Aim. To assess the nutritional consumption of rubidium in the adult population of the Omsk Region.

Materials and Methods. Here we performed a cross-sectional study which included 421 individuals (177 men and 244 women) aged 18 to 83 years (median age 37 (23; 57) years). Rubidium consumption was determined by analysing the frequency of food intake and chemical composition of food consumed by the population of the Omsk Region.

Results. Median daily rubidium intake was 1.1 mg/day (0.81; 1.48) that sufficiently exceeds minimum recommended dose (0.1 mg/day). We defined the reference range of rubidium intake as 1.1 (0.71 – 1.71) mg/day. Rubidium consumption tended to increase along with the population age, albeit no significant differences have been found between different age groups as well as between men and women. The most abundant rubidium sources were vegetables (55.6%) and beverages (29.6%). Among vegetables, the main sources of rubidium were onion (31.7%) and fresh tomatoes (20.7%), while tea was responsible for the majority (84.6%) of rubidium consumed from beverages. The proportion of vegetable-derived rubidium increased with age, in contrast to beverage-derived rubidium which demonstrated an opposite trend.

Conclusion. The reference range of rubidium intake in the Omsk Region is 1.1 (0.71 – 1.71) mg/day. Rubidium intake does not depend on age and gender. The main sources of rubidium are vegetables and beverages.

Aim. To perform a screening for molecular markers of cardiac fibrosis upon myocardial infarction.

Materials and Methods. We carried out echocardiography-guided endomyocardial biopsy of affected and intact interventricular septum segments of 7 patients with anterior myocardial infarction. Fibrotic and adjacent intact cardiac tissue was dissected into 2 equal segments and: 1) homogenized with the further RNA extraction, reverse transcription, and quantitative polymerase chain reaction; 2) fixed in formalin and embedded into paraffin with the further van Gieson staining for the histological verification of cardiac fibrosis.

Results. We found that the expression of ACTA2, VIM, CTGF, COL1A1, TGFB1, TGFBR1, AGTR1, CCL2 and TNF genes in fibrotic cardiac tissue was ≥ 3-fold higher as compared with the adjacent intact myocardium reflective of active extracellular matrix production by fibroblast-derived myofibroblasts.

Conclusion. We have for the first time shown AGTR1, CCL2, and TNF genes as candidates for post-infarction cardiac fibrosis in addition to ACTA2, VIM, CTGF, COL1A1, TGFB1, and TGFBR1 genes.

Aim. To assess the frequency of late HIV diagnosis among newly diagnosed HIV cases in 2019 and to determine associated risk factors.

Materials and Methods. The study included data from 1073 adult patients who lived in the Tatarstan Republic and were first diagnosed with HIV infection in 2019. Criteria for late HIV diagnosis were the presence of stage 4 HIV-infection (AIDS) and/or < 200 CD4+ cells per mm³ at the time of diagnosis. The influence of various factors on the timeliness of diagnosis was carried out using binary logistic regression and adjusted odds ratios (aOR) with 95% confidence intervals (95% CI).

Results. Late diagnosis was documented in 37.7% of HIV infection cases. Clinical examination was associated with late diagnosis in comparison with a preventive examination (aOR = 2.06; 95% CI = 1.40–3.02). The age of ≥ 50 years was associated with late diagnosis in comparison with 30−49 years age range (aOR = 2.18; 95% CI = 1.41–3.37). Vice versa, the age of < 30 years was associated with timely diagnosis as compared to 30−49 years age range (aOR 0.44; 95% CI = 0.30–0.68). Living in urban areas has been associated with late HIV diagnosis (aOR = 1.470; 95% CI = 1.002–2.153) in comparison with living in rural areas.

Conclusion. The factors associated with the late HIV diagnosis were examination for clinical indications, age ≥ 50 years, and living in urban areas. For curbing the HIV epidemic, it is necessary to expand the HIV screening to all population groups, especially elderly.

Aim. To assess the impact of homeostasis parameters on risk of prostate cancer.

Materials and Methods. The study included 108  patients with urologic diseases and with (n = 54) or without (n = 54) prostate cancer. Median age in both groups was 67 (interquartile range 64-73) years. Clinicopathological data and blood test results have been collected from outpatient and inpatient records. In particular, we measured serum levels of total testosterone and prostate-specific antigen.

Results. Risk factors for prostate cancer include increased total cholesterol (p = 0.023), low-density lipoprotein cholesterol (p = 0.035), total triglycerides (p = 0.048), and total testosterone (p = 0.002). High levels of total testosterone directly correlated with the tumor stage (r = 0.56). The concentration of prostate-specific antigen correlated with the lipid parameters and remained a reliable diagnostic criterion (p = 0.002).

