Introduction. In families with such a child his/her siblings often live, whose development will be affected by the current stressful situation for all family members. Siblings of cancer patients appear to be a psychological vulnerable group, as they have low self-esteem, fear of death and loneliness, anxiety, anger. The study aimed to assess the level of physical development (PD) of children, treated for brain tumors, and siblings of childhood cancer survivors, in relation to stressful circumstances of living in a family with an oncological relative. Material and methods. The study involved children aged 6 to 17 years who had completed treatment for a brain tumor (BT), as well as siblings of children with various cancer types. We measured 27 boys and 36 girls with BT, the sample of siblings included 26 boys and 31 girls. To assess the compliance of the level of PD of children of both groups with age standards, for each child of a given gender and age a centile corridor was determined by body length (BL) and BMI, and individual values of signs were ranked in Z-points, using WHO standards. A detailed questionnaire was conducted to assess some characteristics of a child's family environment. Statistics analysis was performed with Statistica 12 software package. Results. For a group of children with BT, a significant shift in the distribution of PD scores along body length and BMI towards low values was found, for a group of siblings, the opposite picture was obtained – the distribution of body length and BMI scores shifted to the higher values. It has been shown that higher developmental scores in body length are significantly more common in children who are older siblings in relation to patients with BT. Conclusion. Thus, brain tumor treatment affects not only the physical development of a child, but is a factor contributing to the growth processes of the body of siblings of children with BT. Siblings of cancer patients represent a special group of children, which indicates the need to take into account the special needs of all their family members in the process of treatment and rehabilitation, as well as the incorrectness of using siblings as a control group in scientific research.

Introduction. The goal of study is the estimation of «peak height velocity» (PHV) as the marker of secular trends in addition to secular dynamics of height (H). Material and methods. The study embraces the block of samples of scholars (6/7-17 years) from Russia and former USSR, examined through the vast historical period from 1920th till nowadays, literary data and personal archives of the authors. The main attention is paid to three urban agglomerations - Moscow, Nizhniy Novgorod, Minsk. The following number of parameters is determined for each sample: the age of maximal velocity of growth dynamics of average levels of H during adolescence (APHV), determined according to the empirical patterns of annual changes of average H levels and consequent smoothing by least square method - differentially for boys and girls; and delta between parameters of boys and girls; maximal quantitative level of growth changes in cm (IPHV), different for boys and girls as well, and delta between the parameters. Results. The difference of APHV between boys and girls for each population under study is about two years - boys have delayed PHV as compared to girls in any ecological niche. Secular dynamics of APHV has nonlinear character, doesn’t decrease progressively through the whole historical interval from 1920th to 2000th, despite of permanent increase of the level of anthropogenic stress in cities under analysis, the lowest APHV is fixed in 1980th. Correlations of APHV with absolute annual H values through the age interval 6/7-17 years is systematic and high enough for boys (correlation about 0,5, determination coefficient about 0,25) and accidental for girls, being revealed for only one annual age group among 12 analyzed. Correlations of IPHV with absolute values of H are maximal at 7 years and minimal at 17 years, the level of correlations is less for girls as compared to boys. Conclusion. PHV really marks the secular somatic dynamics along with H itself as genetic marker. Correlation of APHV with absolute annual levels of H through the interval 6/7-17 years is systematic and significant for boys and accidental for girls, which witness to genetic determination of growth tempo of boys. Correlation of IPHV with absolute values of H, having highest levels at 7 years, points to the fact that height at 7 years is a real trigger of PHV parameters.

