Aim. To assess the consumption of red and processed meat among the adult population of Omsk Region in order to determine its significance as a risk factor for chronic non-communicable diseases. Materials and Methods. In 2023, a quota-based sample of the adult population of Omsk Region (n = 506) was surveyed. The frequency method was used to determine the amount and frequency of consumption of various meat products. Consumption was assessed in accordance with the World Health Organization guidelines. A comparative analysis was performed to evaluate the proportion of respondents who exceed the recommended meat consumption levels by sex and place of residence. Results. Excessive consumption of red meat was observed in every second resident of the Omsk region (51.2 ± 2.2%), in particular in combination with processed meat (71.2 ± 2.0 %). Sausage products accounted for 28.5% of total meat intake, poultry for 17.5 %, dumplings for 13.5 %, and pork and beef dishes for 10.9 % each. Red meat accounted for 50.8 % of consumed meat products. Average weekly red meat consumption was 624.4 ± 21.5 g, and men consumed more than women (690.6 ± 35.1 g per week versus 568.8 ± 26.0 g, respectively, p = 0.002). Processed meat accounted for 42 % of all meat products consumed. The highest consumption levels of meat products, including specific categories (red meat, processed meat, and red processed meat), were observed among urban residents compared with rural residents (p = 0.000), and among men compared with women (p = 0.015). Age-related differences in meat consumption, both overall and by category of meat products, were not statistically significant. Conclusion. Excessive consumption of red and processed meat among the majority of the adult population in the Omsk region poses additional cancer and cardiometabolic health risks.

Aim. To summarize and analyze current data on the epidemiological characteristics and preventive measures of Clostridioides difficile infection in patients after pancreatoduodenectomy, with a focus on risk factors, infection incidence, and strategies to reduce postoperative morbidity. Materials and Methods. A comprehensive literature search was conducted using MEDLINE, Embase, Scopus, Cochrane, PubMed, and Google Scholar databases, as well as through citation tracking of studies published between June 2005 and June 2025. The review included systematic reviews and meta-analyses, single- and multicenter studies, cross-sectional, observational, prospective, cohort studies, and randomized controlled trials in both Russian and English. Results. Patients who underwent pancreatoduodenectomy were found to be at high risk of developing Clostridioides difficile infection due to a combination of factors. High prevalence of C. difficile was noted in surgical departments, with severe disease particularly associated with hypervirulent ribotypes (e.g., 027). Conclusion. C. difficile infection poses a serious threat to patients after pancreatoduodenectomy. Timely diagnosis, strict infection control, and rational use of antisecretory and antibacterial agents are key preventive measures. Further epidemiological and clinical studies are needed to better define risk factors and to develop effective management protocols for these patients.

Aim. To study regional features of the COVID-19 pandemic in healthcare workers. Materials and Methods. We conducted a descriptive epidemiological study of COVID-19 incidence and mortality in healthcare workers and general population of the Kemerovo Region during the pandemic (2020‒2022). The study included analysis of pandemic intensity, and the structure of incidence by sex, age, and medical specialty. To evaluate epidemic dynamics, we estimated the growth rate and increase rate (%) of incidence and mortality. Data on COVID-19 cases were obtained from the Federal Statistical Reporting Form No. 2 “Information on Infectious and Parasitic Diseases,” the Federal Register of COVID-19 Patients for 2020‒2022 (total number of cases: 212,997, including 7,513 healthcare workers), and Statistical Form No. 30 “Information on Medical Organizations” for 2020‒2022 (total number of healthcare workers: 99,848), autopsy reports, and Form No. 013/u (n = 2,848). We have also analyzed the results of SARS-CoV-2 antibody testing among healthcare workers in Kemerovo Region in 2020 (n = 41,355) prior to the start of the vaccination. Results. The incidence of COVID-19 in healthcare workers was 2.77-fold higher than in the rest of the population (average long-term (2020‒2022) incidence among the healthcare workers was 7524.4 per 100,000 (95% CI [7386.9‒7661.9]). Mortality among healthcare workers was 17.9 per 100,000, and was 2.24-fold lower than in the rest of the population. Following the introduction of vaccination in 2021, the incidence among the healthcare workers decreased (5,587.5 per 100,000 (95 % CI [5485.1‒5689.9], reduction rate = 14.48 %), and mortality declined by 1.63-fold. Internists and general practitioners were affected more frequently as compared with other specialties (344.83 per 1,000 doctors of this category). During the pandemic, the most vulnerable age group among healthcare workers was 50–64 years old (7,491.8 per 100,000). Conclusion. The incidence of COVID-19 among healthcare workers in Kemerovo Region was 2.77-fold higher than in the general population. The highest incidence was observed among physicians (107.6 per 1,000), with maximum rates among outpatient internists and general practitioners (344.8 per 1,000). The mortality from COVID-19 among healthcare workers was 2.24-fold lower than in the general population. To improve the protection of medical personnel from biological risks, it is necessary to continue studying the experience of the pandemic, including its regional features.

