Вам открыли доступ к файлу. Отправлено с помощью Облако Mail.ru.

Objective. Examination of schoolchildren in Moscow using a specially designed questionnaire to identify children at risk of developing celiac disease. Patients and methods. The study enrolled 3070 Moscow schoolchildren aged 7–18 years old. Serological and genetic examinations were performed in 42 children at risk for celiac disease, including determination of IgA and IgE to wheat, IgA and IgG to tissue transglutaminase, and IgA to endomysium. Molecular HLA testing for alleles that predispose to celiac disease was conducted. Endoscopic and morphological diagnostics were performed when indicated. Results. The risk group for celiac disease amounted to 10.2% of all schoolchildren surveyed. According to the results of the questionnaire, children in the risk group significantly more often had abdominal pain, excess gas, bloating, flatulence, dyspeptic complaints (diarrhea, constipation, vomiting), asthma attacks or other forms of allergies, headache, joint or body pain, fatigue and weakness, mood swings, depression, anxiety, or episodes of emotional arousal. Changes in height, weight, delayed physical or sexual development, dental enamel defects, and skin rashes were also noted. Of the 42 children in the risk group, the DQ2 heterodimer was detected in 13 (31%) children, the DQ8 heterodimer – in 2 (4.8%), and a combination of DQ2 and DQ8 heterodimers – in 1 (2.4%). Thus, characteristic HLA haplotypes were identified in 38% of the examined children. Three children had IgA antibodies to tissue transglutaminase (at >10 norm) and IgA anti-endomysium antibody titers. Conclusion. The method of questioning by means of a specially designed questionnaire for school-age children allows to identify individuals at risk of developing celiac disease. According to serological, genetic, endoscopic, and morphological investigations, the incidence of celiac disease among children at risk was 7.1%. The prevalence of celiac disease among school-age children in Moscow corresponds to global trends, amounting to 0.7%. Key words: questionnaire, gluten-free diet, cereals, gluten intolerance, celiac disease, children

Objective. To assess the health status of adolescents aged 15–17 years living in Moscow based on the results of comprehensive preventive examinations. Patients and methods. This retrospective analysis included findings of preventive medical examinations of 1,255 adolescents aged 15–17 living in Moscow between January 1, 2024, and December 31, 2024. Results. In most adolescents, indicators of height, body mass index and blood pressure were within the reference range. Among all patients, only 14.1% of adolescents were considered completely healthy, while 85.9% of adolescents had at least one disease or functional disorder. The leading pathologies were diseases of the eye and its adnexa, diseases of the musculoskeletal system and connective tissue, endocrine diseases, and eating disorders, which requires the development of clinical and organizational measures to prevent these diseases in adolescents. According to the results of a comprehensive assessment, 76.6% of patients were classified as health groups I and II, and 69.6% of adolescents were classified as the general physical training group. Conclusion. The results of this study indicate the need to develop and improve the organization of medical care for adolescents. The issue of establishing closer cooperation between educational and medical institutions is becoming increasingly relevant, as is the need to change the model of medical organizations, which will be focused on solving a range of tasks that go beyond the existing pediatric model. In most adolescents, indicators of height, body mass index and blood pressure were within the reference range. Key words: health groups, comprehensive health assessment, adolescents, preventive medical examinations, physical development, physical training groups

Objective. To assess the safety of vaccination in children (0-17 years inclusive) with juvenile idiopathic arthritis (JIA) in Moscow. Patients and methods. An observational analytical cross-sectional study including 400 patients with JIA was conducted. The minimum required sample size of the observational group was 328 patients. Results. Only 23.8% of patients (n = 95) continued to be vaccinated after the onset of JIA. The exacerbation of juvenile arthritis in patients after achieving remission was independent of continuation or discontinuation of vaccination (p = 0.139). Children with a complete vaccination schedule were less likely to have exacerbations than patients with an incomplete vaccination schedule (p = 0.044). Conclusion. Vaccination in children with JIA has been shown to be safe and does not lead to an increase in the number of exacerbations in the post-vaccination period. Further search for other factors that may influence the exacerbation of juvenile arthritis is required.

Background: The differential diagnosis of respiratory distress syndrome (RDS) and congenital pneumonia (CP) in newborns remains a complex clinical challenge due to the similarity in their clinical manifestations and their potential to coexist. Objective: We aimed to determine differential diagnostic predictors of RDS and CP in newborns by using mathematical modeling and machine learning methods. Methods: A retrospective cohort study was conducted; de-identified medical records of 244 newborns (97 with RDS and 143 with CP) were collected to assess clinical, anamnestic, laboratory, and instrumental data by applying multiple regression analysis, ROC analysis, logistic regression models, and Random Forest. Results: Patients with CP presented with a more severe condition at admission (57.1% vs. 23.3%; p = 0.023), required mechanical ventilation (MV) more frequently (22.4% vs. 8.2%; p = 0.004), and were more often transferred to the intensive care unit (ICU) (77.3% vs. 55.7%; p = 0.001). They further had lower hemoglobin levels (151 ± 28 g/L vs. 164 ± 31 g/L; p = 0.001) and red blood cell counts (p = 0.021). Regression analysis demonstrated that the severity of the condition and the presence of cerebral ischemia were dependent on hemoglobin levels in the case of CP, while gestational age played a determining role in RDS. The machine learning models achieved an accuracy of 0.69 and an area under the curve (AUC) of 0.82 (Random Forest). The key predictors for differential diagnosis of RDS were low gestational age, hyperbilirubinemia, and congenital heart defects, while for CP, they were hemoglobin < 151 g/L, lymphocytes < 4.8 × 10³/μL, oxygen saturation < 90–91%, and cerebral ischemia. Conclusions: The use of mathematical modeling methods made it possible to identify prognostically significant predictors for the differential diagnosis of RDS and CP. The resulting models are best viewed as proof-of-concept tools for hypothesis generation and future research, as external validation is necessary before they can be considered for clinical use.