Introduction. Analysis of correlations of sexual somatic dimorphism (SD) with the degree of urbanization (quantity of population) and geographic latitude of the residence place is carried out using the material of monitoring of Russian children and adolescents. Material and methods. The study embraces the wide specter of ethno-territorial samples of children and adolescents from Russia and neighboring countries (literary data), examined through the historic interval 1930-2010 years. To estimate the direction and degree of associations of anthropometric traits (height, weight, chest girth) and ecological factors the classic correlation analysis for pairwise combinations of variables was implemented for age groups of 9-year-old children and 13-year-old adolescents. The quantitative estimation of SD was carried out using Kullback divergence, the analogue of Makhalanobis distance. Results. Significant correlations of SD of height with both ecological factors for 13-year-old adolescents and SD of weight for 9-year-old children with the quantity of population were fixed on base of the whole data massive. The more homogeneous data base (only Slavonic groups examined in 1960s-1970s) shows significant correlations of latitude with SD of height for 13-year-old adolescents only in combination with the quantity of population of the residence place up to 500 thousands of people; and latitude with SD of weight for 9-year-old children only for million-plus cities. Significant correlations of quantity of population were fixed for SD of height of 13-year-old adolescents in more southern ranges of latitude (37-50degrees), for SD of weight for 9-year-old children in more northern ranges of latitude (50 degrees and more). Conclusion. The study shows complex superposition of ecological factors, which influence somatic variability of children through growth process. High degree of urbanization conceal anthropoecological correlations SD-latitude for ecosensitive age 13 years, but reveal them for “neutral” age, 9 years, with the opposite vector. The most southern range of latitudes (about 40 degrees) reveal positive associations of SD with the degree of urbanization for 13-year-olds, which are not fixed in more northern latitudes. More frequent anthropoecological correlations of SD of height, as genetic marker, of 13-year-olds, and SD of weight as the marker of nutrition status and life style of 9-year-olds reflect the physiological essence of age periods - increase of intersex differences for adolescents and decrease of intersex differences for second childhood children

The significance of growth activity peak in screening studies of children and adolescents as biomarker of chronobiological status of the population is the focus of present research. The broad spectrum of samples (N = 43), including different ethno-territorial groups of Russia and former USSR, examined throughout a wide historical period of second half of 20th — beginning of 21st century, was included in the analysis. The material source was data from literature and authors’ own databases. The following indicators of growth activity peak were calculated for each group: age (in years) of the maximal velocity of growth changes of the average level of height through the adolescence, estimated by empiric rows of annual changes of mean height with further smoothing by the least squares method — separately for boys and girls; its absolute value (cm) and chronological age (years). Intragroup sexual differences of these characteristics were considered as well. The subsequent statistical analysis (Statistica 10 package was used) revealed, that intergroup distribution of age at peak height velocity was not Gaussian and gravitated towards bimodality for both sexes. Herewith the least urbanized groups (rural Abkhazians and urban Mongolians) were excluded from analysis due to the specificity of the dynamic lines of height gains. The factor analysis established auton-omy of pubertal growth acceleration of male and female teenagers — the first factor describes growth activity for males, the second one — for females. The analysis of intergeneration dynamics of age at peak height velocity, on the example of Moscow boys and girls, established, that the used parameter might indicate occasional changes of quality of life of a population (for ex-ample, introduction of free school lunches during the NEP period), as well as more global changes (intensified urbanization throughout the 20th century). The results of the study suggest that the variability of the growth activity peak parameters indicate significant social/anthropogenic base of chronobiological status of the population and independent growth strategies of males and females, which allows considering it as valid and promising biomarker in population growth studies.

