[Normal values of temporal parameters of ECG in children according to results of clinico-epidemiological study ECG-screening of children and adolescents in Russian federation].

In order to obtain reliable information about time-domain ECG parameters in Russian children and to analyse their links with physiological changes the Project "ECG screening of children and adolescents of the Russian Federation" was carried out in 2003-2008. Time domain ECG parameters were studied in the representative sample of 5387 healthy individuals aged 0 to 18 years. In each age group, lower and upper limits of the norm for heart rate (HR), P wave, PQ and QRS intervals were defined as 2nd and 98th percentiles of their distribution. The equivalent limits of QT interval duration were defined as its 5th and 95th percentiles. Relationship between time domain parameters of pediatric ECG and HR was analyzed as well as relationship of these parameters with sex and age. The most important differences from prior pediatric studies completed 30 years ago were obtained for the heart rate limits. Among children aged 0 to 3, there was a tendency toward lowering of age-specific lower limits and elevation of age-specific upper limits. At ages older than 3 years, there was a tendency toward lowering of both the upper and the lower limits of HR. The newly obtained 2nd percentiles of the heart rate were lower than the known lower limits in nearly all ages. This indicates the necessity for revision of criteria of bradicardia in children. The present study showed that 5th and 95th percentiles of QTc interval (Bazett's formula) varied between 340 ms and 465 ms and were not significantly dependent on children's age and only for ages under 13 also on sex. Results of the study allowed to build age-specific ranges of norm for the time domain ECG parameters presented in a tabular form.

[Current trends of cardiovascular morbidity and mortality of children in Russian Federation. Structure of cardiac pathology in childhood]. / Sovremennye tendentsii serdechno-sosudistoi zabolevaemosti i smertnosti u detei v Rossiiskoi Federatsii; struktura serdechnoi patologii detskogo vozrasta.

Analysis of structure and prevalences of cardiovascular diseases among children and adolescents is presented and recent trends of cardiovascular morbidity and mortality as well as regional differences in dynamics of these parameters in this age group are discussed. Current situation is characterized by pronounced lowering of age of onset of cardiovascular diseases previously considered as diseases of the adult. Clinical picture and prognosis of many pathological states also has been changed. Since the beginning of the nineties steep rise (more than 2 fold) of morbidity and total number of children with cardiovascular pathology has occurred. This is directly linked with improved diagnostics. While all cause and infant mortality becomes lower cardiovascular mortality remains stable and even has tendency to increase. Mortality from cardiac and vascular diseases is significantly lower in regions with higher prevalence of these states. Substantial effect on lowering of mortality produces intensity of work of specialized services providing timely diagnosis, treatment and rehabilitation of children with heart diseases. The authors suggest some parameters allowing to assess progressive or negative trends in development of specialized care of children with cardiovascular pathology.

[Psycho-autonomic correlations in neurocirculatory asthenia in young age]. / Psikhovegetativnye sootnosheniia pri vegetososudistoi distonii v iunosheskom vozraste.

As many as 91 patients aged 17-25 years seen at the students' outpatient hospital for autonomic disorders, namely for vegetovascular dystonia (VVD) were examined. The data of somatovegetative and psychiatric examinations were compared. It has been shown that the symptomatic diagnosis of VVD may mask both vegetative lability common to the mentally normal and practically healthy subjects and vegetative dystonia syndrome proper, which is a component of psychovegetative syndromes. The statistically significant diagnostic somatovegetative and electrophysiological signs were distinguished, which make it possible to supposedly distribute groups with psychopathological syndromes and mentally healthy subjects.

[Clinico-psychopathologic and somato-autonomic studies of functional hyperthermia in adolescents]. / Kliniko-psikhopatologicheskoe i somatovegetativnoe issledovanie funktsional'nykh gipertermii u podrostkov.

In a non-psychiatric clinic a combined psychiatric and somato-autonomic investigation was performed in 75 prepuberty and puberty children with functional hyperthermia . Syndromal and nosological characterization was performed on a spectrum of psychic disorders in these patients. Some correlations were found between syndromal and nosological distributions and grouping based on somato-autonomic++ picture.

[Psychoautonomic syndrome in non-infectious subfebrile conditions in children]. / Psikhovegetativnyi sindrom pri neinfektsionnykh subfebrilitetakh u detei.

To ascertain the cerebral organization and the importance of its specific levels in the occurrence of the thermopathological syndrome associated with vegetovascular dystonia, 40 children aged 8-15 years with non-infectious subfebrile conditions of long standing were examined. The children's status was marked by polysystemic shifts common to the neurogenous disorders. Of crucial significance was dysfunction of the structures of the suprasegmental level (the limbic-reticular complex) of vegetative regulation with the involvement of the specialized hypothalamic centers of thermoregulation, with excessive sympathetic influences at the periphery and formation of the psychovegetative syndrome. An individual analysis of the psychovegetative syndrome makes it possible to define the contribution of the concrete endo- and exogenous factors to the pathogenesis of non-infectious subfebrile conditions and to develop a differential approach to the treatment.

[Functional status of the cardiovascular system of adolescents with a hereditary predisposition to atherosclerosis]. / Funktsional'noe sostoianie serdechno-sosudistoi sistemy u podrostkov s otiagoshchennoi nasledstvennost'iu po aterosklerozu.

A study of 70 teenagers between 11 and 15, whose parents had suffered, before they were 45, myocardial infarction in the presence of verified coronary arterial atherosclerosis, revealed no organic cardiac changes, while some signs of neurocirculatory dystonia were combined with increased incidence of coronary risk factors and dyslipoproteinemia.

[Status of cerebral structure and hemodynamics in healthy children and those with autonomic-vascular dystonia]. / Sostoianie tserebral'nykh struktur i mozgovoi gemodinamiki u zdorovykh detei i detei s vegetososudistoi distoniei.

From the standpoint of traditional neurology an attempt has been made to evaluate the function of the cerebral structures in 50 children with vegetovascular dystonia and 30 normal ones. On the basis of the data obtained a working hypothesis is advanced about a special role of the defect in the right cerebral hemisphere in the pathogenetic mechanisms of hypertension in the presence of vegetovascular dystonia.