George A. Karkashadze's research while affiliated with Pirogov Russian National Research Medical University and other places

Background. Despite the fact that the study of the olfactory system is still difficult, the detection of dysosmia is promising for the diagnosis of a number of diseases. As a screening method, tests for the identification of various odors can be used. However, similar tests are developed and used for adults. In pediatrics, the use of such methods causes difficulty due to the cognitive and linguistic functions of the child, which are in the stage of development. Aim — to study olfactory function in children using an identification test. Methods. A diagnostic prospective study of 30 healthy children with no complaints of decreased olfactory function, living in the middle zone of the Russian Federation, mainly in the Moscow Metropolitan area, aged 11 to 14 y.o. was held. All children underwent a study of olfactory function using the University of Pennsylvania Smell Identification Test (UPSIT). To control all children, olfactometry was performed using a patented method for assessing the thresholds of olfaction in children, based on the use of various concentrations of aqueous solutions of valerian tincture, ammonia and acetic acid. Results. In the study of sense of smell with the help of an UPSIT test, hyposmia was detected in 30% of children, which was not confirmed later with the help of a threshold test. At the same time, when presenting some odorants, most of the answers were incorrect. Conclusions. The use of olfactory tests developed for adults in children does not reflect the real state of the olfactory system. It is required to create kits for the study of the olfactory function specifically for the children’s category of patients.

Background. The COVID-19 pandemic is a global challenge to States and health systems. The pandemic and its consequences can have a devastating impact on the health and development of children, especially those in vulnerable situations — children with disabilities. The aim of the study is a medical and social assessment of the effect of the COVID—19 pandemic and its consequences on families with children with disabilities. Methods. A descriptive study using the Google forms platform was conducted using the cross-sectional method. Two groups of parents of children aged 0–17 years with disabilities (group 1) and without disabilities (group 2) who apply to a medical organization for preventive examinations were interviewed. Results and discussion. A total of 175 electronic questionnaires were received. Parents from 46 regions of Russia participated in the survey. A significant majority of respondents were women — 172 people (98%), 3 men (2%). More than half of the respondents are residents of the megalopolis. The study showed that the COVID-19 pandemic had a negative impact on the health and education of children and on the lifestyle and families welfare in general. It was revealed that the financial situation of many families who took part in the study worsened, which affected the living conditions of children. During the COVID-19 pandemic, the health care system was being rebuilt taking into account new tasks to counteract dangerous infection, which was reflected in changes in the provision of medical care to children, and in some cases this led to a deterioration of their health. A significant number of parents who participated in the study believe that changes in the organization of medical care during the pandemic had a negative impact on their child’s health. Among the main health problems, parents highlight delays and cancellations of medical consultations, difficulties in obtaining urgent care and problems with drug provision. Among the main health problems, parents highlight delays and cancellations of medical consultations, difficulties in obtaining emergency care and problems with drug provision. The study shows that families with disabled children have been affected by the COVID-19 pandemic to a greater extent than families raising children without chronic health problems. If the deterioration of the financial situation is almost equally revealed in both groups, then problems related to medical care and education have a more noticeable impact on families with a child with a disability. The obtained results should be taken into account in times of new challenges when developing measures of state support for families with children, especially with children with disabilities. At the same time, it is important to pay primary attention to the organization of medical care for children (continuity of planned medical care for the child population and rehabilitation actions) and educational services (providing online learning opportunities for the child, taking into account individual ones). Conclusion. The COVID-19 pandemic and its consequences have had a negative impact on the standard and quality of life of people, especially families with children. The pandemic has had a significant adverse impact on the health and development of children, especially children with disabilities. The study showed a decrease in the financial situation of families, problems with children receiving medical care, difficulties in education, especially with regard to specialized pedagogical classes with disabled children, during the pandemic. According to the study, in order to prevent the negative impact of the pandemic, it is proposed not only to provide financial support to families, but also to maintain access to the educational process with the provision of the required devices, as well as the possibility of receiving medical care for children, especially children with disabilities, including planned.

Background. One of the four important components of the formation of cognitive functions is somatic health. But to date, there are no population studies that consider the relationship with cognitive functions and school performance of a large range of somatic factors, which allows us to compare the strength of their hypothetical contribution to cognitive functioning with each other. This study is the second part of a population-based study, the first part of which is presented in the previous publication "A Single-Stage Population-Based Study of the Prevalence of Mild Cognitive Impairment in Children of Secondary School Age". Aims — to determine the main patterns in the relationship between cognitive-academic and somatic factors in a cohort of Russian children, 5th grade students at school. Methods. In Russian schoolchildren of the 5th grades of municipalities representing cities of all federal districts of the Russian Federation, the links with integrative cognitive success, the number of subtests performed at the level of mild cognitive impairment, the results of individual cognitive subtests, academic performance and the leading hand factor were analyzed — the following somatic factors: the presence of skin pathology, bronchial asthma, orthopedic, ophthalmological disorders, visual acuity, body mass index, parameters of the study of the function of external respiration, electrocardiography, ultrasound examination of the thyroid gland, laboratory blood tests. Results. The results of the survey of 1036 participants, 51% of them girls, were admitted to the analysis. It has been established that iron content is directly related to integrative cognitive success and school performance, the relationship is especially strong between subgroups of iron content above and below 26.4 mmol/l. Clinical levels of erythrocytes are more strongly associated with integrative cognitive success and individual cognitive functions than other factors: in erythropenia cognitive parameters are worse. The presence of thyroid cysts directly correlates with some of the worst parameters of cognitive activity. High body mass index and low hemoglobin are associated with poorer academic performance. Conclusions. The results of the study for the first time on a cohort of Russian schoolchildren showed a connection with cognitive activity and school performance of a number of somatic factors, including iron content, which requires further in-depth study.

