Pediatrics. Consilium Medicum

The journal publishes the works of scientists and practicing pediatricians, including experts in the field of neonatology, gastroenterology, otolaryngology, pulmonology, cardiology, endocrinology, allergy, dermatology, rheumatology, dentistry, clinical pharmacology, neurology, nutrition, emergency care in Russia and CIS countries. During its existence the magazine has gained wide recognition among professionals. 


Main sections: Healthy child, neonatology, endocrinology, otolaryngology and pulmonology, allergology, gastroenterology, cardiology, interdisciplinary problem, childhood infections, methods of diagnosis and treatment, the results of the original clinical trials, scientific reviews, scientific events reports. 


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Current Issue

No 1 (2023)


Cancer alertness as a basis for timely diagnosis and effectiveness of therapy: A review
Volkova A.S., Belysheva T.S., Mikhaylova S.N., Ryabukhina Y.E., Zeynalova P.A.

Early diagnosis of malignant neoplasms in children is an important and relevant task. Despite the growth of “actively” diagnosed malignant neoplasms, the proportion of cases of the disease at stage III or IV remains high. In the structure of pediatric mortality, malignant neoplasms occupy a significant fraction, which marks the need for a thorough diagnostic search and, in turn, early detection of cancer. For patients who have completed treatment for a malignant neoplasm, active observation regarding the occurrence of a relapse or the appearance of second tumors remains relevant. Detection of malignant neoplasms in the early stages is possible with an appropriate level of cancer alertness, a multidisciplinary approach to the diagnosis and treatment of this rare group of diseases.

Pediatrics. Consilium Medicum. 2023;(1):8-11
pages 8-11 views
Maternal-fetal attachment as a natural phenomenon of pregnancy and maternity development: A review
Kelmanson I.A.

Pregnancy is the most important stage in the formation of motherhood, maternal programming. An integral component of this process is maternal-fetal attachment, which can be defined as the bonds between a woman and a fetus that depend on the cognitive and emotional abilities to perceive another human being and include thoughts, behavior, emotions and relationships. The formation of maternal-fetal attachment is presumably due to the high plasticity of the brain of a pregnant woman, which results in significant structural and functional changes in its individual structures. The study of maternal-fetal attachment is possible using standardized questionnaires, one of which is the Maternal Antenatal Attachment Scale. The paper provides the Russian version of this questionnaire and its reference values. Maternal-fetal attachment depends on the personality characteristics of the woman and, to a lesser extent, on socio-demographic factors, and its characteristics have a prognostic value for the psychological and somatic health of the mother and child. Assessment of maternal-fetal attachment and its optimization should be considered as an integral component of medical and psychological support for pregnant women.

Pediatrics. Consilium Medicum. 2023;(1):12-18
pages 12-18 views
Nutrition characteristic of pregnant and breastfeeding women during the pandemic of a new coronavirus infection COVID-19
Legonkova T.I., Shpakovskaya K.S., Shtykova O.N., Shilina N.M., Gmoshinskaya M.V.

Aim. To study the nutritional characteristics of pregnant and lactating women in the context of the development of the pandemic of the new coronavirus infection COVID-19.

Materials and methods. The study has been conducted on 203 women. The first observation group included 100 women whose pregnancy and lactation took place before the development of the pandemic, the second group included 103 women whose pregnancy and lactation took place during the pandemic of a new coronavirus infection. The research of nutrition has been carried out using a comparative analysis based on a frequency questionnaire-survey method.

Results. Specific nutritional abnormalities of pregnant and lactating women in the conditions of the pandemic of the new coronavirus infection, different from the nutrition of this contingent before the pandemic, have been identified. This is reflected in the increased consumption of confectionery, low-alcohol beverages, poultry meat, eggs and reduced consumption of dairy products, “red meat” and seafood in combination with an increased level of anxiety, psycho-somatic abnormalities and a reduced level of physical activity. A nutrition optimization scheme for pregnant and breastfeeding women has been developed.

