Background. Information about the epidemiology of central auditory disorders (CADs) is contradictory and variable. The epidemiology of CADs in Russia is poorly studied. The aim of the study is to investigate the prevalence of CADs among primary school children. Methods. Screening was carried out among younger students of a general education school (students of grades 1–4). Suspicion of the presence of CADs was recorded using the Fisher questionnaire. When deviations were detected, audiological testing of the peripheral part of the auditory analyzer and psychoacoustic testing of the central auditory processing were carried out. Results. The Fisher questionnaire was completed by 222 students. Abnormalities were detected in 65 (29.3%) children, and audiological testing was performed on 56 children. Pathology of the peripheral auditory analyzer was identified in 11 (20%) children. Psychoacoustic testing of the central auditory system was performed on 45 children, and 32 (71.1%) children were found to have significant CADs. These children differed from those who did not have CADs in that they had lower monaural speech intelligibility in noise on both the right and left (p < 0,001) and lower standard dichotic number test scores (p = 0,029). Twelve (26.7%) children showed signs of CADs (borderline group), and one child (2.2%) did not show CADs. Conclusion. The results indicate a high prevalence of CADs among primary school-aged children, which highlights the importance of supplementing audiological screening programs for schoolchildren with methods that can detect signs of both peripheral and central disorders.

Background. Mechanotherapy is an effective method of rehabilitation for patients with cerebral palsy (CP), but its potential use after selective dorsal rhizotomy (SDR) is poorly understood. The aim of the study is to evaluate the feasibility and impact of robotic mechanotherapy methods on the motor skills of patients with spinal cord injury in the first months after surgery. Methods. A prospective, non-randomized, uncontrolled, single-center study was conducted involving 22 children with bilateral spastic forms of cerebral palsy aged 3.5 to 16.9 years (median age: 7.2 years) who had undergone SDR 7 to 25 days (median: 8 days) before the start of rehabilitation. Based on an examination by a multidisciplinary team of specialists, in addition to physical and physiotherapeutic rehabilitation methods, the patients received 10 mechanotherapy procedures: Galileo vibration platform for 22 (100%) patients, Motek C-mill sensory treadmill with support system and biofeedback for 12 (54.5%) children, and EA Bambini exoskeleton for 8 (36.4%) patients. Results. During the analyzed period of time, patients who used the sensory track showed statistically significant improvements in their gait parameters: an increase in the length of their steps with both their right and left legs, a more even distribution of weight on their limbs, and an increase in their walking distance and number of steps per minute. Patients who received training with an exoskeleton showed a significant increase in their training time and walking distance, as well as an increase in their walking speed and total number of steps per training session, and an increase in their voluntary activity on the simulator. The main limiting factors for the usage of these methods were pain syndrome, cognitive impairments, and the psychoemotional state of children after surgery. Conclusion. The use of robotic mechanotherapy methods can help improve patients’ endurance, functional skills, and activity in the early post-SDR period, but the selection of specific methods should take into account individual patient limitations and the time elapsed since surgery.

