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The article presents a rare clinical case of trichobezoar. The article describes the difficulties of diagnostic search when a child was treated for anemia by a hematologist for 4 years. The diagnosis was made already against the background of the developed complication.

Проведен анализ 121 истории болезни детей с ожирением в возрасте от 5 до 17 лет. Ведущими осложнениями и сопутствующими заболеваниями являются: гастропатология (96 %), кардиальные нарушения (50 %), метаболические нарушения (47 %), гипоталамический синдром (46 %), ускоренное или акселеративное физическое развитие (85 %), задержка полового развития у мальчиков (25 %), ускоренное половое созревание (60 %) и гиперандрогения у девочек (5 %). Установлено, что метаболический синдром в 1,5 раза чаще встречался у детей с 1-2-й степенью ожирения, чем у детей с 3-й степенью ожирения. Выявлена высокая заболеваемость детей с ожирением, что отражает сниженную иммунологическую реактивность организма.

Introduction. In recent years, there has been an increase in the number of schoolchildren with chronic diseases. Employees of the Astrakhan State Medical University, together with colleagues from Children’s City Polyclinic №4, worked to study the impact of nutrition on the growth of disease cases in educational institutions.Aim. Study of the impact of nutrition in educational institutions on the state of health of modern schoolchildren in the city of Astrakhan, as well as the understanding of children and their parents of the principles of healthy nutrition of children.Materials and methods. The health status of 9063 schoolchildren was monitored in general education institutions located in the service area of Children’s City Polyclinic No. 4. Data from preventive examinations 2018–2020 were used. Schoolchildren (579 people) in grades 8–11 and parents (591 people) were surveyed for the state of the child’s health and attitude to healthy nutrition in schools.Results. According to the results of monitoring by the Office of Rospotrebnadzor in the Astrakhan region in the region, no educational institution has a balanced diet. Preventive examinations of schoolchildren showed that only 7% of children with health group I entered the first grades. In a significant part of schoolchildren, various functional violations were noted (57%). In the structure of such disorders, the first place is diseases of the musculoskeletal system, the second place is the pathology of the digestive organs, and the third place is the violation of neuropsychiatric health. There was a high level of allergopathology, eye diseases. 3% of children showed hearing loss. When examining the cardiovascular system (ECG screening), only 63% of schoolchildren had no significant abnormalities.Conclusion. Unsustainable nutrition of schoolchildren is one of the reasons for the high level of incidence of schoolchildren, the prevalence of chronic diseases, and physical disorders. It is necessary to introduce healthy-saving technologies in schools and control the organization of nutrition for schoolchildren.

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