices, as well as the possibility of receiving medical care for children, especially children with disabilities, including planned.

The use of magnetic resonance imaging in morphometry, as quantitative assessment of brain parameters (thickness, surface area, volume), allows to detect changes in many neuropsichiatric conditions that were previously considered intact. This article provides data on neuroimaging brain morphometry and effective use of this method in neurosciences.

Congenital aniridia manifests with total or partial absence of the iris. The association of the disease with the PAX6 gene has been proven. Changes in the PAX6 structure lead to intrauterine pathology, visual organ malformation, malformation of master regulator proteins of organogenesis affecting various cells’ differentiation (central nervous system cells included). Such disorders result into the development of PAX6-associated syndromes with various brain malformations, neurological disorders, and systemic pathology (thyroid pathology, Wilms tumor, glucose intolerance). Isolated congenital aniridia is also accompanied by psychoneurological disorders. It can be associated with brain structures’ disorders during embryogenesis and with impact of external stress factors on the child (frequent medical checkup, surgical treatments). The psychoneurological disorders’ pathogenesis as well as congenital aniridia’s genetic mechanisms remain unclear. Thus, it is crucial to review new relevant data within the context of previously obtained information to gather full picture of the clinical signs of the disease and to improve the management of children with congenital aniridia.

Dyslexia (disturbance of reading) and dysgraphia (disturbance of writing) are a common problem of teaching children in secondary schools. Information on the prevalence of these conditions is ambiguous, the data presented in the Russian speech therapy literature differ from the results of a few foreign works, and therefore population studies are becoming particularly relevant. The review of the domestic methodological base with the prospect of application in population research and international approaches to population screening are presented.

Rehabilitation of children with motor disorders is a continuous, staged and dynamic process carried out on the basis of individualization of the program, the effectiveness of which depends on many important factors, starting from the consciousness and motivation of the patient, his rehabilitation potential and ending with the methods of medical rehabilitation used. In recent years, global changes have been taking place in rehabilitation related to the introduction of robotic technology. One of the modern methods is robotic mechanotherapy, with the advantages of the wide possibilities of changing training parameters, continuous computer analysis of motor functions, the possibility of training with simulated movements close to physiological ones. The modern introduction of the possibilities and limitations of the use of robotic complexes in the rehabilitation of children with cerebral palsy will eliminate errors and complications during complex medical rehabilitation and optimally use all the advantages of this method.

Background. The role of recently discovered neurospecific peptides in the pathogenesis of acute and progressive neurologic disorders, their neuroprotective features, and possibilities to use them as markers for the course and prognosis of certain diseases have been actively studied in recent decades. However, neurospecific peptides are almost not studied in chronic residual diseases. In our study we measured the levels of neurospecific peptides and some other markers to achieve understanding of general neurophysiological trends in congenital and acquired chronic non-progressive brain pathology with reference to the selection of relevant groups — study objects. Objective. The aim of the study is to study patterns of neurospecific peptides, neurotransmitters and neuroreceptor markers distribution in the serum of children with various pathogenetic variants of chronic neuropathology. Methods. The study included children from 3 to 16 years old with different pathologies. The sample was divided into groups by pathology type: no sensory and neurological disorders, congenital sensory deficit due to mutation of genes expressed and not expressed in the brain, early acquired sensory deficit of multifactorial nature, congenital mild and severe organic disorders of central nervous system (CNS) in residual stage without baseline sensory deficit, acquired functional CNS disorders without baseline organic defect and sensory deficit. The following laboratory data (neurophysiological components) was studied: nerve growth factor, brain-derived neurotropic factor, neurotrophin-3, neurotrophin-4, neuregulin-1-beta-1, beta-secretase, sirtuin-1, synaptophysin, neuronal nitric oxide synthase, and anti-NR2 glutamate receptor antibodies. The parameters of cognitive activity, sense of vision, sense of smell, and acoustic sense were also evaluated. Results. The study included 274 participants. Neuropeptides and markers have shown a variable degree and range in the group spectrum of differences from normal levels. The most variable in the examined sample was NO-synthase, as well as levels of both neurotrophins, beta-secretase, and glutamate receptor marker. All visual deficits were associated with increased NO-synthase levels (p < 0.001). Neuroplasticity peptides (beta-secretase, neurotrophin-3 and 4) have been activated in all pathological conditions. Nerve growth factor and brain-derived neurotropic factor were specifically activated in mild organic CNS lesions (mild cognitive impairments), while neuregulin — in congenital genetically determined visual deficits. There was no specific activation of neuropeptides and NO-synthase level tended to decrease in cases of severe CNS lesions. Conclusion. The study results suggest that all types of early visual impairment are associated with increased physiological neuronal activity, and non-organic neurological functional disorders — mainly with increased physiological synaptic activity. General neuroplasticity processes were activated in all cases of visual deficits but more specific. However, more specific and well-studied processes were activated in mild organic CNS lesions, and neuroplasticity processes did not activate adequately in severe organic CNS lesions probably due to the limited neuronal and synaptic resources.