Background. The management of patients with multifactorial autoimmune diseases (inflammatory bowel diseases (IBD) and chronic dermatoses) is currently impossible without taking into account the clinical and biological phenotypes of the disease. To develop optimal disease control, it is necessary to study the factors that influence the manifestation, course, and relapse of the diseases. In addition, it is required to understand the phenotypic clinical and immunological parameters of inflammation, which depend on the underlying pathological process, the therapy, and the condition of other organs and systems involved in the underlying pathological process, including the upper respiratory tract. The aim of the study was to determine the main phenotypic clinical and immunological parameters of inflammation in pediatric patients with immune-inflammatory diseases associated with upper respiratory tract pathology (using psoriasis and IBD as an example). Methods. The study included 60 children: 20 patients with psoriasis and 20 children IBD, as well as 20 patients in the control group (conditionally healthy children) aged 6 years to 17 years 11 months. All patients in the study groups were consulted by a pediatrician, an otolaryngologist, an audiologist, and an allergist (if indicated). Patients with psoriasis were examined by a dermatologist, and children with IBD were examined by a gastroenterologist. Instrumental examination methods included nasal and nasopharyngeal endoscopy, otoscopy, tympanometry, and tonal threshold audiometry. Laboratory methods of research: clinical blood test, determination of antistreptolysin O, IL-1α, IL-1β, IL-6, IL-7, IL-8, IL-10, IL-12, IL-15, IL-17, IL-18, IL-19, IL-20, IL-23, and TNF-α levels in blood serum; determination of serum proteins (MDC/CCL22) and TLSP/kallikrein in blood serum. All patients in the target groups underwent rapid fecal testing for Helicobacter pylori and microbiological studies (mycological examination of oropharyngeal discharge for Candida albicans fungi; bacteriological examination of nasopharyngeal discharge for Staphylococcus aureus; and examination of intestinal microbiocenosis). Results. The obtained data allow us to identify the leading comorbid pathology of the upper respiratory tract in both study groups was chronic tonsillitis. Analysis of the intestinal microbiota composition revealed an imbalance of commensals and pathobionts in both children with IBD and patients with psoriasis. Immunologically, the presence of chronic tonsillitis in children with IBD was accompanied by increased levels of IL-23 and MDC/CCL22, while in patients with psoriasis it was accompanied by increased levels of IL-18 (p < 0.05). Another association identified for children with psoriasis — with allergic rhinitis — was also characterized by a significant increase in IL-18 (p < 0.05). The immunophenotype of IBD patients demonstrated an increase in IL-23 (p < 0.05), while in children with psoriasis, an increase in IL-18 (p < 0.05). Conclusion. At this stage of the study, the primary clinical and immunological markers of inflammation phenotypes in children with autoimmune diseases (using the example of psoriasis and IBD) and their relationship with the presence of comorbid pathology of the upper respiratory tract have been obtained. The study is currently ongoing; the results of this work will help improve the principles of managing children with immune-inflammatory pathology.

Background. Alopecia areata (AA) is common autoimmune disease affecting up to 2% of general population and significantly affecting quality of life. The implementation of new medications from the group of Janus kinase inhibitors into practice has expanded therapeutic possibilities in the management of severe AA forms. Current methods have big potential in improving therapeutic response and patients’ dermatology life quality index. Objective. The aim of the study is to evaluate treatment efficacy and quality of life dynamics in pediatric patients with severe AA forms who were administered with Janus kinase inhibitors and combination of external therapy with local narrow-band phototherapy. Methods. Retrospective selection of medical histories of patients received treatment in the dermatology department from January 2024 to June 2025 was carried out. All of them had diagnosis “alopecia universalis” and were administered with Janus kinase inhibitor, tofacitinib, at a dose of 10 mg/day, as well as with combination of external therapy with corticosteroids and local narrow-band phototherapy (311 nm) with follow-up and treatment efficacy estimation after 16 weeks. The primary endpoint in the study was improvement in alopecia severity score (SALT) ≥ 15 points from baseline, the secondary endpoint was improvement in quality of life index (CDLQI) score ≥ 3 points. Results. Two groups were formed. First group included patients administered with tofacitinib, mean age was 10.07 ± 2.14 years (95% CI), mean SALT score — 70.4 ± 17.2 points (95% CI), mean CDLQI score — 6.93 ± 2.23 points (95% CI). Second group included patients whose parents refused to use tofacitinib therapy or who had contraindications to this drug, including those under 2 years of age, and who received a combination of external therapy and local narrow-band phototherapy, mean age was 8.87±1.92 years (95% CI), mean SALT score — 65.5 ± 13.7 points (95% CI), mean CDLQI score — 8 ± 1.92 points (95% CI). SALT score was 36.33 ± 11.14 points (p = 0.0212) in the first group and 55.07 ± 14.71 points (p = 0.1978) in the second group after 16 weeks of treatment. CDLQI score at week 16 was 3.13 ± 1.65 points (p = 0.0334) in the first group and 4 ± 1.31 points (p = 0.0035) in the second group. Conclusion. Administration of tofacitinib, Janus kinase inhibitor, in a dose of 10 mg/day leads to statistically significant decrease in SALT score over 16 weeks of treatment, and shows greater efficacy compared to traditional methods. There were improvements in dermatology life quality index in both groups, however, patients from the first group showed better results. The only limitation was relatively small sample of study participants.

