This article describes the achievements in the study of diagnosis, treatment and prevention of diseases of the biliary tract in children, both from a historical point of view, and on the basis of the results of their own long-term research carried out at the Department, as well as students in different regions of Russia. New directions in the field of study of etiology, pathogenesis, clinic, diagnosis and treatment of biliary tract diseases in childhood with the introduction of new high-tech techniques are presented. The features of childhood do not allow to extrapolate some aspects of diagnosis and treatment tactics from adult practice to childhood. Based on more than 25 years of experience in monitoring and treatment of patients with various diseases of the biliary tract, new, fundamentally different approaches to the choice of diagnostic methods of research, therapeutic tactics of prevention and treatment at different stages of the disease are presented. All presented in the article of provisions is justified and evidence-based. Compliance with these directions will allow practitioners to improve the quality of life of patients and significantly reduce the disability of the child population

Conducted a cross-sectional survey of schoolboys in schools on SAO Moscow. We studied 51 healthy children (31 girls and 20 boys) senior school period, from age 12 to 16 years (mean age 14±0,9 years). The main inclusion criterion in the study was the presence of I or II group of health according to the results of periodic medical examinations. I health group had 9 students, II group of health - 42 student. All children were held peripheral electrogastroenterography according to standard methods The result of the research, following data were obtained (M± σ): The Electrical activity of (Pi/Ps),%: Stomach 26.07 ± 4,7, Duodenum 2,9 ± 1,3, Jejunum 5.3 ± 2.2, Ileum of 14.2 ± 4, Colon 51,5 ± 8,5; the Coefficient of rhythm of (K): Stomach 17.8 ± 26,01, Duodenum 4.3 ± 7,5, Jejunum 6,9 ± 10,3, Ileum 10,6 ± 15,2, Colon 32,4 ± 47,3; The ratio of (Pi/Pi+1) Stomach/Duodenum 15.5 ± 9,3, Duodenum/Jejunum 0,6 ± 0,13, Jejunum/Ileum 0,4 ± 0,09, Ileum/Colon 0,4 ± 0,5.

We retrospectively analyzed 268 medical records and 142 outpatient maps of sick children with a particular pathology of the digestive tract and concomitant iron deficiency anemia The structure of the pathology of the digestive tract with concomitant iron deficiency anemia was determined and a direct relationship was established between the severity of the anemic syndrome and the severity of the concomitant nosology

We had carried out cross-sectional survey with the help of standardized questionnaire which involved 966 schoolchildren in ages from 7 to 17 years in Aginskiy Buryatskiy Okrug aimed at obtaining the information on the presence of gastric intestinal symptoms. We picked up by random 68 subjects out of those mentioned above in order to perform gastroscopy including biopsy of antral sector of corpus gastricum. Morphological estimation of the mucosa was executed after Hematoxylin - Eosin and Giemsa staining. The share of Helicobacter pylori infection in the examined schoolchildren amounted to 64,7 %. Moreover high level of bacterial invasion was observed in 46,7 % of early schoolchildren. Identified infection in the boys matched to that in the girls. The indices were not associated with the presence of dyspepsia clinical signs in the examined subjects, including its specific variations. In children with erosive gastritis/ duodenitis the infection was marked in 100 % cases. Schoolchildren with Helicobacter pylori showed stronger activities in corpus gastricum as compared to non-infected children

