Aim. To assess changes in health-related quality of life (HRQoL) parameters among the adult population of the Omsk region during the implementation of the Federal Project "Strengthening Public Health" as a part of the National Project "Demography." Materials and Methods. The study of HRQoL was conducted on representative quota samples, stratified by age, gender, and place of residence, in 2018 (n = 241) and similarly in 2023 (n = 506). The MOS SF-36 questionnaire was used to assess HRQoL, along with a number of visual analogue scale-based self-assessment questions concerning health. Results. HRQoL indicators showed higher values in 2023 across two scales reflecting both the physical component of health (BP – Bodily Pain, GH – General Health) and the psychological component (RE – Role Emotional Functioning, MH – Mental Health), as well as in the overall MCS scale, which characterizes the psychological health component. Among male respondents, higher values were recorded across all psychological component scales and in the two aforementioned physical health component scales. Among female respondents, improvements were observed in BP and the overall MCS scale. Self-assessed health, life satisfaction, and emotional well-being scores reported by respondents in 2023 were higher than in the previous assessment period. Conclusion. Positive changes in self-rated health assessment scales suggest a certain reassessment of health status by most of the population. Possible factors contributing to these changes include increased adaptive capacity, improved problem-solving skills, and measures implemented within the frameworks of the Demography and Healthcare National Projects.

Aim. To assess the health status of primary school stu­dents by the literature review and to analyze current direc­tions in the prevention and treatment of their diseases.

Ma­terials and Methods. We screened the relevant studies in Russian and English which were published from 2004 to 2024 using eLIBRARY.ru, CyberLeninka, PubMed, Google Scholar, Scopus and Web of Science databases. The search keywords were "primary school students", "primary school", "schoolchildren's health", "children's health", "mental health of schoolchildren", and "physical health of schoolchildren".

Results. Currently, health indicators of primary school stu­dents are still declining. Among the most common diseas­es are musculoskeletal disorders, cardiovascular disease, re­spiratory diseases, decreased visual acuity, dental diseases, and mental disorders. Literature analysis revealed that the scientific community is focused on developing preventive and therapeutic interventions to enhance the health of prima­ry school students. Identifying and meeting the physical and mental health needs of students may significantly improve their academic performance and future professional activity.

Conclusion. Schools can serve as a key platform for promot­ing healthy behaviours among children, as students spend a significant portion of their time in school and are subjected to its strong influence on their health. Schools can also be an important resource for collecting research data and im­plementing health-related preventive measures. Maintaining the health of primary school students requires collaborative efforts of schools, parents, communities, and relevant author­ities.

Aim. To identify risk factors for bloodstream infections in patients admitted to cardiac surgery and neurosurgery units.

Materials and Methods. We conducted a comprehensive combined retrospective (2018-2019) and prospective (2020­2022) case-control study which analysed treatment outcomes in 6,068 patients and examined 16 risk factors of bloodstream infections.

Results. Out of 16 studied risk factors, three had no impact on bloodstream infection development. Central venous catheterization for > 48 hours was associated with an increased risk of catheter-related bloodstream infections (1.2-fold in patients admitted to cardiac surgery units). Extra­corporeal membrane oxygenation dramatically increased the risk of bloodstream infections (OR = 14.18, 95% CI [5.1739.13], p < 0.001). In patients admitted to neurosurgery units, bloodstream infection risk factors included pneumonia at the admission and the degree of consciousness impairment. In cardiac surgery patients, risk factors included multiple organ failure, antimicrobial therapy prior to the admission, hospi­talization within the previous 3 months, age > 65 years, and an intensive care unit stay > 3 days.

Conclusion. Identified risk factors of bloodstream infections should be considered in the epidemiological safety framework of healthcare insti­tutions.

Aim. To study the types of vaginal microbial communities in women with high-grade squamous intraepithelial lesion (HSIL) and those negative for intraepithelial lesion or malig­nancy (NILM).

Materials and Methods. Between 2021 and 2023, we conducted an analysis of vaginal microbial com­munity types among 70 women of reproductive age infected with high-risk oncogenic HPV: those with HSIL verified by cytological examination (n = 40) and those without precancerous cervical lesions (i.e., NILM, n = 30). Identification of microorganisms in the cervical mucus was identified by mass spectrometry.

Results. The frequency of normal microbiota detected by the microscopic examination was 5.3-fold lower, whilst Streptococcus spp. was detected 3-fold times higher in women with HSIL compared to the NILM group (p = 0.023). Among patients with HSIL, community state type (CST) IV was the most frequent (75%), and CST IV-C1 subtype (with Streptococcus spp. as a prevailing genus) was found in 25% of cases (p = 0.132). In patients with NILM, CST IV was also the predominant type (60%) but CST IV-C2 (with En­terococcus spp. as a prevailing genus) was most frequent subtype (23.3%, p = 0.087). The prevalence of HPV type 16 and grade 2 abnormal colposcopy findings were 3.9-fold (p = 0.008) and 3.5-fold (p = 0.040) higher in women with HSIL than in NILM (p = 0.008).

