Background. Reliever medication is necessary for every patient with bronchial asthma (BA) during exacerbation. Active stereoisomeric preparations are safer than racemic mixtures, conserving comparable efficacy. Pressurized metered dose inhaler (pMDI) levosalbutamol is registered for usage in Russia from age 4 years old, but pediatric population studies are insufficient. The aim of the study is to evaluate levosalbutamol pMDI 45 mcg/dose efficacy and safety in treating BA exacerbations in pediatric patients in real clinical practice. Materials and methods . 62 patients from 6 to 17 years old (mean age 9.8 ± 1.3 years) on maintenance treatment of low and medium dose inhalation glucocorticosteroids monotherapy were included during BA exacerbation. The study observation period lasted 7 ± 2 days. Levosalbutamol pMDI 45 mcg/dose was prescribed daily before maintenance inhalations and as needed, but no more than 8 doses per day. Asthma symptoms were evaluated by point-scale, spirometry with bronchodilator test was performed on inclusion visit and week after. Patients daily recorded complaitns and adverse events. Results. All included patients had finished the study as per protocol. When conducting a bronchodilator test with levosalbutamol MDI at a dose of 90–180 mcg 15 minutes after inhalation in children under 12 years of age, the average score for the severity of asthma exacerbation symptoms decreased from 4.6 ± 1.3 to 1.5 ± 0.9 points (p = 0.0032), and the forced expiratory volume in the first second increased by 15.7 ± 2.8%. Any adverse events (AE) during 7 days were registered in 5 (8.1%) patients; cough was most prevalent (6.5%). There were no cases of preterm discontinuation due to AE or serious AE. At visit 2 no patient was registered with asthma exacerbation. There were no cases of tachyphylaxis in terms of bronchodilation due to levosalbutamol. Conclusion. According to our data, levosalbutamol pMDI 45 mcg/dose administration has clinically significant bronchodilation effect and favorable safety profile in 6–17 years old children.
This article presents an analysis of current clinical guidelines for the management of patients with eosinophilic esophagitis (EoE) — a chronic immune-mediated disease of the esophagus characterized by eosinophilic infiltration of the mucosa (≥ 15 eos/hpf) and clinical manifestations of esophageal dysfunction. The review highlights key changes in diagnostic approaches and discusses contemporary treatment strategies, including dietary therapy (starting with the least restrictive diets), pharmacological treatment (proton pump inhibitors, topical steroids, biologic therapy), and endoscopic dilation for strictures. The authors emphasize the need for comprehensive monitoring (clinical, endoscopic, and histological) to assess treatment response and for long-term maintenance therapy given the chronic nature of the disease. Special attention is paid to pediatric aspects of patient management.
Background . Recently, a significant increase in the use of Ancillary Assisted Reproductive Technologies (ART) is noted. Meanwhile, the electrophysiological state of the myocardium, including the risk of cardiac rhythm disorders (CRD), in newborns after in vitro fertilization (IVF) remains poorly understood. No comprehensive assessments of the parameters of a standard electrocardiogram (ECG) is available, as well as approaches to their treatment in the early neonatal period in this category of patients. Objective . The aim of the study is to research the electrocardiographic effects of myocardial depolarization disorders in newborns conceived with IVF and to evaluate the effectiveness of Cytoflavin in treatment of the detected disorders in premature infants with cerebral ischemia (CI). Methods . The study design included 2 stages. At the first stage, a single-center, nonconcurrent, cross-sectional comparative cohort study was conducted, which included 580 newborns divided into 2 groups: the main group (children after IVF, n = 206) and the comparison group (children from spontaneous pregnancy, n = 374). The groups were stratified by fetal age (35–37 and 38-40 weeks), and the presence of CI, grade I–II. On the 3rd day of life, all children underwent a standard ECG with an analysis of rhythm parameters, conduction, and markers of depolarization disorders. At the second stage, an open comparative randomized study of the efficacy of Cytoflavin (2 ml/kg/day) was conducted in 60 premature infants with CI. The dynamics of rhythm disturbances was assessed on the 5th day after therapy. Results . Atrial rhythm (8.3% vs. 2.5%, p = 0.003) and supraventricular extrasystole (15.5% vs. 7.4%, p = 0.004) were more frequently reported in newborns conceived by IVF. Specific changes in depolarization parameters have been identified: a decrease in the amplitude and duration of the P wave, a shortening of the PQ interval, and an elongation of the QRS complex. The most pronounced violations of intraventricular conduction were observed in premature infants with СI of the main group. Multifactorial analysis confirmed that the method of conception (IVF) is an independent risk factor for depolarization disorders (OR = 1.58; 95% CI 1.05–2.38; p = 0.028) along with the presence of CI (OR = 2.41; 95% CI 1.60–3.64; p < 0.001). The administration of Cytoflavin at the basic therapy was accompanied by a statistically significant decrease in the frequency of sinus bradycardia and supraventricular extrasystole by day 5 of treatment (p < 0.05) both in the group of children after IVF and in children from spontaneous pregnancy. Conclusion . Newborns conceived using IVF form an increased risk group for the development of myocardial depolarization disorders on the 3rd day of life. The greatest risk is observed when the IVF factor is combined with prematurity and CI. The use of Cytoflavin in premature infants with CI demonstrates a positive effect in correcting the identified CRD, which justifies the possibility of its use in this category of patients.
