Neuroendocrine cell hyperplasia of infancy (NEHI) is an interstitial lung disease of unknown etiology that develops in the first year of life and manifests itself as persistent tachypnea syndrome. The aim of the study was to determine the diagnostic value of the clinical scale for the diagnosis of NEHI in comparison with computed tomography (CT) data of the chest organs and for differential diagnosis with acute bronchiolitis (AB)/community-acquired pneumonia (CAP). Materials and methods of research: a multicenter case-control study of children aged 21 days of life to 12 months was carried out: – 83 children with NEHI and 83 infants with AB or CAP. To determine the sensitivity and specificity of this scale for differential diagnosis with AB/CAP, the results of the assessment according to the proposed scale were compared in patients with NEHI (study group) and patients with AB/CAP (control group) on the day of treatment and after 3 weeks. Results: the sensitivity of the clinical scale for the diagnosis of NEHI when compared with the CT data of the chest organs was 85.5%. In the differential diagnosis of NEHI with AB/CAP on the day of treatment, the sensitivity of the clinical scale for the diagnosis of NEHI was 85.5%, the specificity was 80.7%; when re-evaluated after 3 weeks, the accuracy of the scale increased from 83.1% to 91.6%, the specificity – from 80.7% to 97.6%. Diagnosis on a scale after 3 weeks reduced the possibility of overdiagnosis of NEHI from 19.3% to 2.4%. Conclusions: the clinical scale for the diagnosis of NEHI has a high diagnostic value in comparison with the results of CT scan of the chest organs and for differential diagnosis with AB/CAP, especially when re-evaluating.

Introduction: The relationship between objective indicators of nasal obstruction and airflow limitation in children with bronchial asthma (BA) and allergic rhinitis (AR) has not yet been studied. Objective: To study the relationship between objective parameters of nasal obstruction and airflow limitation, determined using the methods of anterior active rhinomanometry (AARM) and spirometry in children with BA and AR. Materials and Methods: Eighty eight children and adolescents with BA and AR, boys−65.9% (58/88), were examined. The median age was 11.09 [10.42; 11.76] years. To determine airflow limitation, the following spirometric parameters were evaluated: forced vital capacity of the lungs (FVC), forced expiratory volume in 1 s (FEV 1 ), the ratio of FEV 1 /FVC, and maximum expiratory flow at the point 25% of the flow-volume loop (MEF 25 ). Data were recorded both in absolute values and in relative units (% pred). Nasal respiratory function was determined by AARM based on the total nasal airflow (TNAF) in absolute (Pa/cm 3 /s) and relative units (RTNAF, % pred). Results: In the general cohort and in boys but not in girls, a statistically significant direct correlation was found between TNAF (Pa/cm 3 /s) and absolute spirometry parameters of bronchial patency—all had p < 0.01. Also, RTNAF and relative MEF 25 values (% pred) in the general cohort were R = 0.22, p = 0.04, and in boys, R = 0.28, p = 0.03. In girls, there was no statistically significant correlation between nasal respiratory function and spirometric parameters, all p > 0.05. Additional analysis of literature was conducted to ascertain that the identified gender differences were not occasional. Conclusion: The significant positive correlation of absolute values of AARM and spirometric parameters in children with BA and AR was established, which apparently reflects the physical development of children. Of all the relative indicators of spirometry, only MEF 25 (% pred), which indirectly reflects the patency of small bronchi, had a distinct direct correlation with RTNAF. These patterns are clearly expressed in boys with BA. In girls with this disease, however, the relationship between nasal respiratory function and spirometric indicators seems to be more complex and requires further study.

