Despite a decline in incidence, acute rheumatic fever (ARF) and recurrent ARF is a late autoimmune complication of S. pyogenes infection — remain a significant public health problem, being a cause of chronic rheumatic heart disease.

Objective: to provide a clinical and epidemiological characterization and describe the outcomes of ARF based on observations of patients hospitalized between 2001 and 2025 at the Morozovskaya children’s city clinical hospital of the Moscow Department of Health.

Materials and methods. We observed 113 children (60 girls, 53 boys), aged 4—17 years (median age 10 [8; 13] years), with a diagnosis of ARF (101 children) or recurrent ARF (12 children). We assessed clinical and anamnestic data, laboratory test results (antistreptolysin-O (ASO), C-reactive protein), electrocardiography (ECG), and echocardiography. Children with Sydenham's chorea underwent additional examinations.

Results. A high rate of underdiagnosis of ARF was identified (63.7%). The onset of ARF most commonly occurred during the winter-spring period (61.9 %). To confirm markers of previous streptococcal infection, measuring ASO levels is more informative; an elevated ASO level (median 795 [385; 1440] IU/mL) was detected in 86.7% of children. In theclinical presentation of ARF, carditis was the predominant manifestation (81.4 %), and its frequency increased with age (p = 0,003). The mitral valve (MV) was most commonly affected (54%); combined involvement of the MV and aortic valve (AV) was observed in 34.5% of children, while isolated AV involvement occurred in 11.5 %. Arthritis was detected in 44.2% of children, with a high frequency (36/50, 72%) of atypical joint syndrome. Our study recorded a high incidence of Sydenham's chorea (56 children, 49.6%), including isolated Sydenham's chorea in 30.4%. The incidence of Sydenham's chorea decreased with age (p = 0,004). Rare manifestations of ARF — erythema marginatum and subcutaneous nodules — were observed in 14.2% and 3.4% of patients, respectively. A high incidence of chronic rheumatic heart disease (42%) was noted, with the development of rheumatic heart valve defects in 38% of cases.

Conclusion. The study highlights the need for vigilance regarding ARF in patients following streptococcal infection to prevent severe outcomes such as the development of acquired heart valve defects.

Research objective — to determine the significance of the open oval window in the formation of homeostasis in premature newborns. Materials: 58 premature newborns with a gestational age of 28—36 weeks were examined as the main group, and 20 healthy full-term newborns were examined as the comparison group. Results: The results of determining a number of homeostasis indicators and ultrasound examination of foetal communications in premature newborns without concomitant severe diseases are presented. In the late neonatal period, profoundly premature newborns developed a growing base deficit, predisposing them to ‘late’ acidosis. One of the reasons for this phenomenon was low partial oxygen tension in the blood due to bidirectional atrial shunting through the patent foramen ovale.

In Russia, viral agents dominate the etiological structure of аcute intestinal infections (AII), with rotavirus and norovirus playing the major role. Vaccination against rotavirus infection (RVI) demonstrates high efficacy (78—94%) in preventing severe forms requiring hospitalization. The introduction of rotavirus vaccination has altered the etiological landscape; however, the clinical features of AII in vaccinated children, including breakthrough infections and coinfections, remain insufficiently studied.

Objective: to analyze the course of acute intestinal infections (AII) in unvaccinated and rotavirus-vaccinated children aged 8 months to 3 years.

Materials and methods. A prospective observational cohort study was conducted at the G.N. Speransky Children's City Clinical Hospital (Moscow) in 2023—2024. The study included 205 patients hospitalized with AII within the first three days of symptom onset. Two groups were formed: children vaccinated against RVI (n = 93) and unvaccinated children (n = 112). Etiological diagnosis was performed by PCR; rotavirus genotyping was carried out (Sanger sequencing). Statistical analysis included the Mann—Whitney U test, Pearson's chi-squared test, calculation of odds ratios (OR) and 95% confidence intervals (CI).