Conclusion. The association of hyper/dyslipidemia with prostate cancer provides an opportunity to improve its prevention by routine lipid screening in high-risk groups.

Aim. To reveal the associations of IgA antibodies to benzo[a]pyrene, estradiol and progesterone (IgA-Bp, IgA-Es, IgA-Pg) with the conversion of estrogen-receptor positive (ER+) into estrogen-receptor negative (ER-) tumors during breast cancer progression.

Materials and Methods. Having collected serum samples from 338 healthy volunteers and 1407 breast cancer patients, we have profiled them for IgA-Bp, IgA-Es, IgA-Pg by means of enzyme-linked immunosorbent assay. Conjugates of bovine serum albumin with Bp, Es and Pg were used as adsorbed antigens and anti-human IgA horseradish peroxidase-conjugated antibodies were used for the detection of specific antigen-bound antibodies. Individual IgA-Bp/IgA-Pg and IgA-Es/IgA-Pg ratios were calculated. Estrogen receptor phenotype was determined using immunohistochemistry.

Results. Low IgA-Bp/IgA-Pg ratios (≤ 1) in combination with low IgA-Es/IgA-Pg ratios (≤ 1) indicative of protective immunophenotype were more frequently revealed in healthy women (43.8%) in comparison with stage 1 breast cancer patients with ER+ (12.9%) and ER- (23.9%) tumors. High IgA-Bp/IgA-Pg ratios (>1) with high IgA-Es/IgA-Pg ratios (>1) suggestive of pro-carcinogenic immunological phenotype were less often detected in healthy women (27.5%) as compared with stage 1 breast cancer patients with ER+ (65.5%) and ER- (58.7%) tumors. Prevalence of protective and pro-carcinogenic phenotypes significantly differed in stage 1breast cancer patients with ER+ and ER- tumor phenotypes (p = 0.017). ER- tumor phenotype was more prevalent at II-IV tumor stages (25.6%) than at the stage 1 (16.3%). Conversion of ER+ to ER- tumors reflecting the breast cancer progression was characteristic for the patients with pro-carcinogenic immunological phenotype (p<0.0001).

Conclusion. Detection of antibodies against Bp, Es and Pg may be applied as a risk marker of breast cancer development and progression.

Aim. To evaluate the activity of the 4-1BB/4-1BBL signaling pathway in patients with influenza A (H1N1) virus-associated pneumonia.

Materials and Methods. Here we enrolled 85 patients (41 males and 44 females, median age 48 (36-62) years) with influenza A (H1N1) virus-associated pneumonia. Among the exclusion criteria were unstable hemodynamics, BMI > 30, diabetes mellitus, HIV, tuberculosis, and cancer. Control group consisted of 15 healthy donors. The diagnosis of influenza A / H1N1 was confirmed by a positive PCR test. Pneumonia was diagnosed according to the Federal Clinical Guidelines «Community-acquired pneumonia in adults». Severity of pneumonia was evaluated by using CURB-65 and SMART-COP scales as well as IDSA/ATS criteria. Plasma concentration of 4-1BB (CD137 or TNFRSF9, an inducible costimulatory receptor expressed on activated T cells and antigen-presenting cells) was determined by flow cytometry.

Results. Patients with moderate and severe influenza A (H1N1) virus-associated pneumonia had 1.5- and 2.4 fold-increased concentration of plasma 4-1ВВ as compared with the healthy controls.

Conclusion. The 4-1BB/4-1BBL signaling pathway, involved in multiple immune reactions, is associated with the severity of influenza A (H1N1) virus-associated pneumonia.

Aim. To assess inflammatory markers and organ dysfunction in patients with severe influenza A (H1N1) virus-associated pneumonia.

Materials and Methods. The study included 50 patients (median age 47 (38-62) years, 24 males and 26 females) with severe influenza A (H1N1) virus-associated pneumonia. We analysed the clinicopathological data as well as complete blood count and biochemical profile. Organ dysfunction was assessed using SOFA and qSOFA scales.

Results. The prevalence of multiple organ dysfunction syndrome in patients with severe influenza A (H1N1) virus-associated pneumonia was 46% (23/50 patients). Patients frequently suffered from insufficient oxygenation, impaired coagulation, altered haemodynamics, and central nervous system dysfunction. Out of 23 patients with multiple organ dysfunction syndrome, 10 (43.5%) suffered from reduced oxygenation and excessive coagulation, while 6 (26.0%) had all mentioned syndromes combined. Thrombocytopenia was detected as early as at day 1-2 of the disease and was further accompanied by an increase in the erythrocyte sedimentation rate and white blood cell count from day 2 to day 8. An increase in acute-phase proteins (C-reactive protein and fibrinogen) was noted at the day 5-6 of the disease.