Conclusion. The predominant type among vaginal microbial communities in women with HSIL and NILM was CST IV, with C1 and C2 subtypes pre­vailing respectively in HSIL and NILM.

Aim. To study clinicopathological risk factors for early pregnancy loss in women with obesity.

Materials and Meth­ods. Here we examined 130 patients with early pregnancy loss: 69 women with obesity and 61 patients with healthy body weight.

Results. Early menarche onset, smoking during pregnancy, no gynecologic visits for > 2 years, iron deficien­cy anemia, and past medical history of intrauterine interven­tions were the primary risk factors of early pregnancy loss in women with obesity.

Conclusion. Obese patients with low compliance need better preconception care under the close supervision of an obstetrician-gynecologist to reduce the risk of early pregnancy loss.

Aim. To determine the optimal surgical treatment for uter­ine fibroids in patients with unfulfilled reproductive through the analysis of pregnancy course and outcomes following uterine artery embolization (UAE) and myomectomy.

Ma­terials and Methods. The study assessed pregnancy course and outcomes, as well as neonatal conditions, in 147 patients including those who: 1) underwent UAE; 2) underwent myo­mectomy; 3) had untreated uterine fibroids; 4) did not have uterine fibroids. Data collection was conducted retrospec­tively by reviewing medical records, including case histo­ries, pregnancy and delivery records, and newborn histories.

Results. There have been significant differences in pregnan­cy complications and delivery methods among the women who received distinct surgical treatments for uterine fibroids (myomectomy vs. UAE). In the third trimester, placental ab­normalities were more frequent after UAE (12.5%) that af­ter myomectomy (2.9%) but cesarian delivery was performed twice as low (47.0% vs. 94.3, respectively). Subsequent preg­nancy risks were higher among the patients who had under­gone myomectomy, as 50% of them experienced fibroid re­currence during the pregnancy and there were scars on the uterus as a result of myomectomy and cesarean section.

Con­clusion. No new fibroid nodules as well as growth or vas­cularization of existing fibroids were observed after UAE, suggesting that it can be considered as a preferred treatment option, particularly for women who have not yet completed their reproductive plans.

Aim. To evaluate the effectiveness, safety, durability, and long-term outcomes of UniLine prosthetic valve application in patients with isolated mitral or aortic valve disease who have undergone a surgical valve replacement.

Materials and Meth­ods. The study aims to include at least 2,000 patients from seven Russian research centers who have undergone surgical mitral valve replacement or surgical aortic valve replacement using an epoxy-treated, xenopericardial bioprosthetic valve Uni­Line. The multicenter design of the study enhances patient re­cruitment, ensures a representative sample, minimises selec­tion bias, and improves the generalisability of findings to the population. Currently, 989 patients have been enrolled, with ongoing recruitment, telephone follow-ups, and clinical as­sessments.

Results. The primary endpoint is long-term safety and durability of UniLine valve in patients with isolated mi­tral or aortic valve disease, with the follow-up period up to 12 years postimplantation. The long-term safety will be assessed by the rates of valve-related complications including mortal­ity, chronic heart failure, life-threatening bleeding, valve mi­gration, valve thrombosis, any other valve-related compli­cation requiring re-intervention, access site-related compli­cations, acute coronary syndrome or progression of chronic coronary syndrome to the state requiring percutaneous coro­nary intervention or coronary artery bypass graft surgery, and stroke. Long-term durability will be evaluated via hemody­namic valve performance (maximum and mean pressure gra­dient across the atrioventricular prosthesis and effective orifice area, per manufacturer specifications) measured by echocardi­ography. Secondary endpoints are incidence of adverse event, major adverse events, device-related adverse events, proce­dure-related adverse events, and all-cause mortality.

Conclu­sion. The UniLine RetroFit multicenter observational cohort study is a valuable initiative for obtaining real-world clinical data on the effectiveness, safety, durability, and long-term out­comes of UniLine valve in patients with isolated mitral and aortic valve disease.

Aim. To evaluate the features of local and systemic im­munity in smokers of different age groups.