Results. The groups were comparable in sex, age, and time of hospitalization (median — second day of illness). Vaccinated patients had a significantly shorter duration of illness: median 5 days [4;5] versus a longer course in the unvaccinated group (p = 0.033). The frequency of gastroenteritis in the vaccinated group was almost twofold lower — 29.0% (95% CI: 20.4—38.6%) compared to 56.6% (95% CI: 46.7—65.3%) in the comparison group (p = 0.001). Rotavirus was detected significantly less often in vaccinated children: 10/93 (10.8%) versus 41/109 (37.6%) in unvaccinated children (χ² = 17.79; p < 0.0001; OR = 0.200; 95% CI: 0.093—0.428). The detection rate of norovirus did not differ between the groups (30.1% vs 20.2%; p = 0.143). Campylobacter was detected more frequently in vaccinated children: 12/93 (12.9%) versus 4/109 (3.7%) (p = 0.031; OR = 3.89; 95% CI: 1.21—12.51); however, the authors note the possibility of Berkson's bias due to the small number of cases. Among vaccinated children with confirmed rotavirus infection (n = 10), hyperthermia above 39°C was not recorded (0%), whereas in the unvaccinated group (n = 42) this symptom was observed in 31% (95% CI: 16.7—45.0%). The predominant rotavirus genotype in both groups was G3[P8].

A prospective, open-label, randomized study was conducted to evaluate the efficiency of inclusion of recombinant interferon α-2b with vitamins C and E (Viferon®) in combination therapy for community-acquired pneumonia in children.

Objective: To evaluate the efficacy and safety of interferon α-2b with antioxidants (Viferon® rectal suppositories and gel for topical use) as part of combination therapy for community-acquired pneumonia in children aged 1 to 17 years. The study was conducted in two parallel groups in November—December 2024: the main group (n = 76) received Viferon® plus standard therapy for community-acquired pneumonia according to the 2025 clinical guidelines of the Ministry of Health of the Russian Federation for 7—10 days; the comparison group (n = 65) received standard therapy alone for 7—10 days. A total of 141 children were randomized and allocated to two age strata: stratum I, children aged 1 to 7 years (n = 35; 15 in the main group and 20 in the comparison group), and stratum II, children aged 8 to 17 years (n = 106; 61 and 45 children, respectively).

Study results: In 2024, community-acquired pneumonia of mycoplasma etiology was recorded in 55% of cases and was accompanied by viral co-infection in 21% of cases (influenza A/B — 7%; SARS-CoV-2 — 14%). Clinically, community-acquired pneumonia most often had a focal-confluent pattern, was accompanied by fever ≥ 38 °C, and in most cases occurred without signs of respiratory failure, while broncho-obstructive syndrome was observed in every third child. Inclusion of Viferon® in combination therapy was associated with higher odds of clinical improvement by day 4 (OR = 8.11; 95% CI 3.18—23.28; p < 0.001), faster resolution of cough and chest pain, and between-group differences in selected laboratory parameters on day 7. Serum interleukin-6 (IL-6) levels on day 7 did not differ significantly between groups. No adverse reactions or side effects were reported in children receiving combination therapy with Viferon®.

Conclusions: Inclusion of Viferon® in combination therapy for community-acquired pneumonia in children was associated with faster regression of clinical symptoms and favorable changes in selected laboratory parameters, with no adverse reactions related to therapy recorded in the study.

To study the impact of SARS-CoV-2 on the cardiovascular system in children and adolescents who have had mild to moderate illness, to identify the characteristics of cardiac rhythm and conduction disturbances in the post-COVID period, and to analyze current literature on the stated issue.

Materials and methods. Electrocardiography and Holter monitoring of ECG in 54 children 3 months after discharge, in the age interval from 1 month to the onset of adulthood, who had a new coronavirus infection of mild or moderate severity.

Results. Supraventricular extrasystoles were recorded in 65% of children. Ventricular extrasystoles of various grades were detected in 25%. Sinus tachycardia, not associated with physical activity, was observed in 40% of patients, and sinus bradycardia in 30%. Atrioventricular block of grade 1 was diagnosed in 45% of patients of the pediatric profile, various variants of the sinoatrial block (incomplete and complete) in total were identified in 30% of patients. Migration of the rhythm driver in the atria, recorded in 50% of the examined. Changes in the repolarization processes are recorded: QT interval prolongation was recorded in 45%, the syndrome of early ventricular repolarization was identified in 75% of the examined. A decrease in heart rate variability (HRV) was a direct confirmation of the presence of autonomic dysfunction, and low and very low HRV was observed in 30% and 10% of the examined children, respectively.

Conclusion. Cardiovascular complications in children who have recovered from COVID-19 are a major and multifaceted problem. There is a wide range of cardiac rhythm and conduction disorders, including changes in repolarization processes, in the pediatric patient cohort.