The purpose of this study was to assess changes in the level of neuron specific enolase (NSE) in boys and girls with chronic gastroduodenitis (CGD), taking into account the severity of the disease and the presence of Helicobacter pylori infection. Material and methods: we examined 73 children with CGD. The first group (32 people) included children with erosive gastroduodenitis of them with a positive examination result on the HP-infection and 16 patients (subgroup 1) and 16 negative tests for HР infection (subgroup 2). Group II included 41 children with superficial gastroduodenitis, 14 of them with a positive result of the survey on HР (subgroup 1) and 27 with negative tests for HР (subgroup 2). The control group (CG) consisted of 28 children I-II health groups. In the diagnosis of the disease was used endoscopic and morphological methods; urease, microscopy, molecular biological and serological tests were carried out for the verification of HР. Results: the analysis of the dynamics of the level of NSE showed high values of this index in boys group II subgroup 2 in comparison with children I group 2 subgroups (p≤0,01). High rates of NSE were detected in boys group I subgroup 1 and 2 group II subgroup compared to CG (p≤0,05, p≤0,01). The girls are a group 1 subgroup, the values of NSE above the level I group 2 subgroup, and CG (p≤0,05; p≤0,01). The girls of group II subgroup 2 of index of NSE is higher compared to patients of subgroup 1 and CG (p≤0,01; p≤0,01). The level of NSE in girls group II subgroup 1 were also higher than values of this index in CG (p≤0,05). The results indicate a possible role of NSE in the development of severe forms of the disease in the absence of pathogenic effects of HP and do not exclude a certain link with the function of sex hormones

There were examined 202 children with chronic Helicobacter-associated gastroduodenitis. There was carried out endoscopic and pathomorphological examination of biopsies taken from the wall of the stomach and duodenum. The most frequent cases of chronic Helicobacter-associated gastroduodenitis among children are surface inflammation (65 % of patients); there are more rarely endoscopically detected: subatrophic (10.2 %), hypertrophic (14.5 %) and erosive (10.3 %) gastroduodenitis. In stomach was dominated gastritis with lesions of the glands without atrophy in chronic Helicobacter pylori gastroduodenitis in children. The greatest degree of seeding of the gastric mucosa of HP was found in children with hypertrophic gastroduodenitis.

As a result of specialized mass medical examinations, 2030 children with heart diseases aged 1 month to 15 years were examined in various districts and cities of Krasnodar region. There were 1047 boys (51.6 %), 983 girls (48.4 %). A retrospective epidemiological analysis of the territorial prevalence of congenital heart defects and anomalies in children in relation to the level of environmental pollution was carried out. Mathematical analysis of the effects of polluting factors on the condition of the digestive tract in all examined children showed a tendency to growth and change in the structure of diseases of the gastrointestinal tract with the growth of anthropogenic load. In children with small heart abnormalities from environmentally friendly places of residence, diseases of the upper digestive tract (3.8 %) are more often detected, with congenital heart defects - in addition to the latter, intestinal diseases are registered (2.4 %). The growth of anthropogenic load on the rise of all diseases in three or more times. The obtained data indicate, on the one hand, the relationship of gastroenterological diseases with the degree of environmental pollution, on the other, do not exclude the fact that the course of congenital defects and small anomalies of heart development lead to the formation of diseases of the digestive tract

The purpose of the present study was to study the state of vegetative regulation in children with autonomic dystonia syndrome (SVD) and functional disorders of the biliary tract (FRBT). the incidence of SVD and functional disorders of the biliary tract among children aged 7-17 years in one of the secondary schools of the city of Krasnodar was studied according to the data of preventive medical examinations. The group of schoolchildren (252 people) with a syndrome of vegetative dystonia, consisting on a dispensary account is selected. Of these, 120 children had combinations of dysfunctional disorders of the biliary tract and the syndrome of vegetative dystonia. The functional state of the autonomic nervous system and the reserve capabilities of the cardio-respiratory system in school-age children with autonomic dystonia syndrome were assessed using Functional Samples (the Quetelet index, the Robinson index, the Skibinsky index, the Shapovalov index, the Ruthier index, the life index). Nonmedical correction of the revealed vegetative dysregulation, which testifies to disturbance of homeostasis at the preclinical stage, conducted in the conditions of medical offices of general educational institutions, will prevent the risk of pathological changes from the digestive system and improve the quality of life of patients