Background. Nasal and nasopharyngeal pathology is one of the most important and widespread challenge in pediatrics and pediatric otorhinolaryngology. Prolonged nasal breathing difficulty can be caused by various diseases and their combinations. It requires multidisciplinary approach to diagnosis with the involvement of modern examination methods and pathogenetic treatment. Objective. The aim of the study is to develop complex technology for the management of children with nasal and nasopharyngeal pathologies. Methods. The study included 240 children aged from 6 to 18 years. All patients were divided into 3 groups, comparable by sex and age: Group 1 – 85 patients with confirmed ENT-organ disease, Group 2 — 104 patients with confirmed allergic disease, control group — 51 somatically healthy patients who did not have any ENT-organ or allergic diseases. Examination procedures: diagnostic nasopharyngeal endoscopy, rhinomanometry (RMM), rhinoresistometry (RRM), olfactometry. Results. The obtained results (RRM, RMM) have shown that air flow rate in nasal cavity increased due to nasal resistance decrease. Nasal resistance was higher and air flow rate was lower in all children with various ENT-organs or allergic diseases compared to the control group. Nasal resistance decreased in all study groups (significantly in children with aggravation of allergic diseases of airways and ENT-organs diseases) as well as air flow rate increased in all study groups (significantly in Group 1 and 2) after anemisation of nasal mucosa with decongestants. Apparently, it can be associated not only with anatomical features (nasal septum deviation), but also with inflammatory features of nasal cavity and nasopharynx (adenoid hypertrophy and inflammation, persistent swelling of nasal mucosa at allergic rhinitis). We would like to present the algorithm for diagnosis of children with nasal and nasopharyngeal pathologies according to the study results. The following practical guidelines have been proposed: 1) all patients with complaints on prolonged nasal breathing difficulties require not only otorhinolaryngologist examination, but also diagnostic endoscopy of nasal cavity and nasopharynx; 2) in case of nasal septum deviation and complaints on prolonged nasal breathing difficulties, it is necessary to perform functional methods for nasal breathing evaluating (RRM, RMM) to choose adequate treatment method; 3) the use of RRM, RMM would help to choose the optimal treatment approach in children with complaints on prolonged nasal breathing difficulties and confirmed diagnosis of allergic disease (allergic rhinitis, hay fever, etc.), also associated with adenoid hypertrophy and/or nasal cavity and nasopharynx inflammatory diseases; 4) all patients with confirmed chronic diseases of ENT-organs should be examined by allergist, and, if necessary, should undergo comprehensive allergological examination. Conclusion. The developed complex approach to the management of children with nasal cavity and nasopharynx pathology is innovative and represents the technology of personalized use of modern, objective methods for diagnosing the nasal cavity and nasopharynx state. The presented diagnostic algorithm and practical guidelines allow us to establish diagnosis and choose the treatment tactics within a short time. The use of these studies in clinical practice will allow to monitor the therapy efficacy (including various pharmacotherapeutic strategies) for nasal cavity and nasopharynx diseases in children. Timely examination and pathogenetic treatment will allow to prevent the chronization of pathological process in ENT-organs. This is especially crucial in childhood as it provides children with the best chance of healthy growth and development.

Background. Speech development impairment is urgent and common problem in pediatric neurology. Transcranial magnetic stimulation (TMS) is one of the promising treatment variants for children with speech disorders. Objective. The aim of the study is to evaluate efficacy and safety of the developed approaches to TMS usage in the management of children with speech disorders. Methods. It was non-randomized controlled study. It included 46 children with speech disorders aged from 3 to 6.5 years. All children were divided into two groups comparable by gender and age: 26 children of the treatment group received TMS course, 20 children of the control group received treatment with hopantenic acid. All patients with speech disorders underwent psychological and pedagogical evaluation of speech and cognitive development, electroencephalography (EEG) before and after treatment. Moreover, comparative analysis of TMS and nootropic therapy efficacy was carried out. Specialized examination of speech and cognitive development was also performed via E.A. Strebeleva method for psychological and pedagogical diagnosis of children development. Furthermore, we carried out side reactions / adverse events registration according to patients and/or their parents complaints confirmed by physical examination, patient’s behavior observation, data from specially developed questionnaire for assessing child’s behavior and well-being (filled up by parents). Finally, we evaluated brain bioelectric activity recorded by EEG. Results. The study results have shown that it is possible to achieve significant positive dynamics in cognitive and speech development in preschool children with speech disorders in both groups (TMS course and medical treatment). But hereby, TMS treatment has demonstrated significantly higher positive dynamics in two out of the three evaluated parameters. There were no cases of adverse events in TMS group leading to early course discontinuation. Conclusion. TMS is non-invasive and safe method for treatment of children with speech disorders. This study has demonstrated the efficacy of the method in the field of personalized management of children with impaired speech and cognitive development.

