Fundamental principles of the theory of generations and its Russian version, which have been widely distributed in the last three decades especially in psychological science have been analyzed. The author’s opinion on the real possibility of its implementation in the practice for protecting the health of younger generation of the country considering the degree of formation in family and in, educational organization of the child’s life values, behavior and his own health attitude, is presented. The application perspectiveness of the Theory in the medical and organizational, psychological, ethical, and deontological, legal plan on the model of social patronage in the family, medical and social work, especially in the pediatric primary care, acquaintance with the living conditions specialty, education, development and growing up, intrafamilial relations, “problems of fathers and children” are presented.

The demographic situation in Russia requires escalation of measures to combat infertility including assisted reproductive technologies (ART). The analysis of correlations between ART and features of health and long-term development of “children from the tube” is presented. There is a high risk of dysontogeny after in vitro fertilization/intracytoplasmic sperm injection due to epigenetic disorders such as DNA methylation disorders. Living conditions, parenting, education, and health care are crucial for the healthy development of all children including those conceived by ART. The correlations between long-term cognitive development of “children from the tube” and the aspects of parenting in families are presented.

The pandemic caused by the new coronavirus infection remains the topical health issue and constitutes serious threat to the entire world. Nowadays, active immunization against new type of coronavirus infection continues in Russian Federation and in all other countries. Vaccination is the crucial component in comprehensive program for COVID-19 prevention and control. Mass immunization of population can prevent both admissions and hospitalization in conditions of high incidence of COVID-19 and thereby reduce the burden on the health system. Despite the remaining complications in combating the SARS-CoV-2 pandemic, preventive vaccination is by far the most effective method for protection against this infection Clinical studies on the efficacy of various preventive vaccinations in different regions of the world are extremely relevant especially under conditions of the emergency use authorization for vaccines against new coronavirus infection, the changing epidemiological situation, and the wide variability of different types of vaccines. All countries will need continuously updated data on vaccine efficacy to address new challenges such as weakening post-vaccine protection, new SARS-CoV-2 strains, and need for other preventive measures to mitigate the pandemic.

Background. Worldwide private health care system plays significant role in promoting immunization programs for the children population. The role of private medical facilities in Russia in combating children vaccination issues has not been previously studied.

Objective. The aim of the study is to study immunization and immunization coverage in children population according to the national immunization schedule (NIS) in outpatient clinics of different forms of property.

Methods. The study of medical documentation of children in private (n = 1) and public (n = 2) facilities in Moscow and Moscow region was performed. Immunization (complete vaccination course in those who should be vaccinated by age) and immunization coverage (at least one dose of vaccine by those who have to be vaccinated) were estimated against the NIS schemes according to the data from preventive vaccination cards (form 063/y) and from preventive vaccination lists (form 112/y).

Results. The study includes 313 cards of children from private outpatient clinic and 305 — from public outpatient clinic. Immunization and immunization coverage of children against tuberculosis were similar in these facilities: 293 (94%) and 294 (96%) (p = 0.114), respectively, as well as immunization coverage against hepatitis B — in 282 (90%) and 269 (88%) (p = 0.448). Rates of immunization and immunization coverage against the remaining NIS infections were higher in the private clinic. Maximum differences were noted in immunization (178 (57%) in private and 19 (6%) in public facilities; p < 0.001) and immunization coverage (238 (76%) and 52 (17%), respectively; p < 0.001) against pneumococcal disease. Immunization coverage of children for epidemic indications was also higher in private clinic: the largest differences were in immunization against hemophilic and meningococcal infections.

Conclusion. Children followed up in private outpatient clinic have higher immunization and immunization coverage rates against most of the NIS infections.

Background. Inflammatory bowel diseases (IBD) often occur with hepatobiliary system involvement, including autoimmune ones. The role of IBD in development and severity of liver fibrosis in children remains unknown.

Objective. The aim of the study is to study the correlation of IBD with the presence and severity of liver fibrotic changes and its malfunction at hepatobiliary system autoimmune disorders in children.

Methods. The study included patients hospitalized with isolated (control group) autoimmune hepatobiliary disorders (HBD) (autoimmune hepatitis, primary sclerosing cholangitis, overlap syndrome, autoimmune cholangitis, primary biliary cholangitis) or in combination with IBD. The presence and severity of liver fibrosis was evaluated via invasive (estimation of inflammation activity and liver fibrosis via the METAVIR scale, areas of collagen IV deposition in liver biopsy slides) and non-invasive methods (transient liver elastography, collagen IV levels, liver enzymes activity).

Results. Patients with autoimmune hepatobiliary disorders associated with IBD (n = 41) were comparable to those in control group (n = 44) by gender and age. Patients with IBD were more likely to be diagnosed with autoimmune hepatitis and primary sclerosing cholangitis. Furthermore, patients with IBD had higher frequency of moderate fibrosis, higher gamma glutamine transferase activity, and lower albumin concentration in comparison with patients of control group. We haven't revealed any other differences between both groups on other indicators.

Conclusion. IBD are associated with relatively high incidence and severity of liver fibrotic changes in autoimmune HBD compared to isolated autoimmune HBD cases. However, these differences may be due to the differences in autoimmune HBD structure and, subsequently, its treatment.

