[Moscow schoolchildren's morbidity in the past 50 years].

The paper analyzes morbidity among Moscow schoolchildren in the past 50 years on the basis of the results of in-depth studies of pupils by the researchers of the Research Institute for the Hygiene and Health Care of Children and Adolescents. There is a significant reduction in the number of absolutely healthy children, the proportion of which is 2-4%. There is a considerable increase in the prevalence of dysfunctions and chronic diseases among schoolchildren. Particularly high increment rates of morbidity were observed in the 1990s. The morbidity structure has changed in the past 50 years. Both biomedical and psychosocial factors are responsible for changes in the morbidity levels and structure of children and adolescents.

[Methodological approaches to the assessment of pathological processes dynamics in schoolchildren based on the results of preventive examination].

Analysis of prevalence of various functional disorders and chronic diseases diagnosed in children and adolescents during comprehensive prophylactic examination in educational institutions does not provide complete information about health tendencies because the same statistical data may reflect both favourable development of a pathological process and its deterioration. Such information can be obtained by thorough analysis of complaints, medical histories and catamnestic observations, fulfillment of the complete range of regimented clinical examinations. An algorithm and criteria for characterization of a pathological process as "improving", "worsening" or "unaltered" were developed for different nosological forms and classes of diseases in 2006. It was shown that stage by stage differential assessment of pathological processes and functional disorders in junior and senior schoolchildren in different periods of their development during school years yields new data on different phases of adaptation, occurrence of its favourable and unfavourable outcomes; also, it permits to identify schoolchildren in need of urgent curative and preventive aid.

[The health status dynamics of schoolchildren and the importance of biomedical factors in its development]. / Dinamika sostoianiia zdorov'ia detei shkol'nogo vozrasta i znachenie mediko-biologicheskikh faktorov v ego formirovanii.

The dynamics in schoolchildren's health status varies in time, as the incidence of some chronic diseases decreases and that of the others increases. As a result, the health status of schoolchildren has deteriorated due to a reduction in the number of healthy children and an increase in the number of chronic patients in the past 30 years. Nervous, immune (allergic), and blood diseases have become frequent. Chronic ENT diseases have been encountered more infrequently due to the noticeable reduction in the incidence rates of tonsillitis and otitis. The positive trend is that schoolchildren have no rheumatism, infective allergic myocarditis, chronic pneumonia and diffuse glomerulonephritis and that the prevalence of locomotor disorders, renal and metabolic (obesity) diseases is low. During school time, the health status of children slightly improves due to the lower incidence rates of chronic diseases and the higher proportion of healthy children, but it has remained still worse than it was 30 years ago. The formation of chronic diseases has been found to occur in health group II children, who have morphological and functional changes, in 50% of cases from the first to the sixth forms and in 20% of cases from the seventh to the tenth forms. The present-day children are characterized by a combination of abnormalities and functional disturbances. This all require active and timely prophylactic measures to block chronization at the premorbid stage. Lifestyle (to keep the hygienic school regime, to do exercises and to go in for sports), sociohygienic conditions and genetic factors have profound effects on the health status.

[Significance of hormonal studies in the assessment of the health status of children and adolescents]. / Znachenie gormonal'nykh issledovanii v otsenke sostoianiia zdorov'ia detei i podrostkov.

Hormonal studies into adrenal function were carried out in 500 children and adolescents. Comparatively high correlation ratios attest to the relationship between androgenous and glucocorticoid functions of the adrenals and indicators of the physical, sexual development and osseous age. In the muscular type of constitution, the reserve possibilities of the adrenals appeared to be the most powerful as compared to those seen in the thoracal and digestive types, which is conductive to the least development of the lymphoid and throat ring and the least disease incidence. In children and adolescents engaged in sports swimming, favourable reactions of the adrenals were demonstrable in 50% of cases, pointing to the presence of the reserve possibilities of androgenous and glucocorticoid functions which should be taken into consideration on exercise indication. As influenced by the total school load throughout the entire school year, glucocorticoid function of the adrenals deteriorated 1.5-fold, this is accompanied by the astheno-neurotic manifestations and hypotension. All these facts should be taken into account in the assessment of the health status and undertaking preventive measures.