Сonclusion. The nutrition of a woman during pregnancy and period of lactation has a direct impact on the normal course of pregnancy, the formation of full lactation, the health of the mother and child. It is important to compose a balanced diet, review and correct it taking into account the individual needs of women, physiological characteristics, level of physical activity, pregnancy and lactation.

Pediatrics. Consilium Medicum. 2023;(1):19-24
pages 19-24 views
Formation of the infant's intestinal microbiota depending on the delivery method: long-term consequences and correction options: A review
Dedikova O.V., Zakharova I.N., Kuchina A.E., Berezhnaya I.V., Sugian N.G.

Many studies have been devoted to human microbiome. It has been shown that the microbiome has a significant effect on almost all the vital functions of the host organism. The article addresses the role of various factors in newborns' intestinal microbiota formation. The main emphasis was on the delivery method since the intestinal microbiota of children born via vaginal delivery differs from those born by cesarean section. The microbiota of the mother's intestine and vagina greatly influences the formation of the intestinal microbiome. The delivery method affects not only the formation of the intestinal microbiota but also, indirectly, the development of the newborn's immune system. Changes in the intestinal microbiota associated with surgical delivery probably affect the formation of a newborn infant's immune system. Lack of colonization by the mother's flora during delivery may contribute to a greater risk of infectious and non-communicable diseases. Correcting the microbiota of children born by cesarean section using probiotics (mono- or multistrain probiotics) is essential. When prescribing a probiotic, it is important to choose a well-studied strain shown to be safe, with a positive experience in newborns, and approved for use in children from birth.

Pediatrics. Consilium Medicum. 2023;(1):25-29
pages 25-29 views
Topical issues of the use of meat in baby food: A review
Pyrieva E.A., Safronova A.I., Timoshina M.I.

Meat is one of the main food products, as it is an valuable source of proteins containing all the essential amino acids, some mineral products, primarily iron and zinc. Meat products are an obligatory component of the diet throughout the entire childhood. The results of the assessment on the role of meat in ensuring the health of children, as well as the impact of inadequate intake on cognitive and motor functions, bone condition, etc. are presented. The article presents data on the evaluation of the role of meat in the concept of food programming. Specialized baby food products have undeniable advantages in the nutrition of young children. Standards are established for this category of products, which include regulated requirements for raw meat, ingredients, product quality, labeling, packaging, transportation and storage. These requirements guarantee high quality products with great nutritional and biological value.

Pediatrics. Consilium Medicum. 2023;(1):30-33
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Growth retardation in children with allergies: A review
Zakharova I.N., Berezhnaya I.V., Simakova M.A.

The increase in the prevalence of food allergies among children in recent years is evident with onset in infancy and childhood in most cases. The full value of the elimination diet, the time before diagnosis, and the severity of allergic inflammation can affect the nutritional status of the children and, ultimately, their linear growth. Age-correspondent height is one of the most important indicators of a child's health and well-being, especially in the first few years of life when energy and nutrient requirements per body weight are highest. Insufficient nutrient intake in children with food allergies can impair growth, and developmental delay in infancy and early childhood can have long-term sequelae. It is essential to understand the frequency of developmental retardation in kids with food allergies, the most prevalent allergen that causes it, and whether or not growth retardation may be reversed with effective diet therapy. Based on the studies presented in the article, the following key provisions were identified: of the entire spectrum of food allergens, cow milk protein allergy (CMPA) has the most significant effect on growth; the impact of CMPA on the formation of improper eating habits is also high; careful management of a child with CMPA with adequate diet therapy and timely re-introduced dairy products to induce tolerance can reduce the adverse effect of CMPA on growth and nutrition; apparently, multiple food allergies also harm growth; a nutritionist should more often observe children with multiple food allergies; regular assessment of growth and diet with individual nutrition recommendations to date has shown the best results in achieving the growth target of children with food allergies.