Introduction. The goal of study is description of secular dynamics of sex dimorphism (SD) of height, weight, chest girth of children aged 9 years and teenagers 13 years old from Russia and neighboring countries through 1920–2010. Materials and methods. The main source of data — materials of books on physical development of children and adolescents from cities and rural regions of Russia and USSR, collected and processed according to the universal methodical standards of Research Institute of Hygiene of children and adolescents. The quantitative estimation of SD value was held using Kullback divergence. One-year age groups, contrastive in biological essence, are under discussion. The estimation of the vector and level of associations of SD of anthropometric traits and secular factor was held using correlation analysis. The analysis of local patterns of secular SD dynamics of separate traits was carried out. Results. Secular variability of height and weight SD of 9-year-old children is not significant. While secular dynamics of three body dimensions of 13-year-old teenagers is significant, the highest determination coefficient is fixed for weight. For Moscow samples the decrease of height and weight SD is fixed through the historic interval 1960s – 70s with the following recovery up to the level of 1920s in 2000s. Temporal dynamics of SD of 9-year-old children of St. Petersburg through the interval 1960s – 2000s consists of macrosomization of girls; the tendency for 13-year-old teenagers is opposite. Temporal dynamics of somatic SD of 9-year-old Russian children of Kazan reveals stability through the interval 1960th-1990th; for 13-year-old teenagers’ parameters of transversal body development demonstrate secular stability, as to height – boys compensate their lag compared to girls. For Kirovsk city (Murmansk region) through the interval 1950s – 1970s temporal fluctuations of height and weight SD of 9-year-old children are less than 0,2 standard deviations; height and weight SD of 13-year-old teenagers reveal temporal increase (0,4–0,6 standard deviations). Conclusion. The results confirm the importance of somatic SD as the criterion of secular dynamics for 13-year-old teenagers and witness, as a whole, to the temporal stability of SD during second childhood (9 years). Local differences do not contribute significantly to the intensity of secular dynamics of SD. The process of secular macrosomization of one sex as compared to the other is not the exclusive prerogative of boys and male teenagers.

The study deals with the process of forming of the level and vector of sex somatic differences through early and first childhood, specific peculiarities of sexual dimorphism at 3–6 years of age as compared to the sexual dimorphism of adults, ethnic heterogeneity of sexual dimorphism dynamics of main anthropometric dimensions (height, weight, chest girth); most adequate algorithms of analysis of data considering age peculiarities. Generali-zation of vast material on children of Russia and former USSR of 1950s–2010s (over 200 samples) allowed to describe convincing conformities of intergroup distribution of sex somatic dimorphism; different by sex vector of significant correlations of standardized levels of sexual dimorphism of dimensions with average population values of dimensions themselves — positive for boys , negative for girls, which may be interpreted as confirmation of the contribution of somatic variability of both sexes to forming of sexual differences. When analyzed of data locally, under greater enlargement, sexual dimorphism allowed to estimate inter-ethnic specificity of somatic growth dy-namics. In particular, definite sex synchrony of growth dynamics of Russian children regardless of the ecological niche of development through early and first childhood; similar synchrony for some groups of different ethnicity. To fix well known in age physiology effect of decreasing of growth activity before semigrowth spurt, which chrono-logical age differs between populations, for the case of more homogeneous groups. Thus, the results show the sensitivity of sexual dimorphism of body dimensions as the informative indicator of ethno-territorial diversity of somatic status and growth dynamics through early and first childhood.

Introduction. The physical development of the child population is traditionally one of the main indicators of its health and a marker of the social well-being of society. The total dimensions of the body are both hereditary and final effectors of long-term adaptation processes of the child′s body to the effects of the internal and external environment. The integral image of the proportions of the total body dimensions of the individualized and group orders is determined by the anthropometric habitus. The purpose of the study is to study the anthropometric habitus, characterize the intragroup features of the total body size of children and adolescents in the Nizhny Novgorod region. Materials and methods. In the cross-sectional observation in 2019–2021, 5 143 children and adolescents of the Nizhny Novgorod region aged 7–17 years old, 2 396 boys, 2 747 girls, took part. The program for observing the anthropometric indicators of students was approved by the local ethics committee of PIMU, carried out with the involvement of domestic, certified, trusted equipment. Results. The physical development of the population of children and adolescents of the Nizhny Novgorod region shows intra-group tendencies, differences by gender, in the general population array. The presence of three groups of different tempo somatotypes was shown: mesosomatic boys 58,2 % and girls 61,4 %, microsomatic boys 20,9 % and girls 19,7 %, macrosomatic boys 20,9 % and girls 20,9 %. The modern difference in the growth of physical development indicators from 7 to 17 years of age in the gradation of the tempo somatotype showed that: microsomatics increased body length by a greater percentage (by 45,8 %), whereas mesosomatics this percentage was 43,1 %, and macrosomatics 39,9 %; also, MiS increased body weight by a greater percentage (by 190,5 %), in months it is 179,9 % and in MaS 168,5 %; mesosomatics show a greater increase in the circumference of the chest (by 48,3 %), microsomatics by 43,7 %, macrosomatics by 43,5 %, variances of indicator distributions in habitus differentiation show statically significant differences (p < 0,01). Conclusion. Planned measures to monitor the anthropometric habitus should be carried out taking into account the belonging of individuals both to a certain age-sex group and to the tempo somatotype, that is necessary and sufficient condition for the successful planning and implementation of medical and preventive measures in the fields of pediatrics, hygiene, sports.

