Objective. To optimize an algorithm for the management of children and adolescents with parameningeal tumors based on a comprehensive assessment of diagnostic and therapeutic efficacy in this type of tumors. Patients and methods. The article presents a retrospective study and prospective evaluation of follow-up of 249 patients who underwent surgical treatment in the Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology and in the Russian Children’s Clinical Hospital (Pirogov Russian National Research Medical University) from January 2003 to September 2021. The study included 139 patients with juvenile nasopharyngeal angiofibroma, 82 patients with fibro-osseous lesions, and 28 patients with parameningeal rhabdomyosarcoma. The follow-up period was at least 1 calendar month. Results. A comparative analysis of the efficacy of preliminary diagnosis of parameningeal tumors depending on the nosology was described; analysis of patient safety during the intra- and postoperative periods, postoperative adaptation, surgical radicality and survival analysis according to the surgical treatment method was performed; algorithm for the management of patients with parameningeal tumors was described. Conclusion. It is advisable to introduce the algorithm developed by the authors into routine clinical practice to optimize medical care for children and adolescents with parameningeal tumors. Key words: children, tumors, parameningeal site, surgical interventions, juvenile angiofibroma, juvenile ossifying fibroma, rhabdomyosarcoma

Objective. To assess the structure of thyroid pathology in young elite athletes, depending on sex and type of sports. Materials and methods. The study included data from outpatient records of members of national sports teams, who underwent a comprehensive medical examination. Data of a random sample of 2307 outpatient records of young athletes in 26 sports were analyzed. Results. The prevalence of thyroid pathology in young elite athletes was 22.5%. Thyroid focal changes were detected in young athletes in 13.74% of cases; chronic autoimmune thyroiditis and subclinical hypothyroidism – in 4.2% and 3.85%, respectively. The frequency of single-node non-toxic goiter was 1.21%. Subclinical hypothyroidism was more often detected in combat and speed-power sports, while thyroid focal changes were more common in cyclic sports, team sports and complex-coordination sports. Nodular goiter was most often diagnosed in athletes engaged in cyclic sports. Conclusion. Young elite athletes are characterized by a high frequency of thyroid diseases. The features of the structure of thyroid pathology in certain sports were revealed. Further studies are needed to identify factors contributing to the development of thyroid diseases in young elite athletes. Key words: children, elite sports, endocrine pathology, thyroid diseases.

Introduction. Fecal incontinence of various origins still remains a complex medical and social problem that reduces both the quality of life and the chance of child’s full integration into the modern society. Antegrade enema, originally described by Malone, consists of creating an appendicostomy or neoappendicostomy of the ileum, which allows to irrigate the entire colon in order to empty the colon and rectum. As a result, children stay clean from 24 to 72 hours. Thus, surgical intervention can significantly improve the quality of life of children suffering of incontinence. Laparoscopic access minimizes surgical trauma and shortens rehabilitation period.Purpose. To analyze the obtained outcomes after treating children with laparoscopic umbilical appendicostomy.Material and methods. We report our own results obtained after performing laparoscopic umbilical appendicostomy in 3 children at the Federal Scientific and Clinical Center for Children and Adolescents, FMBA of Russia. Two children had neurological disorders of the pelvic organ; the third child suffered a severe combined injury, which led to the development of gross scarring changes in the sphincter area with a complete loss of its contractility. All children underwent laparoscopic umbilical appendicostomy. The article describes in detail all the stages of preoperative preparation and surgical intervention.Results. The duration of surgery ranged from 60 to 80 minutes. An appendicostomy intubator was left for 1 month in all cases. Hospital stay ranged from 8 to 11 days. The catamnesis was traced for 3–7 months. Therapeutic effect was assessed by children’s parents as satisfactory; the child remained clean for 12–18 hours, which contributed to socialization and significantly improved the quality of life. Conclusion. Performing laparoscopic umbilical appendicostomy is a relatively affordable technique. Our own experience has proven its effectiveness. Laparoscopic access minimizes surgical trauma, reduces rehabilitation time, and brings excellent cosmetic results. Malone surgery in children should be considered as a method of choice.

Introduction. After an infection with the SARS-CoV-2 virus, in some cases, the so-called post-covid syndrome is formed, which includes conditions and symptoms that develop during and / or after the disease, lasting more than 12 weeks, occurring in waves or on a permanent basis, and without a confirmed alternative diagnosis. Vegetative, psycho-emotional disorders, as well as disorders of the cardiovascular system, digestive and some others can be considered as manifestations of the post-covid syndrome. The variety of clinical manifestations of post-COVID syndrome in children can have a significant impact on their quality of life (QoL).Aim. To estimate the quality of life of children aged 5 to 17 years after COVID-19.Materials and methods. The study included 92 children aged 5 to 17 years, divided into two groups. The study group included 62 children (31 boys, 31 girls; mean age 12.0 (7.4; 14.5) years) after a new coronavirus infection. The control group consisted of 30 children who had acute respiratory tract infection of a different etiology and did not have COVID-19 (16 girls and 14 boys; mean age 12.5 (7.5; 15.1) years). The assessment of QoL in children of the study groups was carried out using the Russian version of the PedsQL 4.0 questionnaire. Parental and child forms of the questionnaire were used.Results. The average follow-up period after a coronavirus infection was 6 months (from 3 to 12 months). 92 patient questionnaires were analyzed: 14 in the group of children 5–7 years old, 36 in the group of children 8–12 years old, 42 in the group of children and adolescents 13–17 years old, and 14 parental questionnaires in the group of children 5–7 years old. The indicators of the quality of life of children after COVID-19 were statistically significantly reduced compared to the control group in all age groups. Differences in the assessment of the quality of life by preschool children and their parents were revealed.Conclusions. A significant decrease in the life quality was revealed in children with COVID-19 history after six months (3–12 months) of the disease manifestation in comparison with control group.