To evaluate the effectiveness of inhalation phagotherapy in diseases of the oropharynx in children. Patients and methods. 120 patients from 4 to 17 years, including 60 children with acute bilateral upper-jaw sinusitis, 30 people with acute hemisinusitis and pansinusitis, respectively. The efficiency of bacteriophages was assessed by three main criteria: 1. anoscopically picture with the use of endoscopic techniques with videoarchive; 2. data of bacteriological research; 3. X-ray computed tomography (CT) before treatment and after the therapy. Inhalation therapy was carried out using compressor nebulizers OMRON and PARISINUS. At admission of the patient, on the 5th and 10th days of the carried-out phagotherapy results of bacteriological research testify to lysis of the causative agent of the disease by the 10th days in 98 % of crops at all 120 patients of the investigated groups. CT data before and after treatment confirmed the positive dynamics and resolution of the process in 84 %. Phagotherapy in gastroenterology and otorhinolaryngology, especially in childhood, is a full-fledged method in complex therapy, allows optimizing the entire process of treating patients, in many cases copes with the problem of antibiotic resistance, prevents the development of early and late postoperative complications in many areas of surgical treatment of the pathology of the oropharynx.

The study was conducted in 17 patients with CD at the age of 10 to 17 years. The erythrocyte deformability, aggregate morphology in autologous plasma, state of membrane cytoskeleton and cell aggregation induced by lanthanum were studied. In patients with CD significant changes of average erythrocyte deformability and changes in distribution of the cell number for the degree of their deformability were revealed. Morphological pattern of erythrocyte aggregation was changed - along with the formation of «rouleaux» aggregates globular structures (clump) appeared. The stability of the erythrocyte cytoskeleton significantly decreases. Studying of human erythrocyte aggregation induced by lanthanum was shown that erythrocyte aggregation of patients at studied lanthanum concentration significantly different from normal cell aggregation. Current treatment resulted in improvement of rheological and membrane erythrocyte properties. However, complete normalization of erythrocyte properties did not occur. The results show significant changes in the rheological and membrane properties of erythrocytes in children with CD. Determination of rheological and membrane properties of erythrocytes allow to obtain additional information on the process of the disease and the effectiveness of its treatment.

210 clinical, endoscopic and morphological studies in children patients with gastroesophageal reflux disease were performed. Тhere were 115 (54,8 %) boys and 95 (45,2 %) girls. Their age was from 6 to 18 years. Endoscopically negative form of GERD with minimal clinical manifestations was in one third of the patients. The esophagitis A degree was in 41,1 % cases, the esophagitis B degree - in 17,6 %, the esophagitis C degree - in 7,6 %. HP was detected in the mucous membrane below the Z-line in 34,9 % cases, preneoplastic changes - in 10,9 % cases, mainly on the background of minimal degrees of the esophagitis. The peak incidence of GERD in children is 13-15 years old. The GERD of minimal degree is dominated in children, but preneoplastic changes of mucosa membrane with columnar epithelium is detected often on this background, which requires clarifying methods and morphological study for the prevention of more severe changes in the mucous membrane of the esophageal-gastric transition.

It was performed the analysis of modern ideas about the features of etiopathogenesis, diagnosis and treatment of diffuse family polyposis. Diffuse family polyposis or familial adenomatous polyposis (FAP) refers to genetically conditioned multi-tumor syndromes, which represent a separate group of diseases characterized by polyps in the gastrointestinal tract and are considered as potentially malignant multifocal process. The most frequent clinical manifestations of pathology and methods of its diagnostics are described, features of monitoring of this category of patients are characterized. The methods of treatment of FAP are considered, while all the revealed colloctal polyps should be removed. The method of choice in this case is endoscopic polypectomy, with their location no more than 5-7 cm from the edge of the anus - transansal resection. The need for early diagnosis and treatment of this category of patients is indicated, while specialists should be informed about extraintestinal benign and malignant manifestations of FAP and associations between them. It was noted that a timely diagnosis of hereditary syndrome in patients with high-risk FAP, as well as dynamic monitoring of them, helps to recognize the presence of a malignant tumor and provides the possibility of sparing treatment in the early stages of the disease.