Рассматривается степень информативности полового диморфизма (ПД) размеров тела детей в грудном периоде онтогенеза как самостоятельного индикатора межгруппового разнообразия. К исследованию привлечен спектр выборок детей грудного возраста от рождения до 12 месяцев с территории бывшего СССР с помесячной динамикой весоростовых и обхватных (головы и груди) соматических показателей. Численность каждой месячной половозрастной группы в любой из выборок составляет около 100 человек. Материалы для анализа заимствованы из сборников по физическому развитию детей и подростков, данные собраны и обработаны по единым требованиям НИИ гигиены охраны здоровья детей и подростков и в силу этого методически унифицированы и абсолютно сравнимы. Для увеличения гомогенности массива данных и минимизации возможного влияния этнического и секулярного факторов в анализ включены только выборки русских младенцев, городские, обследованные на протяжении конца 1950-х-1960-х гг. Для количественной оценки величины ПД использована дивергенция Кульбака, аналог расстояния Махаланобиса. Показано синхронное для всех территориальных групп увеличение ПД всех размеров тела в первом триместре первого года жизни на фоне более активных ростовых процессов у мальчиков; увеличение различий между выборками по показателям ПД во втором и третьем триместрах. Наибольшее увеличение уровней ПД фиксируется для выборок крупных городов, наименьшее - для небольших провинциальных. Что касается связи половых различий с географической широтой, то прибавки длины тела у девочек в холодном климате отстают от таковых у мальчиков, но половые различия в упитанности незначительны. Одновременно в жарком климате мальчики опережают девочек по показателям упитанности (масса тела), а половые различия по длине тела менее значительны. Такая комбинация возрастной динамики показателей длины и массы тела свидетельствует о выраженной лептосомности мальчиков-северян сравнительно с девочками и альтернативно более брахиморфном телосложении мальчиков-южан.

Obesity is one of the most important and actual problems of public health, of healthcare, which dramatically expanded through the latest four decades. The aim of the study was the analysis of physical conditions of Moscow preschoolers at the beginning of 21th century as the indicator of nutritional status in «obesogenic» environment of megalopolis. Material and methods. Complex anthropometric study of children attending kinder gardens in Moscow (aged 3-7 years) was held in 2005-2006 (n=759). Literature data on samples of the 1970s were used for comparison. Anthropometric measurements were used to calculate personal values of body mass index (BMI, kg/m2). The more detailed estimation of somatic specificity of children included calculation of average values of standardized differences of each single body dimension of material of 2005-2006 from the values of samples of the 1970s. Results and discussion. The distribution of BMI of Moscow preschoolers at the beginning of 21th century (13.6% were overweight and 7.5% were obese) is quite comparable to the results of other population studies in Russia and around the world. The circumferences, mediated by adipose tissue, and skinfolds of modern Moscow preschoolers showed very significant increase of average standardized levels of dimensions (0.9-1.1 standard deviations as compared to the data of the 1970s). The comparison with the results of the similar study of Moscow school children allows, probably, to speak about the existence of accumulation effect as the mechanism of obesity development in the age aspect. Conclusion. The effect of the significant and valid increase of adiposity in preschoolers, combined with very modest changes of the size and shape of skeletal/muscle system and even its relative weakening was shown based on the results of the survey of Moscow preschoolers, conducted in 2005-2006, in comparison with the series of the 1970s.