This article is devoted to the development of an intelligence system for medical decision making support (MDMSS) designed for reducing the burden on doctors and increase the differential diagnosis accuracy. Hybrid model, as a key feature, is suggested to be capable to analyse unstructured clinical history in Russian language. The system architecture, including data base structure, text preprocessing module, hybrid symptom extraction mechanism (with linguistic rules and semantic analysis based on BERT neural network model), is described.

Background. Learning difficulties are a common problem in primary school, affecting up to 30–40% of students. They are often associated with mild cognitive impairments, but existing methods for diagnosing them are time-consuming and not suitable for large-scale surveys. This creates a need for quick and accessible screening tools to identify at-risk children in a timely manner. The aim of the study is to conduct a psychometric validation of the developed screening method for assessing cognitive functions in primary school-aged children by comparing its results with generally accepted psychodiagnostic tools. Methods. A one-time observational prospective study involved 102 children aged 7 to 8 years and 11 months. The study used a developed screening method to assess auditory-verbal memory, verbal-logical thinking, constructive praxis, analytical-synthetic abilities for understanding the plot, and voluntary attention. To assess the construct validity, the Wechsler Intelligence Scale for Children (WISC), the A.R. Luria neuropsychological examination, and the Tuloz – Pieron test were used. The relationship between the indicators was assessed using the Spearman rank correlation coefficient. Results. Statistically significant correlations were established between the indicators of all subtests of the screening methodology and similar indicators of validating instruments. In particular, the results of the “Auditory — speech memory” subtest correlated with the indicators of the “10 words” test and the state of phonemic hearing; the “Kohs Block Design” subtest showed high consistency with the classical version of the Wexler test (P = 0.736, P < 0.0001); “Story pictures” — with the performance of the task “Interpretation of plot pictures” (P = 0.587, P < 0.0001); the effectiveness of the Dot cancellation test is associated with the stability of the Toulouse – Pieron attention (P = 0.556, P < 0.0001). Conclusion. The developed screening method demonstrated sufficient construct validity. This tool can be recommended for screening assessment of cognitive functions in order to identify children of primary school age from the risk group for the development of learning difficulties for their subsequent in-depth diagnostics.

Background. Childhood obesity has become one of the most serious health problems of the 21st century, affecting both developed and developing countries. The widespread prevalence of obesity underscores the importance of studying its causes and pathogenesis mechanisms, which will allow for a better understanding of the main directions of treatment and prevention of this condition, which should be implemented in various spheres of society: at home, in educational and medical institutions, and at the national level. The aim of the study is to study the possible effect of certain breast milk (BM) hormones (leptin, ghrelin, adiponectin, insulin-like growth factor 1 (IGF-1)) in overweight and obese mothers on the physical development of offspring at an early age. Methods. A prospective study examined two groups of infants who were breastfed during the first year of life. The first group included 48 children born of overweight and obese mothers with a median maternal body mass index (BMI) of 32.75 [min 26.1; max 43.03] kg/m2. The control group included 35 children born of mothers with normal body weight (median BMI was 21.1 [min 17.9 max 24.7] kg/m2). Results. The effect of overweight and obesity in the mother during pregnancy on the physical development of the child begins to manifest itself after birth from the age of 9 months, primarily through accelerated growth in body length, and by the age of 2-3 — overweight. BM showed a negative correlation of BMI with IGF-1 (r = –0.455, p = 0.021) and a positive correlation between BMI and adiponectin. (r = 0,45, p = 0,042). The threshold values of BM hormones were found, which are statistically significantly more often recorded in overweight and obese mothers: IGF-1 < 12.0 PG/mL (p = 0.0027), adiponectin ≥ 0.5 Mcg/mL (p = 0.020), ghrelin < 0.6 PG/mL (p = 0.006). There was a significant increase in the body length of infants aged 6 months when they consumed BM with IGF-1 levels < 12 PG/mL and significantly higher body weight at the ages of 2 and 3 years. In the group of children who consumed BM with ghrelin content < 0.6 PG/mL, a significantly higher body weight was found at the age of 3 years compared with children who consumed BM with a higher level of the hormone. Conclusion. IGF-1 levels in BM < 12 PG/mL and ghrelin < 0.6 PG/mL can serve as biomarkers of accelerated physical development of children from overweight and obese mothers. The effect of certain hormones in breast milk from mothers on the physical development of young children is an ambiguous problem that requires further study.