Pediatrics. Consilium Medicum. 2023;(1):34-41
pages 34-41 views
Results of a regional immunoprophylaxis program for children at risk of a severe course of respiratory syncytial virus infection with palivizumab in the Republic of Bashkortostan
Amirova V.R., Greshilov A.A., Sholokhova A.V.

Background. Palivizumab has been successfully used in many countries worldwide to prevent respiratory syncytial infection in children at risk of severe infection. Despite the drug use experience in some regions of the Russian Federation, evidence on the outcomes of specific immunoprophylaxis in children from risk groups is scarce.

Aim. To assess the results of the regional immunoprophylaxis program for children at high risk of severe respiratory syncytial virus infection (RSVI) with palivizumab in the Republic of Bashkortostan.

Materials and methods. A single-center retrospective cohort study was conducted at the Catamnesis Cabinet of the Republican Clinical Perinatal Center, Ufa. A total of 516 preterm infants born before the full 35 weeks of gestation and who reached the age of 1 year of life between April 2020 and April 2022 were included in the study. Group 1 (palivizumab+) included 250 infants who received at least one immunization against RSVI at a dose of 15 mg/kg; Group 2 (palivizumab-) included 266 infants without immunization. In both groups, the percentage of children admitted to the clinic for acute respiratory infections and hospitalized for lower respiratory infections was determined.

Results. It was found that children born at a gestational age of 32 weeks had immunoprophylaxis more often than children born at a gestational age of 32–35 weeks (58.1% vs 37.2%; p<0.001); also, they more often received 3–5 injections of palivizumab (32.9% vs 17.9%; p=0.018). The proportion of children who were admitted to the clinic for ARI was lower among those immunized than among those not immunized: 63.6% vs 82.0% (p<0.001; relative risk – RR 0.77, 95% confidence interval – CI 0.69–0.86). Of children who received 1–2 injections of palivizumab, 70.2% sought medical care for acute respiratory infections versus 53.3% of children who received 3–5 injections (p<0.001; RR 1.51, 95% CI 1.15–1.98). Among the immunized infants, the percentage of children admitted to the hospital for bronchitis was significantly lower: 24.0% vs 31.6% (p=0.045; RR 0.74, 95% CI 0.55–0.99). The most significant effect of palivizumab was demonstrated in children born at the gestational age of 32 weeks or less, who received 3–5 injections of the drug.

Conclusion. The study demonstrated the effectiveness of the regional RSVI immunoprophylaxis program with palivizumab in children in the first year of life at risk for severe infection in the Republic of Bashkortostan.

Pediatrics. Consilium Medicum. 2023;(1):42-47
pages 42-47 views
Key issues in selecting an antibacterial drug for the treatment of acute respiratory infections in children: A review
Zaytseva S.V., Lokshina E.E., Zaytseva O.V.

Аcute respiratory diseases in children remain an urgent problem in pediatric practice. Most respiratory infections are due to viruses, but some may be due to bacterial pathogens or associations. During the pandemic of a coronavirus infection the number of unjustified prescriptions of antibiotics increased, which significantly complicated the situation with drug resistance of microorganisms and changed the strategy for choosing a starting antibacterial drug in children. Under the current circumstances, timely diagnosis of bacterial inflammation and the adequate choice of drug are the key issues in the practice of a pediatrician. On an outpatient basis it is important for a pediatrician to determine the indications timely and empirically prescribe an effective antibacterial drug. In Russia, in recent years, Federal Clinical Guidelines for various nosologies have been approved, defining indications for systemic antibiotic therapy. According to clinical guidelines, amoxicillin is the first-line antibiotic for most bacterial acute respiratory infections. In addition, there are cohorts of children who are expected to have risk factor as drug-resistant organisms and these children are eligible for protected amoxicillin as a first-line medication. The indications for prescribing macrolides and third-generation oral cephalosporins have fundamentally changed. The article presents the defining indications for systemic antibiotic therapy and the features of the choice of the starting antibacterial drug in children with acute respiratory infections.