Background. The study of digital activity correlation with cognitive-emotional features, as well as with other parameters of adolescents’ life-activity in non-capital regions of Russian Federation remains relevant.Objective. The aim of the study is to analyze the digital activity structure in adolescents and its correlation with cognitive-emotional features, school performance and social and age factors.Methods. Participants are secondary school students of the 8th–11th grades. Digital activity was examined via online survey among adolescents. We took into account the use of social media, information search, watching videos on the Internet, using of messengers, playing games with electronic devices. Cognitive features (memory, thinking, executive functions, sensory information procession, reading and speech, understanding of emotions, decision-making) and emotional state of adolescents (anxiety) were evaluated by clinical psychologists via various tests. School performance was determined by the recent results of the school quarters/semester finished by the time of the survey. Social and age factors included regular out-of-school physical activity and family structure (complete/ incomplete).Results. We have examined 438 teenagers. 53 (12%) respondents spend more than 5 hours a day with digital devices on weekdays, 133 (30%) — on weekends, 147 (34%) — during the holidays. Structure of digital activity during weekdays (≥ 1 hour) among adolescents was the following: activity in social media prevailed (63.5% of respondents), fewer teenagers searched for information or watched videos on the Internet (47.3 and 42.9%, respectively), about a third (34.9%) played via electronic devices. Structure of digital activity changed over the weekend and during the holidays. We have revealed differences between the information search activity and the volume of short-time memory, understanding the verbal messages, and verbal-logical operations level. Adolescents with different levels of computer gaming activity have shown diversity in sensomotor reaction speed, visuospatial memorization accuracy, number of errors in high-speed reading, reading pace, and understanding text basic meaning.Conclusion. The greater time of digital activity among 8th–11th grades students is associated with negative results of cognitive activity and school performance.

The description of new promising method of functional neuroimaging, functional near-infrared spectroscopy (fNIRS), is presented. General information on functional tomography and its features in children are given. Brief description on the history of fNIRS development, the method itself, its advantages and disadvantages are covered. fNIRS implementation areas in science and clinical practice are clarified. fNIRS features are described, and the role of this method among others in functional tomography is determined. It was noted that fNIRS significantly complements other research and diagnostic methods, including functional magnetic resonance imaging, electroencephalography, induced potentials, thereby expanding the range of scientific and clinical issues that can be solved by functional neuroimaging.

The demographic situation in Russia requires escalation of measures to combat infertility including assisted reproductive technologies (ART). The analysis of correlations between ART and features of health and long-term development of “children from the tube” is presented. There is a high risk of dysontogeny after in vitro fertilization/intracytoplasmic sperm injection due to epigenetic disorders such as DNA methylation disorders. Living conditions, parenting, education, and health care are crucial for the healthy development of all children including those conceived by ART. The correlations between long-term cognitive development of “children from the tube” and the aspects of parenting in families are presented.

Background. Nasal cavity and nasopharyngeal pathology are crucial and common issue in pediatric otorhinolaryngology. One of the major reasons for the nasal breathing difficulties are adenoids, allergic rhinitis, acute rhinitis, rhinosinusitis, nasal septum deviation. All these diseases can occur individually and in combination with each other, while clinical signs can be similar.Objective. The aim of the study is study and estimate the condition of nasal breathing and sense of smell in children with different nasal and nasopharyngeal pathology.Methods. The study included 128 children, all children were divided into 3 groups comparable by gender and age. Children with confirmed acute ENT organ disease were included in the 1st group, children with allergic disease exacerbation were included in the 2nd group, and clinically healthy children (control group) were included in the 3rd group. Survey methodology: rhinomanometry (RMM), rhinoresistometry (RRM), olfactometry.Results. It was revealed that nasal resistance in children with allergic diseases exacerbation is significantly higher both before and after anemisation of nasal mucosa with a solution of nasal decongestants than in children of the control group (according to the RRM). The air flow rate increases by average of 25% in children with various ENT organs diseases, and in children with allergic diseases — by average of 43% after anemisation of the nasal mucosa. The obtained data shows the role of nasal mucosal edema in patients with allergic diseases during exacerbation. Analysis of our RMM and RRM data suggests the importance of further use of these methods in children.Conclusion. The obtained results will allow us to optimize the diagnosis approach and personalize the management of patients with various nasal cavity and nasopharynx pathologies. Nowadays, the study is ongoing.