Background. The usage of topical androgens has become increasingly popular in recent years due to their availability and ease of use at home. However, a lack of awareness about the precautions to be taken when using topical gels can lead to unintended secondary exposure of third parties, including the risk of developing exogenous hyperandrogenism in children. Case Reports describe 5 patients (3 boys and 2 girls) who were examined for signs of precocious sexual development (PSD): pubic hair, enlargement of the penis or clitoris, accelerated growth, and advanced bone age. All patients showed isolated increases in blood testosterone levels, low values of gonadotropic hormones, and other indicators of the steroid profile. During a repeated proactive survey of parents, it was revealed that the patients’ fathers were using transdermal forms of testosterone and were not following the precautions to avoid exposing their children to these products. After eliminating the exogenous exposure to androgen, all patients’ blood testosterone levels returned to prepubertal levels. During follow-up, two patients developed gonadotropin-dependent PSD, necessitating the initiation of triptorelin therapy. Conclusion. These case reports highlight the need for increased awareness among physicians and patients of the potential risk of developing exogenous hyperandrogenism in children with unintentional exposure to transdermal androgens as a result of parental or guardian use of these medications and, consequently, the importance of taking precautions. Thorough collection of family and social history in children with signs of precocious puberty is essential in the timely diagnosis of an exogenous cause of hyperandrogenism and in the selection of examination and treatment.

Autism spectrum disorders (ASDs) are heterogeneous group of neuropsychiatric developmental disorders characterized by abnormal social interactions, communication, and stereotypical behavior. Major part of children and adolescents with ASDs have comorbid sleep-wake cycle alterations such as insomnia, circadian dysregulation, breathing disorders during sleep, parasomnia, etc. The interaction between ASDs and sleep disorders is multifactorial and bidirectional. There is data on biological, psychological, socio-environmental factors that contribute to sleep problems development, including sensory hyperreactivity, alterations of melatonin circadian rhythm, genetic mutations, inter- and externalizing behavior, changes in the environment. Disease itself, comorbid conditions (attention deficient hyperactivity disorder, mood disorders, epilepsy), as well as drugs used to treat them often have negative effects on sleep macro- and microstructure. This review examines and discusses the problem of sleep-wake cycle alterations in children with ASDs, its prevalence, structure, etiopathogenesis, clinical manifestations, sleep architecture features, diagnostic principles, and management options. Timely detection and treatment of sleep-wake cycle alterations in patients with ASDs can lead to improvements not only in their sleep quality, but also in overall functioning and development, as well as in overall family well-being.

Chronic subacute inflammation typical for obesity may underlie the development of autoimmune diseases. Increased adipokines (such as leptin and resistin) and proinflammatory cytokines secretion are crucial in pathogenesis. Chronic inflammation in obesity promotes accelerated pancreatic β-cells apoptosis, leads to demyelination and damage to neuronal axons, intestinal microbiome changes, and impaired synthesis of thyroid hormones. Altogether, it can result in development of such conditions as type 1 diabetes mellitus, disseminated sclerosis, inflammatory bowel diseases, and autoimmune thyroiditis. Timely management obesity may prevent autoimmune diseases development.