Background . Pearson syndrome (PS) is an exceptionally rare mitochondrial disorder of childhood, characterized by marked clinical polymorphism, which often leads to diagnostic errors and delayed correct diagnosis. The presented clinical case is intended to draw clinicians’ attention to the early hematological manifestations of the syndrome and to highlight the complexity of differential diagnosis in neonates and infants. Case Report. From the first day of life, the child was found to have hyporegenerative normocytic anemia (hemoglobin 90 g/L on day 2 of life), which required red blood cell transfusions. Subsequently, the development of pancytopenia (leukocytes down to 2 × 10 9 /L, platelets down to 93 × 10 9 /L) and episodes of severe hyperlactatemia — up to 11.2 mmol/L — were noted. Morphological examination of the bone marrow revealed vacuolization of cellular elements and moderate hypocellularity without narrowing of the erythroid lineage, which led to suspicion of PS. Molecular genetic testing confirmed the presence of a large deletion of mitochondrial DNA (~5000 bp) in a homoplasmic state, thus verifying PS. Symptomatic therapy was administered, including blood component transfusions, high-dose intravenous immunoglobulin, and antibacterial treatment, which resulted in temporary stabilization of blood counts. Conclusion . The presented case report underscores the importance of including mitochondrial disorders early in the diagnostic workup of hyporegenerative normochromic normocytic anemia with elevated lactate levels in infants, demonstrates the need for a multidisciplinary approach, and highlights the necessity of timely genetic testing.
Cerebral palsy (CP) is one of the leading causes of neurological disability in childhood. Owing to modern medical advances, survival and life expectancy of patients with CP are increasing, and consequently, the number of adolescents and adults with CP is also growing. However, data on the development of neurological and associated symptoms characteristic of CP as patients age remain insufficient in the domestic literature, which limits the awareness of specialists regarding the age-related progression of the disease and reduces the quality of care provided to this patient population. This review analyzes and presents current data on the dynamics of the major neurological and associated symptoms in adolescents (10–17 years) and adults (18 years and older) with CP, as well as approaches to the identification and prevention of typical complications, for a broad range of specialists working with these patients. This first part of the review addresses general factors influencing the age-related changes in the condition of patients with CP, as well as motor functions, dysphagia, and sialorrhea in aging patients with CP.
Background . Congenital disorder of glycosylation type Ia (Jaeken syndrome; congenital disorder of glycosylation, type Ia; CDG-Ia) is a hereditary progressive disorder with a pronounced neurodegenerative component, caused by pathogenic variants in the PMM2 gene (encoding the enzyme phosphomannomutase-2). CDG-Ia accounts for the majority of registered patients with congenital disorders of glycosylation (62% in 2018). At least 1,000 patients with CDG caused by PMM2 gene mutations are known, but due to diagnostic difficulties, the true number of individuals with this condition is undoubtedly much higher. Case Report . We present a case report of CDG-Ia in a child with progressive ataxia, nystagmus, and delayed psycho-speech and motor development. The patient was a female infant, born from the third pregnancy, which was complicated by acute enteritis at 15 weeks of gestation and an acute respiratory viral infection at 20 weeks of gestation. Delivery was at term (42 weeks) and was the second childbirth. The child was born into a family with no history of hereditary disorders; the parents were 37 and 38 years old at the time of the girl’s birth. The disease manifested from birth with reduced sucking reflex, breast refusal, and slow weight gain. At 1.5 months of age, horizontal nystagmus was added to these symptoms. The diagnosis was established based on molecular genetic testing of the proband using next-generation sequencing to rule out hereditary ataxias, as well as transferrin isoelectric focusing (revealing an abnormal transferrin spectrum: abnormal diand asialotransferrins — isoforms S2 and S0), and magnetic resonance imaging of the brain (showing progressive cerebellar atrophy at 11 months of age). Conclusion. We describe a case report of CDG-Ia in a child from a family in which both parents are carriers of mutant alleles and have a healthy child. Despite comprehensive patient management, progressive disease course was observed; the girl has severe psychomotor retardation and clinical signs of multisystem involvement of internal organs. Arresting disease progression is not feasible due to the underlying genetic defect in the synthesis of mannose and glycoproteins, which are essential components of most metabolic pathways in the body.
The keen researcher’s interest nowadays is focused on the study of potential celiac disease. It is characterized by increased levels of specific autoantibodies to tissue transglutaminase and endomysium and by HLA-DQ2/DQ8 alleles in the genotype with no or minimal changes in small intestine mucous membrane. Patients with potential celiac disease may have various intestinal and extraintestinal symptoms, however the disease can be asymptomatic. Disease pathogenetic mechanisms are not fully understood, and villous atrophy (typical for celiac disease) risks remain unknown. There is no management strategy for such patients. Gluten-free diet efficacy in patients with potential celiac disease, who do not have any clinical symptoms, is also not conclusively established.