Pediatrics. Consilium Medicum. 2023;(1):48-54
pages 48-54 views
Risk factors for allergic rhinitis in children residing in five different regions of the Central Federal District: Observational study
Berezhanskiy P.V., Malakhov A.B., Tataurshchikova N.S., Gutyrchik T.A., Iushina T.I.

Aim. To detect known risk factors for allergic rhinitis and determine the associated risks in five regions of the Central Federal District of the Russian Federation for 2017–2021 in different age groups.

Materials and methods. The study was conducted at the Odintsovo Regional Hospital (Odintsovo), the Regional Children's Clinical Hospital (Yaroslavl), the City Children's Clinical Hospital (Tver), the Regional Children's Clinical Hospital (Vladimir), and the Vologda Children's City Polyclinic (Vologda). The homogeneity of the studied populations for the time criterion was assessed; the risk factors for allergic rhinitis (AR) recorded by the pediatrician in patients with an established diagnosis with ICD-10 codes J30.1, J30.2, J30.3, and J30.4 were analyzed. The total children population was 361,281 in the fourth quarter of 2021, and the number of children diagnosed with AR was 6,757. The study included children aged from 0 to 17 years. When assessing the evidence base, the data analysis and synthesis for each study site in each time range was performed in 100% of patients with AR.

Results. The analysis results showed that in 2017–2021, in all studied regions, there was a steady increase in the total children's population and an increase in AR patients from birth to 17 years, and in some regions, such as Odintsovo and Tver, the prevalence of AR is growing exponentially. All risk factors were divided into three groups according to the feasibility of controlling their effect: uncontrollable (6 factors), partially controlled (10 factors) and controlled (12 factors). Most controlled risk factors were socio-biological and medical, and partially controlled ones were medical and socio-economic.

Conclusion. The breakdown of risk factors into groups according to control feasibility will enable the reformatting of therapeutic and preventive measures aimed at reducing the prevalence of AR, which is a predictor of bronchial asthma occurrence.

Pediatrics. Consilium Medicum. 2023;(1):55-61
pages 55-61 views
Incidence of the new coronavirus infection in children based on outpatient data in Voronezh
Cherkasova O.A., Moshurova L.V.

Background. The article analyzes the COVID-19 incidence in children managed in the pediatric outpatient department of the Voronezh City Outpatient Clinic №1, summarizes and systematizes the data on the spread of SARS-CoV-2 in children.

Aim. To study the COVID-19 incidence in the children of the pediatric outpatient department №2 of the Voronezh City Outpatient Clinic №1 by age group and gender for 2020–2022.

Materials and methods. A retrospective epidemiological analysis was carried out at of the pediatric outpatient department №2 of the Voronezh City Outpatient Clinic №1. The incidence of COVID-19 in children in 2020–2022 was studied on the basis of information from the register of infectious diseases (form 060/y). The study included all laboratory-confirmed cases of COVID-19 infection in children registered in the Voronezh City Outpatient Clinic №1 for 2020–2022. Patients were divided into groups by age and gender to study the features of the course of the new coronavirus infection.

Results. There were no gender differences in the structure of COVID-19 incidence in 2020–2022, according to the data of the pediatric outpatient department №2 of the Voronezh City Outpatient Clinic №1. COVID-19 was reported in all age groups; the lowest rate was in newborns (0.3%), the highest in children 10–14 years old (25.7%).

Conclusion. Six completed epidemic waves were observed in the study period, corresponding to all-Russian statistical data. There were no deaths reported in healthcare organizations for the study period.

Pediatrics. Consilium Medicum. 2023;(1):62-66
pages 62-66 views
Microbiota and diarrhea. From theory to practice

Интервью с д-ром мед. наук, проф., гл. науч. сотр. отд. гастроэнтерологии Научно-исследовательского клинического института педиатрии им. акад. Ю.Е. Вельтищева ФГАОУ ВО «РНИМУ им. Н.И. Пирогова», рук. Московского областного центра детской гастроэнтерологии, гепатологии ГБУЗ МО «НИКИ детства», проф. каф. педиатрии с курсом детских хирургических болезней Медицинского института ФГАО ВО НИУ БелГУ Анатолием Ильичом Хавкиным.

