Objective of the Review: To determine the mechanisms of development of pulmonary hypertension in children suffering from bronchopulmonary dysplasia.

Key points. The pathogenesis of bronchopulmonary dysplasia is currently not fully understood. Changes in the transmission of intracellular signals affecting the regulation of angiogenesis play an important role. Hypoxia, hyperoxia, and exposure to mechanical ventilation lead to oxidative and inflammatory stress, causing damage to the lung alveoli and vasculature with the development of pulmonary hypertension. It is necessary to understand the interaction of growth factors, transcription factors and inflammatory processes that regulate the normal development of the parenchyma and microvascular bed of the lungs to develop preventive methods.

Conclusion. Further study of the role of significant biomarkers of the formation of bronchopulmonary dysplasia can help in the early diagnosis and prevention of the development of this disease, as well as such a threatening complication as pulmonary hypertension.

Objective of the Review: on the basis of domestic and foreign conciliation documents and the results of our own research, to present up-to date information about a dangerous complication of bronchopulmonary dysplasia - pulmonary hypertension.

Key Points: pulmonary hypertension is a common complication of bronchopulmonary dysplasia, which has antenatal, perinatal and postnatal risk factors. The presence of risk factors, respiratory failure, bronchial obstruction in a child with bronchopulmonary dysplasia is the basis for excluding pulmonary hypertension by echocardiography, which allows to detect an increase in pressure in the pulmonary artery, indirect signs of pulmonary hypertension. An obligatory method of treatment of pulmonary hypertension in children with bronchopulmonary dysplasia is oxygen therapy. With insufficient effectiveness of oxygen therapy, treatment is sequentially carried out with sildenafil, bosentan, and nitric oxide.

Conclusion: Since the clinical manifestations of pulmonary hypertension in children with bronchopulmonary dysplasia are indistinguishable from the symptoms of the underlying lung disease, timely screening of this complication and the appointment of therapy are necessary.

Objective of the Review: To analyze modern scientific research on clinical syndromology, genetic factors of epilepsy and cerebral palsy (CP), therapeutic tactics and outcomes.

Key points. Multiple genetic factors contribute to the emergence of CP. With CP, low birth weight, neonatal seizures, epileptic seizures during the first year of life, a burdened family history of epilepsy, the severity of CP and the presence of changes in neuroimaging are associated with the risk of developing epilepsy. Children with CP may have Otahar, West, Lennox — Gastaut, syndromes-focal epilepsy of childhood with structural brain changes and benign epileptiform discharges in EEG — FECSB-BEDC. The selection of antiepileptic drugs in patients with epilepsy and CP is determined by the epileptic syndrome, cognitive, motor manifestations and side effects of the drug. Most of the failures of remission occur within the first year after discontinuation of therapy. Failure of remission is associated with a greater likelihood of subsequent development of pharmacoresistant epilepsy.

Conclusion. Video EEG monitoring and spectral analysis of bioelectric activity of the brain can be of great importance for optimizing the management of patients with CP and epilepsy. In addition, the search for EEG criteria for the withdrawal of antiepileptic drugs in patients with a combination of CP and epilepsy, as well as predictors of failure of remission, remains relevant.

Study Objective: To identify the features of psychoemotional characteristics of children and adolescents with migraine.

Study Design: Comparative study. Materials and methods. We have examined 160 patients: preschool children (5–6 years old), primary school-aged children (7–10 years old), secondary school-aged children (11–14 years old), and high school-aged children (15–18 years old). Patients with verified migraine (G43.0, 43.1, 43.3, 43.8 as per ICD-10) were included into study group (I , n = 80), patients without migraine comprised group (controls) II, n = 80). Questionnaires were used to find out complaints, collect medical and family history, history of early development of the child; children underwent standard neurological and somatic tests and a comprehensive clinical and laboratory examination

Study Results. 80.0% of subjects who complained of headache said their headache was severe and either markedly (1/3 of cases), or significantly (2/3 of cases) affecting their daily life. Patients in group I more frequently had mild situational or neurotic depression vs. group II (18.7% vs. 13.5%) and situational or personal anxiety (28.8% vs. 11.4% and 33.8% vs. 11.4%, respectively).