The article presents the position of experts from the Joint Committee on Infant Hearing on the role of immunoprophylaxis in patients with cochlear implants. It emphasizes that viral and bacterial infections are a significant cause of sensorineural hearing loss, underscoring the importance of routine vaccination as a primary prevention method. In cochlear implants patients, surgery and the presence of the implant create additional risks of infectious complications, including acute otitis media and meningitis. Particular attention is paid to the necessity of vaccination against pneumococcal, Haemophilus influenzae type b infections, as well as influenza. The authors recommend assessing vaccination status before and after surgery, administering immunizations according to the National Immunization Schedule, and implementing an individual schedule for high-risk groups. Specific vaccination regimens are provided, including the combined use of pneumococcal conjugate and polysaccharide vaccines. It is concluded that strategically sound immunoprophylaxis is a key factor in minimizing risks and enhancing the effectiveness of auditory-speech rehabilitation.
13 февраля 2026 г. на XXVII Конгрессе педиатров России с международным участием прошел симпозиум «Новая глава в изучении сахарного диабета 1 типа: курс на раннюю диагностику». В центре внимания докладчиков и слушателей данного симпозиума находились вопросы, посвященные раннему выявлению и мониторингу сахарного диабета 1 типа (СД1), наблюдению за пациентами на доклинических стадиях, а также нейрокогнитивному развитию детей с СД1.
С 13 по 15 февраля 2026 г. в Москве с большим успехом прошел XXVII Конгресс педиатров России с международным участием «Актуальные проблемы педиатрии» в соответствии с Планом научно-практических мероприятий Министерства здравоохранения Российской Федерации на 2026 год и Информационным письмом Министерства здравоохранения Российской Федерации № 15-2/И/2-490 от 19.01.2026.
13–15 февраля 2026 г. в Москве состоялся XXVII Конгресс педиатров России с международным участием «Актуальные проблемы педиатрии», ставший площадкой для обмена передовым опытом и научными достижениями. Традиционно в рамках Конгресса прошла Всероссийская вакцинальная Ассамблея «Защищая поколения» — уже в пятый раз она собрала ведущих российских и зарубежных специалистов в области иммунопрофилактики. Центральными событиями Ассамблеи стали симпозиумы, посвященные новым подходам к профилактике управляемых инфекций.
Hypereosinophilic syndrome (HES) is a heterogeneous group of disorders characterized by tissue eosinophilic infiltration and a wide spectrum of clinical manifestations. The issue of pathogenetic therapy for this condition remains unresolved, as some patients are refractory to conventional treatment. Case report. This article discusses the main challenges of differential diagnosis and current approaches to the treatment of HES in pediatric practice, and presents a rare clinical case of primary HES in a 14yearold girl. After a thorough diagnostic workup and confirmation of the diagnosis, the patient received systemic glucocorticoid therapy, which produced a temporary effect. However, due to the development of a severe exacerbation upon attempted withdrawal of hormonal therapy, treatment with mepolizumab — a humanized monoclonal antibody against the interleukin5 receptor — was initiated. Conclusion. The management of patients with HES often presents significant difficulties due to the polymorphism of clinical manifestations, the need to rule out a wide range of diseases, and possible refractoriness to standard therapy. The usage of this genetically engineered biological agent demonstrated high efficacy, enabling the patient to overcome glucocorticoid dependence and prevent the development of glucocorticoid-related adverse effects.
This review presents the main approaches to the treatment of children suffering from Crohn’s disease (CD). Special attention is paid to conservative methods, which primarily maintain remission in patients with uncomplicated forms of the disease. The cornerstone of CD treatment includes lifestyle modifications, dietary therapy, and the elimination of factors that trigger exacerbations. Pharmacological therapy has demonstrated the greatest efficacy, comprising both time-tested drugs and modern high-tech genetically engineered biological agents. Thuswise, the combination of these technologies, which reduces the frequency of relapses and improves patients’ quality of life, is widely used in the management of moderate and uncomplicated forms of CD. However, in complicated and severe cases where conservative therapy fails to produce positive results, surgical treatment methods should be considered. Currently, the laparoscopic approach is the most appropriate, characterized by lower invasiveness and a shorter recovery period. It should also be noted that disease recurrence occurs much less frequently compared to open surgical techniques. The choice of the correct therapeutic strategy remains a decisive factor in the management of pediatric patients with CD, as inappropriate tactics can lead to relapses and complications that could otherwise be avoided.
Симпозиум «Дело о тяжелой бронхиальной астме: раскрывая секреты терапии», который прошел в рамках XXVII Конгресса педиатров с международным участием «Актуальные проблемы педиатрии» 14 февраля 2026 г., был посвящен современным стратегиям ведения пациентов с Т2-ассоциированными заболеваниями.