Materials and Methods. Here we collected venous blood and oropha­ryngeal swabs from conditionally healthy men. A total of 59 participants were included: 20 individuals aged 18-25 years and 39 individuals aged 45-60 years. Each age group was subdivided into smokers and non-smokers. The aver­age smoking history was 5 years in the younger group and 28 years in the older group. Total leukocyte count and the proportions of different cell types in blood and oropharyn­geal secretions were assessed using light microscopy. Neu­trophil cytotoxic activity was evaluated using the nitro blue tetrazolium test. Concentrations of interleukin-8 (IL-8) and IL-18, IgA, and IgE were determined in blood plasma and supernatant from oropharyngeal swabs by enzyme-linked immunosorbent assay.

Results. Age-related changes affect­ed both local and systemic immunity. A reduction in mac­rophage numbers as well as IL-18 and IgA levels in oro­pharyngeal washes were accompanied by an increased pro­duction of pro-inflammatory cytokines IL-8 and IL-18 and a rise in circulating neutrophils. In individuals aged 18-25 years (with an average smoking history 5 years), an increase in blood monocytes and a sharp decrease in IL-8 level were observed, along with a twofold reduction in leukocytes in oropharyngeal washes. In smokers aged 45-60 years, there was a trend toward increased IgA and IgE plasma levels, alongside a significant decrease in IgA and IL-18 in the oral mucosa.

Conclusion. The impact of smoking and the dura­tion of exposure to tobacco smoke on the local and systemic immunity of smokers from different age groups is primari­ly reflected at the local level. Smoking exacerbates age-re­lated weakening of the oral mucosal barrier properties and induces systemic immune shifts, even with a short smoking history.

Aim. To perform a correlation analysis between QoL scales and diagnostic indicators of sarcopenia in CKD stage 5 (CKD5) patients, determined using bioimpedance spectroscopy (BIS) for body composition assessment. Materials and Methods. The study included 182 CKD5 patients residing in the Kemerovo Region. Sarcopenia was diagnosed in 56 patients according to the European Working Group on Sarcopenia in Older People 2 (EWGSOP2) criteria. To assess QoL, we applied a dialysis-specific Kidney Disease Quality of Life Short Form ((KDQOL-SF) version 1.3 and sarcopenia-specific Sarcopenia Quality of Life (SarQoL) questionnaires. Results. In patients with sarcopenia and CKD5, the KDQOL-SF questionnaire showed low scores with regards to the following specific scales: CKD burden (60 [53.75; 70.0]), cognitive functions (61.1 [50.0; 66.67]), quality of social interaction (66.67 [55.56; 73.61]), quality of sleep (60.71 [57.14; 64.29]) and general perception of health (60 [50; 60]). The SarQoL questionnaire demonstrated low QoL scores in the following domains: physical and mental health (61 [54; 71]), locomotion (68 [65; 68]), body composition (45 [30; 45]), leisure activities (50 [50; 50]). A moderate and statistically significant positive correlation was identified between the Short Physical Performance Battery (SPPB) and the following domains: daily activities (r = 0.66), functionality (r = 0.72), body composition (r = 0.65), and physical and mental health (r = 0.66). Conclusion. Correlations were identified between SPPB scores and three specific scales of the KDQOL-SF questionnaire (symptoms/problems, cognitive function, and quality of social interaction), as well as five domains of the SarQoL questionnaire (leisure activities, activities of daily living, functionality, body composition, physical and mental health).

Ataxia-telangiectasia (Louis-Bar syndrome) is a genetic disorder inherited in an autosomal recessive manner, char­acterized by impaired deoxyribonucleic acid (DNA) repair. Clinically, it manifests as ataxia due to cerebellar degener­ation, telangiectasia, severe immunodeficiency, a predispo­sition to cancer, and increased sensitivity to radiation expo­sure. Signs and symptoms of this primary immunodeficiency disorder are relatively specific; however, the diversity in dis­ease course, multiple neurological symptoms, and variable clinical features often lead to delayed diagnosis and an un­favorable prognosis. Here we present a clinical case of Lou­is-Bar syndrome in 8-year-old patient, in which an extended diagnostic search ultimately led to the correct diagnosis. The first neurological symptoms appeared at the age of 3 months with the formation of clubfoot, strabismus, unsteady gait, and speech disorders by the age of 2. The child has been reg­ularly treated in the neurological department. Immune dys­function was manifested by autoimmune (pauciarticular ju­venile rheumatoid arthritis) and allergic (allergic conjuncti­vitis and insect sting allergy) syndromes, as well as frequent infectious diseases and verified hypogammaglobulinemia. At the age of 8, the patient was sent for examination to the Department of Immunology of the Dmitry Rogachev Na­tional Research Medical Center, where full-exome sequenc­ing was performed and a heterozygous mutation in the ATM c.5932G>T, p.(Glul978Ter) gene was found, thus confirming ataxia-telangiectasia (Louis-Bar syndrome).