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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.

BACKGROUND: There has been an increase in the prevalence of autism spectrum disorders (ASD) worldwide over the past decades. Studies have shown that the number of confirmed diagnoses correlates with the awareness of the disorder among the general public and the professional community, in particular, as well as the availability of formalized screening procedures and modern medical and educational tools for families raising children with ASD in regional population centers. Thus, comparing autism prevalence rates in regions of the same country helps identify regions with limited access to diagnostic services and adequate medical care. AIM: To estimate the overall number of individuals meeting the diagnostic criteria for ASD in Russia and determine the differences in the number of registered individuals with established diagnosis in the constituent territories of the Russian Federation. METHODS: We conducted a retrospective, observational study and analyzed data from official statistical reports (form 12 Information on the Number of Diseases Registered in Patients Residing in the Service Area of a Healthcare Institution for 20202021). RESULTS: A steady upward trend in the number of individuals with autism has been observed since 2014 in the Russian Federation as a whole and in the federal districts, although the prevalence rates differ from the global median prevalence of ASD (all-Russian figure by almost 40 times). In addition, regional differences (by 104.5 times) in the frequency of the diagnosis have been revealed: from a minimum of 1.7 to a maximum of 177.7 per 100,000 population. The percentile distribution of the number of individuals with ASD that are followed-up at healthcare facilities in the constituent territories of the Russian Federation was in the interquartile range (2575th percentile), below the 25th percentile, and above the 75th percentile in 38, 26 and 21 regions, respectively. CONCLUSION: The study has shown significant differences in the ASD diagnosis rates by regions in the country against a backdrop of a low (compared to international data) number of registered cases of autism. The presented data suggest that, due to the lack of proper diagnosis, a significant number of individuals with ASD do not receive adequate medical care, nor do they receive social, psychological, or pedagogical support. Possible reasons for this probably include low awareness of new diagnostic approaches among psychiatrists; low level of involvement of pediatrics professionals in screening activities; and fear of stigmatization because of a psychiatric diagnosis in the absence of a developed medical care infrastructure that encompasses a social, psychological, and pedagogical support system for people with ASD.

Background. Child and adolescent suicides remain one of the most painful public issues. The COVID-19 pandemic has aggravated this topic as the number of suicides among children population has increased in this period. Research and practice guidelines identify the leading role of primary care physicians in the prevention, identification, and routing of patients with suicidal behavior. At the same time, there were no studies on pediatricians’ competence in the field of suicides.Objective. The aim of the study is to study pediatricians’ competence in prevention, risk determination or and detection of suicidal behavior.Methods. Cross-sectional study was conducted with the usage of original electronic questionnaire aimed on identifying the level of pediatricians’ competence in evaluating suicidal behavior in children. Questionnaire included 18 questions.Results. We have received 208 electronic questionnaires. 97.1% of specialists have confirmed that they evaluate emotional status of their patients during admission. During admission: 86.1% of specialists have considered the characteristics of children appearance, facial expression, voice intonation, 65.4% — have asked questions about mood, 62.5% — have interviewed parents. 98.6% of specialists pay attention to the presence of self-inflicted injuries marks, 88.4% — ask about the origin of these injuries. Only 36.1% of respondents ask patients about suicidal thoughts, intentions, or actions. Only 69.3% of specialists are ready to refer their patients to psychologist, and 51.7% — to psychiatrist.Conclusion. Even though most surveyed pediatricians notice signs of suicidal intent (low mood, self-inflicted injuries), they avoid discussing the topic of suicide during admission. Increasing the competence of pediatricians should be aimed on destigmatisation in the field of mental health, increasing the knowledge level, and developing practical skills in working with children with suicidal behavior.

Autism spectrum disorders (ASDs) are common neurodevelopmental disorders characterized by heterogeneity and high variability in severity of mental, neurological, and somatic symptoms. Such gastrointestinal malformations as abdominal pain, constipation, diarrhea, gastroesophageal reflux, nutritional disorders, intestinal microbiota disorders are common in autistic children. The association between the severity of gastrointestinal malformations and the severity of behavioral symptoms in ASDs was revealed. Early diagnosis and assessment of gastrointestinal malformations in ASDs is crucial for their further correction to optimize nutrition, to develop individual complex treatment and management with the involvement of multidisciplinary specialists.

