Objective. To determine the spectrum and prevalence of sleep and sleep-related breathing disorders and the daytime/nighttime patterns associated with them in elementary school children. Patients and methods. A questionnaire was administered to parents of 262 schoolchildren aged between 7 and 10 years (142 boys and 120 girls). It comprised 76 questions on the features of nighttime sleep, factors influencing its disorders, as well as on complaints about various sleep and sleep-related breathing disorders. Signs of sleep disorders were assessed through verbal communication with children or were recorded by parents during their nighttime sleep. The questionnaire provided “yes”/”no”/”do not know” response options. Statistical analysis included the frequency analysis of sleep disorders and sleep complaints. The analysis was performed using Python software libraries: pandas 1.4.3, scipy.stats 1.8.1. Results. According to the results of the questionnaire, 46% of elementary school children had from 2 to 11 different complaints about sleep, and these were mainly 9-10-year-old children. The most frequent complaints were difficulty falling asleep (19%), sleep talking (18%), and nightmares (12%). Short sleep duration was noted in every fifth child due to late bedtime (р < 0.001) and early awakening (р < 0.001). It was significantly associated not only with fatigue, irritability, reduced cognitive performance, but also with indirect signs of sleep-disordered breathing: excessive morning thirst (р = 0.019) and morning dry mouth (р = 0.04). Complaints of nocturnal snoring (12% of children) and short sleep duration showed a strong correlation with frequent ARIs per year (р < 0.001, р = 0.003, respectively). Daily screen time of more than four hours was registered in 13% of children, and 51% used electronic devices predominantly before bedtime. The following waking patterns were found to be the most significant for sleep disorders: late bedtime (р = 0.004), using gadgets at night (р = 0.028), and finishing using gadgets before bedtime (р < 0.001). In addition, 31% of children took a meal before bedtime, which was significantly correlated with nightmares (р = 0.049) as one of the most frequent signs of sleep disturbance. Conclusion. Questioning elementary school children and their parents for early detection of signs of sleep disorders, prevention of ARIs, identification of children with sleep-disordered breathing and timely treatment of their causes, control over compliance with hygienic requirements for waking and sleeping regimes, especially with the recommended sleep duration, restriction of meals and using gadgets before going to bed are a set of measures for sleep normalization, promoting the development of a personalized approach to prevent a whole range of socially significant pathologies. Key words: sleep disorder, elementary school children, comorbidity, snoring, prevention

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Background.In recent years, the opinion has been established that skin manifestations of psoriasis are associated with the damage of other organs and systems, and that psoriatic lesions have a systemic nature, and therefore the term ‘psoriatic disease’ is increasingly used in scientific literature. Among psoriasis comorbidities, metabolic disorders and cardiovascular diseases are of particular clinical importance.Our aim wasto study the effect of systemic cytostatic therapy with methotrexate on the remodelling processes of large vessels in children with psoriasis who have normal and increased body mass index.Methods.The primary data was collected by extracting data from medical records and case follow-up records. The subsequent accumulation, storage, grouping and primary sorting of research data were carried out using a personal computer and Excel application package. Clinical evaluation of the severity of psoriasis and skin lesions was assessed by calculating the PASI index. Non-invasive oscillometric arteriography was performed on a portable ArterioGraph (TensioMed Ltd, Hungary).Results.A direct significant correlation has been established between the revealed impairments of the function of large arteries and the indicators of fat metabolism, the severity of psoriasis and body mass index. During the systemic pathogenetic cytostatic therapy with methotrexate, a significant positive dynamics of the function parameters of large arteries was revealed in children with psoriasis who have both normal and increased body mass index.Conclusion.The undertaken studies showed that methotrexate is an effective and safe agent for treating psoriasis in children aged from 3 to 18 years, has a positive effect on the function of large vessels.Nikolay N. Murashkin — receiving research funding from pharmaceutical companies Jansen, Eli Lilly. Receiving fees for scientific advice from Galderma, Pierre Fabre, Bayer, Astellas, Libriderm.Alexander I. Materikin — receiving research funding from pharmaceutical company Eli Lilly. Receiving fees for scientific advice from Bioderma, Libriderm.

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Background:  High mortality rates of cardiovascular disease request research revealing risk factors and early markers of cardiovascular dysfunction in children with chronic pathology.Objective:  to reveal the risk factors and early markers of night hemodynamic disorders for the development of personalized cardiovascular disease prevention in children based on the results of the combined daily monitoring of arterial pressure, ECG examination, and analysis of night sleep. Patients and methods:  Parents filled screeningquestionnaire of night sleep before the study onset. Combined monitoring and examination was performed  in 232  children aged 6–17 with different blood pressure disorders using Astrocard НS E2bp (Russia) equipment in the outpatient setting.Results: 24-hour BP monitoring identified arterial hypotension 3.8 times more often than routine ambulance method. 21% of children or every fifth child with hypotension  had night hypertension  associated  with maximum (93%) pathology  of ENT organs  with nasal obstruction. Differentiation of investigated groups by night PP and DBP show these marks of hemodynamics to be really important at the early period of pathology development in children. 62% of children had QT interval with bad adaptation to RR-interval at night. In the group with high BMI we found 1.6 times more often children with height more than 85th percentile of the norm. These children had night diastolic hypotension  5 times more often, children with obesity didn’t have normal 24-hour  BP dynamics, children with high BMI had longer QT-interval at night.Conclusions: We demonstrate the necessity of night sleep hemodynamics investigation in children for personalized cardiovascular disorder prevention. Children of early school age suffering from chronic ENT-pathology with nasal obstruction and/or high BMI, with high BMI, and with height ≥85th percentile of gender-age norm have risk of development of cardiovascular diseases.