Due to the polymorphism of clinical manifestations, yersiniosis is a diagnostically complex infectious disease. The course of the disease in infants occupies a special place, as the limited amount of literature data and, as a result, insufficient vigilance on the part of specialists lead to a delay in diagnosis.

The aim of this study is to summarise current knowledge on the epidemiology, pathogenesis, clinical features, approaches to diagnosis and treatment of yersiniosis in infants, as well as to present our own clinical observations.

Materials and methods: We analysed the medical records of a nine-month-old child who was hospitalised in a paediatric multidisciplinary hospital with an intestinal form of yersiniosis, which manifested itself with pronounced gastrointestinal and intoxication symptoms, as well as the presence of exanthema, but without involvement of the joints, hepatobiliary system, or mesenteric lymph nodes. Current domestic and foreign scientific medical literature on yersiniosis infection in children was studied using search engines and databases such as eLibrary, PubMed, ResearchGate, Google Scholar, and Scopus.

Conclusion. In infants with acute intestinal infection accompanied by exanthema, yersiniosis should be included in the differential diagnosis, which in this age group usually manifests itself as a combination of intoxication and gastrointestinal syndromes with prolonged vomiting and diarrhoea, often mixed with blood, and characteristic punctate, maculopapular or haemorrhagic rash.

To prevent the death of children from meningococcal infection, it is extremely important for doctors to be committed and knowledgeable about the epidemiology and available prevention options. Objective: To assess the commitment of pediatricians to vaccination against meningococcal infection. Materials and methods: A questionnaire was administered to pediatricians to assess their knowledge about the serotype landscape of N. meningitidis in the region, the level of N. meningitidis carriage, and the composition of vaccines for the prevention of meningococcal infection. Results: 83% of doctors consider it necessary to inform parents of children about the danger of meningococcal infection and vaccination. 69% of pediatricians do not know about the serotype landscape of N. meningitidis in the region, 50% of doctors could not correctly list the composition of vaccines with the inclusion of serotypes used for the prevention of meningococcal infection; only 28% correctly indicated the vaccines recommended from 6 weeks of age. Conclusion: The study results demonstrate the existing serious gaps in terms of sufficient commitment by primary healthcare providers and achieving coverage of the pediatric population in the region with meningococcal vaccination, as well as providing accessible information to parents about available options for preventing meningococcal infection.

Purpose: to conduct a comparative assessment of modern methods for diagnosing mumps infection.

Materials and methods: The study was conducted on samples of biomaterial taken from 16 children aged 4 to 17 years, who were undergoing treatment at the State Budgetary Institution of the Republic of Dagestan «Republican Center for Infectious Diseases, Prevention and Control of AIDS named after S.M. Magomedov», Makhachkala. Patients were admitted to the hospital between May 23 and June 7, 2024. Samples of biomaterial were taken upon admission and during treatment. Specific antibodies IgM and IgG to the mumps virus were determined in the blood using enzyme-linked immunosorbent assay (ELISA), viral RNA was detected in oropharyngeal swabs using polymerase chain reaction (PCR) and loop-mediated isothermal amplification (LAMP).

Results: in all patients, the diagnosis of «mumps» was established on the basis of a serological test (ELISA IgM + ). At the same time, IgG antibodies were not detected in any of the children during their hospital stay. Using the PCR method, mumps virus RNA was detected in all smear samples from the oropharyngeal mucosa both upon admission and during their hospital stay. Using the LAMP method, mumps virus RNA was detected in all children on the 1—2 day of illness, in 13 out of 16 children (81.25% of cases) on the 3—13 day of illness. Thus, it should be noted that molecular methods are appropriate to use for diagnosing mumps in children at the present stage.