Modern approaches for the management of children with gastrointestinal pathologies include optimal nutritional support that makes it possible to replete energy failure and restore essential nutrients balance. The article presents key information on gastrointestinal diseases in which modern amino acid formulas can be used to regulate nutritional status. The authors have conducted the extensive analysis of all available for now evidence on the efficacy, safety and utility of using such innovative medical technology as special elemental formula in gastrointestinal tract pathological conditions. This material is the basis for guidlines on the use of amino acid formulas developed by expert specialists of the Union of Pediatricians of Russia in 2020.

The article presents modern approaches to the use of balanced formulas for nutrition and diet correction in children with various forms of food allergies. The guidelines are based on all available up to date evidence on the efficacy, safety and utility of using such innovative medical technology as specialized amino acid formulas. This formula is the targeted medical intervention for food allergies and confirmed cow's milk protein allergy, and particularly for patients with reduced physical growth and development (growth rates included). The material is based on methodological guidelines on the amino acid formulas usage previously developed by specialist experts of the Union of pediatricians of Russia in 2020.

Background. Many social problems have worsened nowadays especially in the context of the COVID-19 pandemic. It is important that child health professionals have all the necessary knowledge for detection of child abuse in modern society. Aim of the study is to study the awareness and competence of pediatricians on child abuse. Methods. The cross-sectional study was conducted using the international standardized questionnaire (22 questions). The study has included practicing pediatricians from inpatient and outpatient (95% of all respondents) clinics in Kazan. Results. The data from questionnaire survey of 73 pediatricians has shown that 29 (40%) and 39 (53%) of all respondents encountered physical and psychological abuse against children, respectively. Physical abuse was considered as the most common form of abuse by 38 (52%) pediatricians. The child abuse was revealed during routine examination in 33 (45%) cases. 20 (28%) respondents have initiated proceedings for every case of physical abuse, and 23 (31%) — for psychological abuse. One in three pediatricians, 23 (31%), consider the present legislation comprehensive enough in the sphere of children protection against abuse. Meanwhile, 50 (68%) pediatricians regarded their own level of awareness in this topic as insufficient. Conclusion. The study has shown insufficient competence of pediatricians (especially in the visiting services) in the detection and maintenance of children abuse cases (physical and psychological). It is crucial to enhance and continuously improve education of pediatricians on pre-graduate and continuing professional education levels in issues of children abuse.

Objective: Our aim was to clarify and standardize the definitions of the term "social pediatrics."Methods: Terminological analysis, functional interpretative content analysis and method of expert assessments.Results: We found 86 definitions of the term "social pediatrics" in the Russian and foreign scientific sources (1939 to 2015). The earliest publication (1945) on social pediatrics was found in the PubMed database. After excluding duplicate and similar definitions, 24 logical definitions were included in the final analysis. Between 1970 and 1979, the highest number of foreign publications related to social pediatrics (PubMed) was found giving the grounds for considering this period the time of the official development of social pediatrics as a branch of science and practice abroad.Discussion: The definitions under the study compose a picture of a broader interpretation of the term "social pediatrics" in Europe, including different children healthcare levels (state, public, individual), while, for example, in Canada, the emphasis shifts towards a purely practical sphere — primary medical care with social pediatrics applied to vulnerable groups of children. Content analysis identified the main categories of social pediatrics in the presented definitions that were recorded in the developed matrix table.Conclusion: Based on the conceptual and categorical apparatus of social pediatrics, including a "holistic approach to healthcare," "social determinants of children's health," "preventive component," "children in difficult circumstances of life," "multidisciplinary approach/interagency cooperation," "system approach (to the organization of healthcare)," "health support," "psychosocial support," and "rights of the child," we introduced our own definition of social pediatrics. Preventive component of social pediatrics is recognized as one of the most important features according to both the content analysis and experts.