Conclusion. In patients with severe influenza A (H1N1) virus-associated pneumonia, an early systemic inflammatory response evolves into an uncontrolled multiple organ dysfunction syndrome by day 7-8 of infection.

Aim. To perform a systematic analysis of COVID-19 adverse outcomes in patients with tuberculosis.

Materials and Methods. We queried PubMed, Cochrane Library, Embase, ClinicalTrials.gov, medRxiv, bioRxiv, and Elibrary databases for studies on COVID-19-related mortality in patients with tuberculosis published from 2020 to 2022. We considered open randomised controlled trials, cohort, and case-control studies. Pseudorandomisation and interventional studies have been excluded from the analysis as well as those without a clear comparison group (i.e., patients without tuberculosis) and duplicate studies.

Results. Out of 23,296 hits, 10 studies were included in our review. The risk of death in patients with COVID-19 and tuberculosis was significantly higher (odds ratio = 2.24, 95% confidence interval = 1.46 – 3.43] as compared with the patients without tuberculosis.

Conclusion. Tuberculosis is associated with COVID-19-related mortality.

Aim. To evaluate the trends of vaccination against COVID-19 among pregnant women in Siberia for the period from October 29, 2021 to November 26, 2021.

Materials and Methods. The vaccination data have been collected from official records from October 29, 2021 (86,859 pregnant women) and November 26, 2021 (85,600 pregnant women) in 10 regions of Siberia.

Results. Before the pregnancy onset, as of October 29, 2021, only 4,056 (4.7%) women had past medical history of COVID-19. These numbers have significantly increased to November 26, 2021 (5,656, 6.6%, p < 0.001). The number of vaccinated pregnant women increased from 4,185 (4.8%) to 8,318 (9.7%) (p < 0.001). As of November 26, 2021, we registered a reduced proportion of women vaccinated at the preconception stage (from 4.6% to 4.0%, p < 0.001), yet the number of vaccinated pregnant women raised both before (from 0.7% to 1.3 %, p < 0.001) and after 22 weeks of pregnancy (from 1.6% to 2.3%, p < 0.001). The highest proportion of pregnant women was documented in the Tyva Republic and the Irkutsk Region (p < 0.01). Major vaccination-associated adverse events have not been reported.

Conclusions. The proportion of pregnant women recovered or vaccinated from COVID-19 increased from October 29, 2021 (16.4%) to November 26, 2021 (23.9%); however, this rate is clearly insufficient to reach herd immunity and reduce maternal mortality from COVID-19.

Here we review the recent literature on pelvic floor dysfunction, which is increasingly common in women of reproductive age and represents a significant medical problem occurring as a result of injured pelvic floor ligaments. Pelvic floor dysfunction is largely associated with vaginal delivery and might lead to urinary and fecal incontinence as well as pelvic organ prolapse. Intraabdominal hypertension, nerve damage, obesity, and genetic predisposition are among the major contributors to pelvic floor dysfunction. Being asymptomatic at the early stage, pelvic floor dysfunction gradually leads to the irreversible alterations in pelvic floor anatomy, ultimately deteriorating quality of life. Surgery remains a gold standard in the treatment of pelvic organ prolapse, yet POP-Q stage I-II prolapse should be treated conservatively. Currently, there are no specific treatment regimens and no evidence-based opinion regarding Kegel exercises and laser therapy. Biofeedback pelvic floor muscle training is the treatment of choice for urinary incontinence. Use of pessaries represents another efficient approach to conservative treatment.

Mutations represent a natural mechanism for adaptation of species to changing environmental conditions. Chromosomal rearrangements play a pivotal role in the evolution, as evidenced by the comparison of human and non-human primate karyotypes, and have diverse clinical consequences. In most cases chromosomal aberrations are compatible with life, yet their carriers might show a variety of mental and physiological abnormalities and malformations. Albeit chromosomal rearrangements often do not affect the health and reproductive ability, offspring of their carriers still have a high risk of inherited disorders. Most notably, chromosomal aberrations strongly correlate with cancer risk. When unbalanced, chromosomal abnormalities are associated with reduced life expectancy and reproductive potential. In this lecture, we analyse the mechanisms of chromosomal aberrations, review their diversity, and describe significant clinical consequences such as inherited syndromes which are illustrated with images of patients' karyotypes. The lecture is primarily aimed at biomedical students, researchers and physicians who often have an unmet need to analyse and interpret the results of cytogenetic analyses.