Zellweger syndrome (ICD-10: Q87.8; OMIM: #214100) is a multisystemic peroxisomal disorder caused by an autosomal recessive mutation in genes of the PEX family. Distinctive features of the condition include facial dysmorphism and neurological disorders, manifesting as convulsions, hypotonia, epileptic seizures and leukodystrophy. A similar set of symptoms is seen in another disorder within the spectrum of peroxisomal biogenesis disorders, caused by an autosomal recessive mutation in the HSD17B4 gene and designated in the international nomenclature of diseases as D-bifunctional protein deficiency (ICD-10: E88.8; OMIM: #261515). Despite differences in their molecular-genetic basis, the aforementioned diseases share significant phenotypic similarities, which considerably complicates their clinical differentiation and necessitates molecular-genetic testing to verify the diagnosis. The aim of this study is to review the current literature on Zellweger syndrome and D-bifunctional protein deficiency, and to analyse their clinical similarities, the characteristics of their differential diagnosis, and current treatment approaches. Materials and methods: An analysis was conducted of domestic and international scientific literature on Zellweger syndrome and D-bifunctional protein deficiency, using the electronic databases PubMed, NIH, Google Scholar, ResearchGate and the eLibrary.ru scientific library; data on clinical manifestations, molecular-genetic characteristics, diagnostic criteria and therapeutic strategies, including modern approaches to targeted therapy, were selected and systematised.

Purpose of the review: Assess global trends in the prevention of HPV development.

Materials and methods: The following databases were searched and analyzed: PubMed, Embase, Cochrane Library and Google Academy.

Results: Current evidence suggests that human papillomavirus (HPV) infection rates are higher in developing regions. The main risk group for HPV infection are sexually active young females and adolescents. It has been shown that in order to combat HPV effectively, it is advisable to carry out mass vaccination of young females and boys before their first sexual contact. Also, vaccination of other age groups shows positive dynamics in the fight against HPV-associated diseases. To date, there are six licensed HPV prophylactic vaccines comparable in effectiveness.

Conclusion: The main strategy for the prevention of cervical cancer should be to vaccinate teenagers before their first sexual contact. Vaccination against human papillomavirus has been proven to prevent precancerous conditions of the cervix, as well as other diseases associated with HPV infection.

The lecture is devoted to modern concepts of the diseases caused by Group A β-hemolytic Streptococcus. The main microbiological characteristics of the pathogen, pathogenicity factors, epidemiological patterns and clinical features of various nosological forms, consequences of acute infection, with an assessment of the disease burden are presented. Various methods of etiological diagnostics, their advantages and disadvantages are considered. Particular attention is devoted to the problem of antibiotic resistance, which is becoming increasingly global in modern conditions. The article presents prospects for the prevention of streptococcal infection, active immunization as a potentially effective way to reduce the incidence and spread of infection in the population. The effectiveness of timely methods of diagnosis, therapy, and vaccination against group A streptococcal infection are important areas for further research.

Reactivation of the varicella-zoster virus (VZV) in neurons of the trigeminal and spinal ganglia causes a disease known as herpes zoster (shingles, ZH). The disease is rare in childhood and is mainly associated with immunosuppressive conditions. This article presents a case of early diagnosis of ZH in an immunocompetent 7year-old child, which developed due to predisposing factors. Prescribing antiviral therapy at the first sign of a rash allowed for rapid containment of the infection and prevention of complications. Physicians must remain vigilant for herpes zoster to effectively limit the epidemic. This clinical case once again highlights the importance of routine varicella vaccination not only to prevent primary infection but also the risk of developing herpes zoster later.

Objective: Hemolytic uremic syndrome (HUS) is the leading cause of acute kidney injury. In pediatric patients, it is characterized by a tendency to progress to chronic kidney disease (CKD) and a high mortality rate. Shiga toxin-associated HUS (STEC-HUS) accounts for the majority of acute kidney injury cases in young children, representing approximately 90% of all HUS variants. This article presents a clinical case of hemolytic uremic syndrome associated with acute intestinal infection of viral-bacterial etiology, with a favorable outcome in a 2-year-old child. The disease onset was marked by signs of hematocolitis; on the sixth day of illness, the patient’s condition deteriorated, with the appearance of macrohematuria and increasing intoxication. In this case, renal function recovered without the need for renal replacement therapy (RRT). The child was discharged from the hospital on the 15^th day of illness (7 bed-days) in satisfactory condition. This clinical case underscores the need for vigilance among pediatricians when infants and young children present with gastroenterocolitis syndrome, as it constitutes a risk factor for HUS development.

The article presents a description of clinical cases of liver and brain echinococcosis in children, detected as a result of routine medical examinations and surveys. Analysis of these clinical cases allows for a better understanding of the epidemiological aspects of echinococcosis in children in the Perm region and also emphasizes the need to raise awareness of this disease among health workers for timely diagnosis and effective treatment.