Long-term dynamics of the level of sexual dimorphism (SD) of body dimensions of newborns, embracing eight decades and inter- and intragroup variation, is under discussion. The study deals with a vast canvas of literary data – over 200 samples of newborns of each sex from former USSR and modern Russia through 1920-s till nowadays, including main anthropometric dimensions (body length and weight, chest and head girths). All samples are urban, the data is divided by decades, the number of each age/sex group as about 100 persons. Several levels of somatic variation were analysed: a) the whole data base above ethnic factor; b) only neighboring Slavonic groups; c) only Russian samples; d) regional Russian samples from Moscow and Kursk. The estimation of the level of SD is implemented using Kullback divergence, analogue of Makhalanobis distance. The results of meta-analysis, including the whole territory of Russia, witness to the definite secular sexual synchronism of dimension’s dynamics (increase of height/weight parameters and decrease of head girth), which results in very modest oscillations of SD around the level of 0,3 standard deviation. Still some secular decrease of SD is fixed for weight, due to more intensive increase of the parameter for girls, and for head girth, due to more intensive secular decrease of the parameter for boys. Some microsomisation of newborns is fixed in unfavorable war years 1940s and increase of SD due to greater decrease of the anthropometric parameters of girls (samples of Kursk). The same trend if fixed for Moscow newborns of 1960s, obviously above economic background, probably mediated by physical conditions of their mothers, who experienced economic depression of 1940s in their early childhood. Temporal fluctuations of SD level of main body dimensions of newborns keep within narrow interval 0,14-0,5 standard deviations, which does not exceed significant level of 0,3 standard deviations in the context of the study. This witnesses once again to the fact that the main factor of variation of newborns dimension is stabilizing selection, providing the stability of the dimensions of newborns of both sexes, as well as the level of sexual differences

This study deals with long-term temporal changes of body height and weight during various stages of ontogeny: newborns, infancy, early age, fi rst childhood, second childhood, adolescence, and youth. Each age/sex group numbers ca 100 persons, the total sample size is ca 2 000. The meta-analysis is based primarily on growth standards for Russian children, regularly renewed by the Research Institute for the Hygiene and Health Protection of Children and Adolescents and mostly relating to separate decades of the 20th century. The intensity of the secular trends was assessed through the analysis of scatter plots. The largest share in the secular increase of bodily dimensions belongs to intense growth during the second year of life and during the adolescent growth spurt. The smallest share is that of intrauterine growth, limited by the mother’s body size, and that of growth during adolescence, when the mature body size has been virtually reached and growth rate is minimal. Boys, who are more eco-sensitive, demonstrate greater secular changes than girls, who are eco-resistant. Smaller secular changes in weight than in height in both boys and girls result in the increase of leptosomy. This heterochrony concerns mostly newborns, whose body mass is a standard example of stabilizing selection.

Syncope is an event that causes a transient loss of consciousness (LOC) secondary to global cerebral hypoperfusion. The transient nature of the event can make diagnosis in the emergency department (ED) difficult, as symptoms have often resolved by time of initial presentation. The symptoms and presentation of syncope are similar to many other conditions, which can lead to difficulty in establishing a diagnosis in the ED.This review evaluates patients presenting with a history concerning for possible syncope, mimics of syncope, and approach to managing syncope mimics.Syncope is caused by transient LOC secondary to global cerebral hypoperfusion. Many conditions can present similarly to syncope, making diagnosis in the ED difficult. Some of the most emergent conditions include seizures, stroke, metabolic disorders, and head trauma. Other nonemergent conditions include cataplexy, pseudosyncope, or deconditioning. Many laboratory studies and imaging can be nondiagnostic during ED evaluation. For patients presenting with apparent syncope, immediate treatment should focus on identifying and treating life-threatening conditions. History and physical examination can help guide further diagnostic evaluation and management.Patients with apparent syncope should be evaluated for potential immediate life-threatening conditions. A thorough history and physical examination can aid in distinguishing syncope from common mimics and help identify and subsequently treat life-threatening conditions.