The term “thyrogastric syndrome” - combined thyroid and stomach damage, defines the association between autoimmune thyroid disease and atrophic gastritis. Today thyrogastric syndrome is considered as a manifestation of polyglandular autoimmune syndrome type IIIb, characterized by Hashimoto’s thyroiditis in combination with one or more endocrine and non-endocrine autoimmune diseases. The incidence of thyrogastric syndrome is high: among patients with autoimmune thyroiditis, 12-40 % of adults and one-third of children have antiparietal antibodies; among patients with atrophic gastritis, Hashimoto’s thyroiditis is diagnosed in 40 % of cases. In this paper we describe general genetic, embryological, immunological and infectious factors, the interaction of which leads to the formation of the disease.

A clinical and laboratory examination of 60 patients with acute severe pancreatitis divided into two groups was performed: the first (n = 30) patients who received standardized treatment, the second (n = 30) patients who were treated with remaxol: intravenous drip infusions of 400,0/daily for 6 days with a corresponding decrease in total infusion volume. Control (3rd) group - 30 healthy people. It was found, that the inclusion of remaxol in the therapy of the patients in the early stage of the disease leads to significant changes in the state of the coagulation-lytic system. It was noted, that the reliable effect of the remaxol on most of the studied parameters was recorded from the second day, and after four days of the study became near to normal level.

The article presents: the definition of peptic ulcer disease, a brief history of its study, characteristics of Helicobacter pylori - infection, as well as critical consideration of the concept of the leading role of Helicobacter pylori in the etiology of the disease. The opinion of the author about peptic ulcer disease is like a systemic disease with complex multifactorial pathogenesis and still unknown etiology. Data on various bacterial microbiota colonizing the stomach, in addition to Helicobacter pylori, and its properties are presented. Considerable attention is paid to substantiation of complex treatment of peptic ulcer disease with influence on various links of its pathogenesis

This article provides a clinical example of the flow Toxocara under the guise of diseases of the digestive system with a partial lesion of the lungs. It is shown that timely administration of antiparasitic treatment gives the possibility of degelmintizatsii with the restoration of the sphincter disorders, including clomazone

There is a clinical case when Crohn’s disease was detected in the early postpartum period. The diagnosis was made after the development of complications of the disease, the patient did not seek medical help and was not examined because of the erased (malosymptomatic) course of the disease. Crohn’s disease is a chronic recurrent disease of the gastrointestinal tract of unclear etiology, characterized by transmural, segmental (intermittent), granulomatous inflammation of the gastrointestinal wall with the development of local and systemic complications. Crohn’s disease can affect various parts of the gastrointestinal tract. Isolated involvement of the small intestine is observed in 25-30 % of cases, ileocolitis - in 40-50 %, isolated lesions of the large intestine - in 15-25 % of patients. Until now, the exact cause of Crohn’s disease remains unknown. Among the reasons are hereditary (genetic), infectious, immunological factors. The diagnosis of “Crohn’s disease” should be confirmed by endoscopic and morphological method and / or endoscopic and X-ray method. Treatment activities in BC include the appointment of medications, surgical treatment, psychosocial support and diet therapy. The goals of therapy BC are induction of remission and its maintenance without a constant intake of glucocorticosteroids, prevention of complications, prevention of operations, and with the progression of the process and the development of life-threatening complications, the timely administration of surgical treatment. The presented clinical observation shows the importance of careful collection of anamnesis (episodes of recurring abdominal pain, periodic diarrhea), the need for timely examination of the intestine in unclear cases. The absence of patomonical clinical picture does not exclude Crohn’s disease. Timely diagnosis of this disease and adequate treatment make it possible to achieve clinical and endoscopic remission, avoid complications, preserve the patients’ ability to work and improve the quality of life of patients.

This article presents a clinical example of a surgical finding of extracurricular enterobiosis in a teenager operated on for inflammation of the epithelial coccygeal course. Presented as a demonstration of the complexity of the diagnostic search and the diversity of clinical manifestations of enterobiosis.