Background: Uncontrolled asthma (BA) can be complicated by cardiac conduction disturbances and arrhythmias. It is typical mainly for adult asthmatics patients. In asthmatics children the effect of bronchoconstriction on cardiac conduction, including the supraventricular component of the ECG, is currently under discussion. The objective of the research is to analyze ECG parameters of the atrial complex and atrioventricular conduction and to assess their relationship with spirometric indicators in children with BA. Methods: Hundred three patients with BA from the age of 6-17 years were examined. The spirometric parameters were evaluated, including the Tiffeneau index (TI): FEV1/FVC (%), according to the level of which the patient groups were distinguished. Group 1 (G1): with TI more than 85%, (n = 15); Group 2 (G2): with TI from 85 to 75%, (n = 40); Group 3 (G3): with TI <75%, (n = 48). The ECG parameters that characterize supraventricular conduction, including the PQ interval (sec) and the sPQ segment (sec), were analyzed. We had calculated relative PQ (rPQ) by the formula rPQ=PQ/PQmed, where PQ is the patient's PQ, PQmed are the median PQ values of healthy children of age selected. Results: The duration of the PQ in groups G1 and G2 was 0.13 (0.11; 0.14) s; and 0.13 (0.12; 0.14) s, respectively, which is statistically significantly less than in patients of groups G3-0.14 (0.13; 0.15] s, p = 0.01. The duration of the sPQ segment in children of groups G1 and G2 was also generally shorter than in patients of groups G3, and amounted, respectively, to 0.05 (0.04; 0.06) s, 0.04 (0.04; 0.05) s, and 0.06 (0.04; 0.07) s, p = 0.02. The rPQ increased progressively as TI decreased and amounted in G1 to 92.9 (85.7; 106.3) %, in G2 100.0 (92.9; 103.0) %, and in G3 104 (100.0; 107.7) %, p = 0.009. A statistically significant negative correlation between IT and PQ-r = -0.23, p = 0.02; with sPQ-r = -0.20, p = 0.045; and with rPQ-r = -0.25, p = 0.01 was revealed. Conclusion: A decrease in TI in asthmatics children is associated with a prolongation of the PQ. This may indicate a slowdown in supraventricular conduction in patients with uncontrolled asthma and, thus, be considered as a risk for the formation of subsequent supraventricular arrhythmias.

Рентгенодиагностика бронхолегочной дисплазии: обзорная рентгенография грудной клетки АНАЛИТИЧЕСКИЕ ОБЗОРЫБронхолегочная дисплазия (БЛД) впервые была описана в 1967 г. на основании корреляции морфологических и рентгенографических изменений у недоношенных детей, находившихся на искусственной вентиляции легких.С тех пор был предложен ряд рентгенологических шкал диагностики БЛД с различной информативностью и диагностической ценностью.В обзоре на основании данных литературы и результатов собственных исследований и клинических наблюдений приводятся рентгеноморфологические сопоставления при БЛД, рентгенологические шкалы диагностики заболевания, информация о дифференциальной диагностике, рентгенологических изменениях по мере увеличения возраста ребенка.Финансирование.Исследование выполнено в рамках инициативной научно-исследовательской работы Медицинского института РУДН по теме № 031216-0-000 «Изучение клинико-патогенетических аспектов приобретенных и врожденных заболеваний дыхательной системы у детей».Конфликт интересов.Авторы заявляют об отсутствии конфликта интересов.Вклад авторов.Разработка концепции и дизайна, написание статьи, сбор, анализ и интерпретация данных, окончательное

Neuroendocrine hyperplasia of infancy (NEHI) is an interstitial lung disease (ILD) of unknown etiology, which develops in infancy and manifests as persistent tachypnea Objective of the research: to summarize results of observations of patients with NEHI, including during the pandemic of a new coronavirus infectious disease (COVID-19) Materials and methods: clinical and follow-up observation, laboratory and instrumental examination, including lung biopsy, 52 children with NEHI aged from 21 days to 10 years Results: NEHI more often affects boys in the first 6 months of life;can be diagnosed on the basis of pediatric ILD-syndrome detection;specific CT signs, lung biopsy It is characterized by undulating course with increased respiratory failurec aused by acute respiratory viral infections, COVID-19;half of the patients need oxygen therapy

Хроническая гипоксемия у детей утяжеляет течение хронических заболеваний легких и сердца, ряда других органов и систем у детей, приводит к развитию легочной гипертензии и легочного сердца, нарушает рост и развитие, повышает риск летального исхода. Коррекция гипоксемии с помощью длительной кислородотерапии, в т.ч. в домашних условиях, представляется наиболее патогенетически обоснованным методом терапии при данных расстройствах. В обзоре на основании современных литературных данных и собственного опыта приводятся сведения о показаниях и эпидемиологии домашней кислородотерапии, механизмах ее действия при различных клинических ситуациях, влиянии на рост и развитие ребенка. Обсуждаются нормативные значения и необходимый мониторинг оксигенации, тактика ведения детей, требующих проведения домашней кислородотерапии, и методика отлучения от кислорода. Детально описаны важные технические характеристики обеспечения длительной кислородотерапии на дому. Ключевые слова: домашняя кислородотерпия, хронические заболевания легких, легочная гипертензия, концентратор кислорода, дети. Цит.: М.А. Беляшова, Д.Ю. Овсянников, А.С. Зайцева, М. Даниэл-Абу, Т.И. Елисеева. Длительная домашняя кислородотерапия у детей: кому, когда, как? Педиатрия. 2018; 97 (6): 133–140.