Pediatrics. Consilium Medicum. 2023;(1):67-72
pages 67-72 views
Mysterious Akkermansia muciniphila. What do we know about it? A review
Zakharova I.N., Berezhnaya I.V., Dubovets N.F., Skorobogatova E.V., Dubovets E.A., Dubovets A.A.

"Microbes and humans" is a topic that has been continuously studied over the past decade. Numerous recent studies show that quantitative and qualitative changes in the composition of the gastrointestinal tract microbiota have direct and indirect effects on metabolic changes in the host. Many countries are researching the microbiome and opportunities to influence health through environmental modification and introducing a probiotic, a metabiotic, or a synbiotic into the body. Considerable attention is paid to metabolic disorders and obesity, as these are issues that are becoming a progressive global epidemic. More than 2 billion people are overweight and obese, and many experts continue to look for promising methods to combat it. A special group of high risk for obesity is children. Statistics show a steady upward trend of obesity in children. Over the past 10 years, this trend has shown a rapid pace: from 6.7%, according to 2010, to 9.1% by 2020. In this context, Akkermansia muciniphila attracts special attention among all bacteria inhabiting the gastrointestinal tract due to its potential to treat insulin resistance, obesity, and diabetes mellitus. This article reviews new research on the A. muciniphila effects on the host and ways to correct metabolism using probiotics.

Pediatrics. Consilium Medicum. 2023;(1):74-80
pages 74-80 views
Progressive familial intrahepatic cholestasis type 2 on the example of one family. Liver transplantation as an effective treatment method. Case report
Loskutova S.A., Belousova T.V., Nikulina A.B., Blagitko N.E., Plyushkin V.A.

The article presents the structure of diseases that led to the need for liver sector transplantation in children living in the Novosibirsk region. The paper provides a detailed description of progressive familial intrahepatic cholestasis, principles of modern diagnosis and treatment. A description of the medical history of family members and, in particular, a clinical case in a young child with type 2 PFIC (Byler's syndrome) is given.

Pediatrics. Consilium Medicum. 2023;(1):81-85
pages 81-85 views
Assessment of the nutritional status of children admitted to thoracic surgical department
Fomina М.V., Borovik T.E., Yatsyk S.P., Alkhasov A.B., Zvonkova N.G., Gusev А.A., Sokolov I., Bushueva T.V., Lebedeva L.V.

Background. Numerous studies aimed at assessing the nutritional status and organizing nutritional support for surgical patients cover the adult patients, only a handful assess underaged patients with surgical pathology in the pre- and postoperative period and their needs for assessment of the nutritional status and approaches to their dietary correction.

Aim. To assess the possible risks of developing malnutrition in children with various pathologies of the chest organs during the preoperative period, and to conduct a comprehensive assessment of their nutritional status.

Materials and methods. The single-center non-comparative cross-sectional study included 50 children between 5 months and 17 years 7 months, hospitalized in the thoracic department of the National Medical Research Center for Children's Health of the Ministry of Health of the Russian Federation. All patients underwent an assessment of clinical and anamnestic data, somatometric and clinical laboratory parameters, and Z-scores analyzed: body weight/age, height/age, BMI/age, shoulder circumference, skin-fat folds above the triceps and under the scapula, as well as a number of biochemical parameters (concentrations of total protein, albumin, prealbumin, transferrin and C-reactive protein).