Conclusion. The specific features of the psychoemotional state of children and adults with migraine require psychological support, especially in depression and anxiety.

Objective of the Review: To provide information on the prevalence of COVID-19 coronavirus infection in children and young people, on the negative impact of the epidemic on children and adolescents, the long-term consequences of COVID-19, and the psychosomatic status of people who have had a coronavirus infection.

Key points. The COVID-19 pandemic has caused an unprecedented multi-modal (medical, professional, economic and social) crisis affecting most countries of the world, has become a factor of psychosocial disadvantage. The conducted studies give an idea of the prevalence, structure and clinical manifestations of mental disorders, disorders of the somatic and emotional status in children and young people during the epidemic, and in those who have recovered from this infection — about the features of the course of the post-COVID period.

Conclusion. It is necessary to conduct longitudinal studies of the psychosomatic status of COVID-19 convalescents in the child and youth population in order to develop methods for correcting and preventing mental health disorders in this contingent.

Study Objective: To determine the risk factors for the development of a progressive course of atopic dermatitis (AD) in children and adolescents.

Study Design: Observational prospective cross-sectional study.

Materials and Methods. The study enrolled 89 outpatients with AD aged 2 months — 17 years. The diagnosis was verified based on Hanifin and Rajkа criteria (1980); skin disorders were assessed via SCORAD followed by statistical analysis. Family history, breastfeeding duration and symptoms manifestation were assessed.

Study Results. Based on our results, compared to children with erythemato-squamous plaques with lichenization AD (ESPL) and lichenoid AD (L), children with erythemato-squamous plaques of AD (ESP) predominated (ESP vs. ESPL vs. L: 44 (50%) vs. 28 (31%) vs. 17 (19%) respectively (p < 0.05). Progressive AD was noticed in more than 50% (p < 0.05). SCORAD index was maximal in lichenoid AD (p < 0.05). Progressive AD is frequently accompanied with genetic predisposition on the mother’s side as well as early AD manifestation and shorter breastfeeding. Prolonged course of the disease influences the risks for lichenoid forms.

Conclusion. Risks for progressive course of AD is higher in children with genetic predisposition on the mother’s side, duration of breastfeeding with regard to early AD manifestation. Basically, clinical symptoms of the atopic march were related to seasonal allergic rhinitis, less often with asthma.

Objective of the Review: To analyze current data on eosinophilic lesions of the stomach in children with the analysis of a clinical case.

Key points. Diseases of the gastrointestinal tract associated with primary tissue eosinophilia are a heterogeneous group of changes characterized by inflammation, with predominantly eosinophilic tissue infiltration in the absence of other known causes. Clinical manifestations of allergic inflammatory diseases of the gastrointestinal tract are most often nonspecific. Depending on the level of the lesion, eosinophils are distinguished: gastritis (EoG), enteritis, and colitis. In recent years, more and more attention of experts has been directed to research in this area, but so far there are no general epidemiological data on the prevalence of this pathology in the population, both adults and children.

Conclusion. Currently, there are no clear morphological criteria for diagnosing eosinophilic lesions of the stomach, small and large intestine in children, and clinical manifestations, especially in young children, are nonspecific. When making a diagnosis of EoG, it is necessary to take into account a family allergic history, a set of laboratory diagnostic data (eosinophilia in a clinical blood test and a high level of total IgE) and a morphological study of a biopsy of the gastric mucosa.

Study Objective: to investigate the association of dyspepsia and heartburn in school-age children.

Study Design: A continuous epidemiological screening of heartburn and dyspepsia in school-age children was carried out using a single point (transverse) method.

Material and Methods. A total of 328 children were examined (163 boys and 165 girls, mean age 12.4 years). Heartburn was determined according to the recommendations of the international pediatric consensus on gastroesophageal reflux disease. Dyspepsia was diagnosed in accordance with the pediatric section of the Rome IV criteria.