The use of magnetic resonance imaging in morphometry, as quantitative assessment of brain parameters (thickness, surface area, volume), allows to detect changes in many neuropsichiatric conditions that were previously considered intact. This article provides data on neuroimaging brain morphometry and effective use of this method in neurosciences.

Dyslexia (disturbance of reading) and dysgraphia (disturbance of writing) are a common problem of teaching children in secondary schools. Information on the prevalence of these conditions is ambiguous, the data presented in the Russian speech therapy literature differ from the results of a few foreign works, and therefore population studies are becoming particularly relevant. The review of the domestic methodological base with the prospect of application in population research and international approaches to population screening are presented.

Background: Various mild cognitive impairments in children are socially significant disorders that are often found in the practice of pediatric neurologists, but the apparent lack of epidemiological data does not allow us to judge the scale of the problem. Aims: The aim of the study was to assess the prevalence of combined mild cognitive disorders in a large cohort of Russian children, 5th grade students at school. Materials and methods: The results of the examination of Russian schoolchildren of municipalities representing cities of all federal districts of the Russian Federation (RF) are analyzed. Cognitive functions were tested, which consisted of six subtests. According to the results of testing, using the method of assessing cognitive functions in population studies, the frequency of assigning participants to a high-risk group of combined mild cognitive impairment and the probability of diagnosis of combined mild cognitive impairment were evaluated. The analysis of the links between the breadth of results performed at the level of mild cognitive impairment, integrative cognitive success, the results of individual cognitive subtests with academic performance and the leading hand factor was carried out. . Results: 1,067 5th grade students at school were included in the study, 1,036 participants completed it, 51% of them girls. Belonging to the cluster of integrative cognitive successes and representation of the leading hand had no gender differences, subtests for visual-spatial perception/memory and constructive practice were better performed by boys (p 0.001 and p = 0.020), and girls, as a rule, performed better subtests for verbal-logical thinking and voluntary activity. attention (p = 0.050 and p = 0.051). According to the results of cognitive testing, a high risk of combined mild cognitive impairment was detected in 30.2% of the examined, and the probability of diagnosis of combined mild cognitive impairment was 7.5%. It was found that of the studied factors, the breadth of the results obtained at the level of moderate cognitive impairment and the effectiveness of the verbal-logical thinking subtest are more related to academic performance. At the same time, the strength of these ties was very moderate. The image of the leading hand was in no way associated with cognitive factors, including academic performance at the level of moderate cognitive impairment, but left-handedness was partially associated with better academic performance in literature. Conclusions: The results of the study, conducted for the first time on a multi-regional cohort of Russian schoolchildren, demonstrated a wide scale of the potential prevalence of mild cognitive impairment in children, and also revealed a number of patterns in the neurobiology of cognitive development.

Congenital aniridia manifests with total or partial absence of the iris. The association of the disease with the PAX6 gene has been proven. Changes in the PAX6 structure lead to intrauterine pathology, visual organ malformation, malformation of master regulator proteins of organogenesis affecting various cells’ differentiation (central nervous system cells included). Such disorders result into the development of PAX6-associated syndromes with various brain malformations, neurological disorders, and systemic pathology (thyroid pathology, Wilms tumor, glucose intolerance). Isolated congenital aniridia is also accompanied by psychoneurological disorders. It can be associated with brain structures’ disorders during embryogenesis and with impact of external stress factors on the child (frequent medical checkup, surgical treatments). The psychoneurological disorders’ pathogenesis as well as congenital aniridia’s genetic mechanisms remain unclear. Thus, it is crucial to review new relevant data within the context of previously obtained information to gather full picture of the clinical signs of the disease and to improve the management of children with congenital aniridia.

Background. The study of digital activity correlation with cognitive-emotional features, as well as with other parameters of adolescents’ life-activity in non-capital regions of Russian Federation remains relevant. Objective. The aim of the study is to analyze the digital activity structure in adolescents and its correlation with cognitive-emotional features, school performance and social and age factors. Methods. Participants are secondary school students of the 8th–11th grades. Digital activity was examined via online survey among adolescents. We took into account the use of social media, information search, watching videos on the Internet, using of messengers, playing games with electronic devices. Cognitive features (memory, thinking, executive functions, sensory information procession, reading and speech, understanding of emotions, decision-making) and emotional state of adolescents (anxiety) were evaluated by clinical psychologists via various tests. School performance was determined by the recent results of the school quarters/semester finished by the time of the survey. Social and age factors included regular out-of-school physical activity and family structure (complete/ incomplete). Results. We have examined 438 teenagers. 53 (12%) respondents spend more than 5 hours a day with digital devices on weekdays, 133 (30%) — on weekends, 147 (34%) — during the holidays. Structure of digital activity during weekdays (≥ 1 hour) among adolescents was the following: activity in social media prevailed (63.5% of respondents), fewer teenagers searched for information or watched videos on the Internet (47.3 and 42.9%, respectively), about a third (34.9%) played via electronic devices. Structure of digital activity changed over the weekend and during the holidays. We have revealed differences between the information search activity and the volume of short-time memory, understanding the verbal messages, and verbal-logical operations level. Adolescents with different levels of computer gaming activity have shown diversity in sensomotor reaction speed, visuospatial memorization accuracy, number of errors in high-speed reading, reading pace, and understanding text basic meaning. Conclusion. The greater time of digital activity among 8th–11th grades students is associated with negative results of cognitive activity and school performance.