Background. Autosomal recessive polycystic kidney disease is a rare congenital anomaly with poor prognosis. It characterized by the development of cysts in kidneys parenchyma, secondary dilatation, and hyperplasia of normally formed collecting tube in kidneys.

Clinical case description. Autosomal recessive polycystic kidney disease was diagnosed in the fetus via ultrasound in the third trimester of pregnancy, signs of “large hyperechogenic kidneys” were revealed. The fetal kidneys were significantly enlarged, the parenchyma was thickened, and there was no cortico-medullary differentiation. The renal pelvises and bladder were identified. Amniotic fluid volume was normal. The ultrasound diagnosis was confirmed with magnetic resonance imaging. Female child born at full term, weight — 4500 grams, she was discharged home in satisfactory condition. At the age of 7 months, child physical development corresponds to her age. Ultrasound examination shows the persistence of pronounced increase in the size of kidneys, parenchyma thickening and no cortico-medullary differentiation. The renal pelvises and bladder are not dilatated. Urine analysis results: epithelia in large quantities, single leukocytes and isomorphic erythrocytes, as well as protein of 0.066 g/l. Blood creatinine and blood urea were within normal ranges.

Conclusion. Amniotic fluid volume and presence of urine in the bladder are the most important characteristics of the kidney functioning in case of antenatal ultrasound signs of autosomal recessive polycystic kidney disease. The absence of amniotic fluid at visualization of “large hyperechogenic kidneys” is considered as poor prognostic feature. MRI is crucial to clarify the diagnosis of autosomal recessive polycystic kidney disease and allows adequately estimate the amniotic fluid volume in the third trimester of pregnancy.

Background. Assignment of causes of generalized lymphadenopathy causes as a symptom of various diseases is still challenging. In case of no infectious causes, the morphological study is necessary also to exclude sarcoidosis, rare for young children immunemediated systemic disease with intermediate prognosis.

Clinical case description. 4 years girl was diagnosed sarcoidosis with typical lesions of intrathoracic lymph nodes and lungs along with signs of generalized lymphadenopathy. Molecular genetic testing has revealed pathogenic variant in the TNFRSF13B gene that was previously described in adult patients with general variable immunodeficiency and pulmonary sarcoidosis. Catamnestic follow-up data on this patient are presented for 3 years. There were no relapses without immunosuppressive therapy.

Conclusion. Sarcoidosis was described as the cause of generalized lymphadenopathy in preschool child. Following the federal guidelines has helped to adjust diagnosis tactics, to establish diagnosis, and to choose treatment.

Background. The main method of surgical treatment of toe walking is Achilles tendon extension, which is associated with the risk of excessive correction, tendon rupture, its poor blood supply, plantar flexion deformity. Another alternative is minimally invasive technique, myofasciotomy.

Objective. The aim of the study is to study the results of percutaneous myofasciotomy in patients with idiopathic toe walking with severe foot deformity and with no effect of conservative therapy.

Methods. The study included data (medical records) from patients with idiopathic toe walking who underwent Ulzibat percutaneous myofasciotomy. We have evaluated the frequency of persistence (recurrence) of toe walking on the next day and 12 months after surgery among all the treatment outcomes. Additionally, the range of motions in ankle joint, the presence of foot deformities, parental satisfaction with surgery results, as well as the number of postoperative complications were analyzed.

Results. Percutaneous myofasciotomy was performed in 50 children (11 females) with median age of 13 (10; 16) years during the study period. There were no cases of toe walking on the next day after surgery. Recurrence of toe walking was revealed in 3 (6%) patients within 12 months after surgery. Dorsiflexion rates reached ≥ 10 degrees in all patients at evaluating foot mobility on the next day after surgery and 12 months later. The only revealed surgical treatment complication was postoperative hematoma in 10 (20%) patients. Parents of 3 (6%) children (all with recurrent toe walking) were dissatisfied with surgery results.

Conclusion. Ulzibat percutaneous myofasciotomy has shown high efficacy and relative safety in the treatment of patients with idiopathic toe walking.

This article covers the history of children healthcare development in Presnensky district of Moscow. Social projects of Prokhorov Trekhgornaya manufactory, activities of Sofia Children’s Hospital, public charitable organizations, and city authorities together have created unique environment in the region for the successful implementation of innovations in children healthcare in the beginning of the 20 century. Pediatric medical and diagnostic technologies developed at Presnya were fully developed and created the basis for the Soviet children healthcare system. The Union of Pediatricians of Russia Forums have been held in Presnya since 1994. They continue the tradition of innovative development of children healthcare in Russian pediatrics. This article provides new data on the activities of distinguished Russian pediatricians G.N. Speransky and D.E. Gorokhov.

This sketch describes the historical period of the Artek establishment as a children’s camp in the first half of 1920s. The facts of not well-known story are presented, it was not so widely covered in publications, but the actions and decisions of subjected people made significant contribution to their job, to the success in which they believed, and to the development of self-awareness of those who lived in this period. People’s Commissariat of Public Health Nikolay Alexandrovich Semashko and first chief physician of Artek Feodor Feodorovich Shishmarev had significant impact on development of children healthcare and the strengthening of medical personnel during the most difficult years of “Red Terror” in Crimea.