Study Results. The prevalence of dyspepsia syndrome was 14.0%, heartburn — 10.4%. Increasing age in children was a risk factor for dyspepsia. The frequency of heartburn was registered in 39.1% of patients with dyspepsia and only in 5.7% of those without dyspepsia (p < 0.001). The prevalence of overlap syndrome of dyspepsia and heartburn in school-age children was 5.5%.

Conclusion. The association of heartburn and dyspepsia in school-age children is a real problem that requires the attention of practitioners.

Objective of the Paper: To draw the attention of pediatricians, otorhinolaryngologists, general practitioners to the possibilities of irrigation therapy in the treatment of acute respiratory viral infections in children.

Key points. Irrigation therapy is widely used for the prevention and treatment of acute infections of the upper respiratory tract in children, and is an effective and safe method. However, there are no indications in the clinical guidelines about the exact concentrations of saline solutions, the method of irrigation therapy, and its duration. For use in acute respiratory viral infections in children at different periods of the disease, it is preferable to use a slightly hypertonic solution of sea water in the form of a fine spray. In the acute period, irrigation therapy reduces the need for the use of decongestants and antibiotics. In the subacute and post-viral periods, it promotes the regeneration of the ciliary epithelium.

Conclusion. The addition of Ascophyllum nodosum brown algae extract to solutions for irrigation therapy can increase the effectiveness of treatment, promote faster relief of inflammation in the nasal cavity, and restore the mucosa due to the anti-inflammatory, antimicrobial, and immunomodulatory properties of fucoidans.

Objective of the Paper: Demonstration of a clinical case of successful use of golimumab in a child with juvenile polyarthritis.

Key points. Juvenile polyarthritis is one of the most disabling clinical variants of juvenile idiopathic arthritis (JIA). In recent years, the range of medicines used in the therapy of JIA has significantly expanded. With the ineffectiveness of methotrexate, the appointment of genetically engineered biological drugs (GIBP) is shown, among which tumor necrosis factor α (TNF-α) inhibitors are most often used, one of which is golimumab.

Conclusion. To date, for the treatment of juvenile polyarthritis, there is golimumab in the arsenal of medicines, which is human monoclonal antibodies to TNF-α, which allows to achieve an inactive phase of the disease with the ineffectiveness of the use of other GIBP.

Objective of the Paper: to demonstrate the observation of the long-term consequences of postresection short bowel syndrome in a 13-year old boy.

Key Рoints. Short bowel syndrome (SBS) is characterized by a low absorption capacity of the small intestine as a result of extensive resections, which is manifested by malabsorption, malnutrition and digestive disorders. Observation of a 13-year-old child with a history of postresection short bowel syndrome 10 years after acquiring intestinal autonomy (independence from parenteral nutrition) illustrates the long-term consequences SBS: megaloblastic B12-deficient anemia with neurological symptoms, delayed physical development, persistent anastomositis.

Conclusion. In children with a history of short bowel syndrome, after acquiring intestinal autonomy, some risks remain that significantly disrupt the patient's health. Such patients need long-term food insurance and supervision by a multidisciplinary team of specialists.

Objective of the Paper: Show the importance of genetic diagnosis in children with movement disorders.

Key points. Pontocerebellar hypoplasia (PCH) is a heterogeneous group of autosomal recessive neurodegenerative diseases. They are characterized by a beginning in the prenatal period, a slowdown in the growth of the cerebellum, frontal and occipital cortex of the cerebral hemispheres, and microcephaly. The disease manifests itself from birth and is steadily progressing. PCH2A is the most part of the described variant of the disease. It is characterized by moderate respiratory disorders, swallowing disorders, dyskinesia at rest, choreic hyperkinesias, muscle spasticity, pharmacoresistant epilepsy and progressive microcephaly. To date, about 80–100 cases have been described. An own observation of a patient with pontocerebellar hypoplasia of type 2A is presented. The girl noted a slowly progressive violation of motor, speech and mental development of a severe degree of severity, epileptic seizures and extrapyramidal paroxysms.

Conclusion. Timely genetic diagnosis in children with the phenotype of microcephaly and cerebral palsy allows reaching an etiological diagnosis, determining treatment tactics, rehabilitation prognosis and helps in the future to plan the birth of healthy children in the family.