The authors present current data on the etiology, pathogenesis, clinical manifestations of celiac disease in children of different ages, associated diseases, laboratory and instrumental diagnostics, diet therapy, additional treatment methods, vaccination, and follow-up of children with celiac disease based on the developed clinical guidelines “Celiac Disease. Children”.

Целиакия у детей: проект клинических рекомендаций

Malnutrition (MN) is common in children with acute and chronic illnesses. The use of questionnaires to assess nutritional risk in children admitted to hospital is a simple and quick way to identify patients who need nutritional advice and nutritional support. Various English-language screening questionnaires, such as STRONGkids nutritional risk screening tool for children, in particular, have been developed and validated. The purpose of the study is to adapt the STRONGkids nutritional risk screening tool for the Russian language speaking audience and to determine the reliability and validity of its new language version. Materials and methods of research: linguistic ratification of the STRONGkids questionnaire was carried out and the Russian language version was created. This single-center prospective study included 419 children admitted from October, 2019 to March, 2021 for treatment in Therapeutic Pediatric (cardiac, nephrological, gastroenterological, pulmonological etc.) and Surgical Pediatric (abdominal, thoracic, otorhinolaryngological, cardiosurgical etc.) Departments of the National Medical Research Center for Children’s Health (Moscow, Russia) with a hospital stay longer than a single day. The reliability of the questionnaire was assessed in 50 children. The anthropometric indicators were used to assess the current validity; the duration of hospitalization was used to assess the predictive validity. Body mass index-for-age (BMI-for-age) <-2SD and Length/height-for-age <-2SD z-scores were criteria for acute and chronic MN, respectively. Results: almost complete (κ=0.84) inter-expert agreement was found during the evaluation of reliability of the STRONGkids questionnaire. The validation study included 419 patients (51% boys/49% girls) aged from 1 month till 17 years and 11 months old (8 years old as median) with hospitalization duration from 1 to 100 days (10 days as median), of which 314 (75%) and 105 (25%) therapeutic pediatric and surgical pediatric patients, respectively. The frequency of acute and chronic MN at admission was 9.1% and 7.4%, respectively, and the percentage of children at low, moderate and high risk (assessed by the questionnaire) was 22.7%, 66.6% and 10.7%, respectively. Children at nutritional risk had statistically significantly (p<0.05) lower BMI-for-age and Length/height-for-age z-scores, greater incidence of MN and longer hospital stays than patients without nutritional risk. A chronic disease addendum, complications and high nutritional risk according to the questionnaire are independent unfavorable factors for an increase in the duration of hospitalization. Conclusion: the Russian language version of the STRONGkids nutritional risk screening tool for children was adapted and validated to assess nutritional risk in children admitted to hospital for treatment. Since right now it can be of use for identifying patients at high risk of MN for the purpose of their additional examination and timely administration of nutritional support and can be used both in routine pediatric clinical practice and in purpose of further scientific research.

ЭФФЕКТИВНОСТЬ ИСПОЛЬЗОВАНИЯ АДАПТИРОВАННОЙ СМЕСИ НА ОСНОВЕ КОЗЬЕГО МОЛОКА В ПИТАНИИ ЗДОРОВЫХ ДЕТЕЙ ПЕРВОГО ПОЛУГОДИЯ ЖИЗНИ: РЕЗУЛЬТАТЫ МНОГОЦЕНТРОВОГО ПРОСПЕКТИВНОГО СРАВНИТЕЛЬНОГО ИССЛЕДОВАНИЯ

The article presents a review of modern domestic and foreign literature, which reflects the current problems associated with the diagnosis of malnutrition in children admitted to surgical hospitals. The article gives definition of the concept of «nutritive insufficiency», and its prevalence. The clinical, anthropometric, instrumental and laboratory research methods used to assess the nutritional status are characterized in detail. It has been shown that malnutrition has a negative impact on the course of surgical pathology, reduces immunological protection, increases the risk of complications, nosocomial infections, and length of hospital stay. Various methods for assessing the risks of malnutrition in surgical patients upon hospital admissions are presented.

Актуальность оценки нутритивного статуса у детей с хронической сердечной недостаточностью