Results. When assessing the nutritional status of children upon admission to the thoracic department, acute malnutrition was detected in 21 (42%) patients (of which 10% had mild, 14% moderate, and 18% severe malnutrition), chronic malnutrition was found in 18% of children. For the first time in Russia, using a validated Russian-language version of the STRONGkids screening questionnaire, nutritional risks of malnutrition have been assessed. The vast majority of patients were at moderate (28%) or high (70%) risk of developing malnutrition or its aggravation. Z-scores of skin-fat folds above the triceps and under the scapula, as well as the circumference of the shoulder were within the reference values. 16 (36%) patients had a decrease in the concentration of total protein, 10 (22%) had a drop of prealbumin accompanied by an increase (40%) of the C-reactive protein level. The levels of other proteins were within the reference values.

Conclusion. The identified risks of malnutrition and its moderate/severe manifestations in children with surgical pathology are able to contribute to the development of infectious and non-infectious postoperative complications, increase the length of stay in the clinic, and require nutritional support from the first day of hospitalization in a surgical hospital.

Pediatrics. Consilium Medicum. 2023;(1):86-94
pages 86-94 views
The results of the use of the telescopic intramedullary system in the surgical treatment of patients with osteogenesis imperfecta types I and III
Solodovnikova K.N., Zherdev K.V., Pimburskiy I.P., Сhelpachenko O.B., Soloshenko M.A., Yatsyk S.P., Butenko A.S., Timofeev I.V.

Background. The main orthopedic manifestation of osteogenesis imperfecta is multiple fractures. In severe disease, frequent fractures lead to malunion and deformity, which increases the risk of refracture. Surgical treatment of children with osteogenesis imperfecta is aimed at reducing the risk of complications and improving the quality of life of the child. The Fassier-Duval telescopic intramedullary system has taken the leading place among the “growing” metal fixators. In this study, we conduct a comparative analysis of the results of a longitudinal study between patients with osteogenesis imperfecta types I and III, as well as an assessment of motor activity.

Aim. To evaluate the efficiency of using the telescopic intramedullary system depending on the type of osteogenesis imperfecta.

Materials and methods. A prospective analysis of surgical treatment of 20 children with types I and III was carried out. Group I included 8 patients with type I NO, group II included 12 with type III. The average age of patients was 8.2 years. Surgical treatment was carried out on the basis of the neuroorthopedic department with orthopedics of the National Medical Research Center for Children's Health. A total of 48 intramedullary telescopic pins were installed. The average period of postoperative dynamic follow-up was 42 months. The analysis of the results of surgical treatment was carried out according to the following criteria: the frequency of migrations of metal structures, the formation of bone deformities, the number of revisions, as well as the number of bone fractures with an installed metal fixator. Evaluation of the results of motor activity was carried out using two scales: Gillette Functional Assesment Questionnaire (Gillette FAQ) and Hoffer–Bullock.

Results. There were no statistical differences in the number of complications in the two groups. Fractures among patients with type I occurred more often than in patients with type III by 19.3%. The frequency of migrations in the I study group was 7.1% (1 segment), in the II group 35.3% (12 segments). The formation of deformation was the main factor in the revision intervention, which in our case amounted to 83.3%. In the group of patients with type I, the number of repeated operations was 7.1% (1 segment in 1 patient), in the group of patients with type III – 17.6% (6 segments in 4 patients). All patients in the postoperative period had II or I level of motor capabilities on the Hoffer–Bullock scale. According to the Gillette FAQ scale in the postoperative period, the subjects showed a result above 4 points.

Conclusion. The Fassier-Duval telescopic rod is a modern and reliable metal fixator. Despite the absence of statistical differences in the two study groups (p-value2<0.005), there was an increase in the tendency to complications in severe course with NO. Correction of varus deformation when restoring normal values of DN>125° and HEA within 25–38° is the prevention of the re-formation of the truth of Coxa Vara. The motor activity of children with severe course did not statistically differ from children with mild course (p-value2>0.005) in the postoperative period with an average follow-up period of 42 months, regardless of the initial low motor capabilities in children with type III.

Pediatrics. Consilium Medicum. 2023;(1):95-100
pages 95-100 views

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