Aim. To assess the prevalence of gynecological diseases and thyroid status in women with iodine deficiency disorders and antithyroid autoantibodies living in the iodine-deficient region. Materials and Methods. A prospective, controlled, multicenter study involved 99 women of reproductive age residing in the territories of moderate to severe iodine deficiency. The study population was divided into three groups: 1) women with iodine deficiency disorders and antithyroid autoantibodies but without thyroid dysfunction (n = 22); 2) women with iodine deficiency disorders but without antithyroid autoantibodies (n = 35); 3) women without iodine deficiency disorders and antithyroid autoantibodies (n = 34). We then collected clinicopathological data, evaluated gynecological status was evaluated, and measured serum levels of thyroid-stimulating hormone, triiodothyronine (T3), thyroxine (T4), thyroglobulin, antibodies to thyroid peroxidase, and antibodies to thyroglobulin. Results. In total, 62.6 % women were diagnosed with iodine deficiency disorders, and 38.6 % had concomitant thyroid autoantibodies. Women with antithyroid autoantibodies frequently reported fatigue, memory impairment, and had a higher tendency toward overweight and obesity. The majority of women with iodine deficiency disorders and antithyroid autoantibodies (13; 59.1 %) had body mass index > 25.0 kg/m² compared with 12 (34.3 %) women with iodine deficiency disorders but without such autoantibodies (OR = 2.77; 95 % CI [0.92–8.32], p = 0.067). The prevalence of iron-deficiency anemia or latent iron deficiency among women with iodine deficiency disorders and antithyroid autoantibodies was associated with a 3.6-fold higher risk of complications as compared to women with iodine deficiency disorders but without such autoantibodies (OR = 3.63; 95 % CI [1.17–11.22], p = 0.023). Secondary infertility was more common in women with iodine deficiency disorders but without antithyroid autoantibodies (16; 45.7 %, OR = 6.33; 95 % CI [1.59–25.22], p = 0.010). Women with iodine deficiency disorders and antithyroid autoantibodies had a higher frequency of cesarean section due to complicated pregnancy and labor (8; 44.4 %, p = 0.001). Conclusion. Women of reproductive age living in iodinedeficient regions require a multidisciplinary approach, including assessment of thyroid function, detection of latent iron deficiency, preconception counseling, and pregnancy management within a high-risk group for obstetric and perinatal complications.

Aim. To evaluate the sensitivity and specificity of a phonocardiography-based method for diagnosing fetal hypoxia using the FetaCare software and hardware complex. Materials and Methods. The study included 204 pregnant women with a high degree of perinatal risk who were stratified into three groups by gestational age: 1) 26–31.6 weeks; 2) 32–36.6 weeks; 3) 37–41 weeks. Phonocardiography records of the fetus were obtained for all participants, followed by mathematical audio data processing and construction of cardiointervalograms. Fetal condition was assessed based on cardiointervalogram-derived parameters: basal fetal heart rate, oscillation amplitude, number of oscillations, acceleration amplitude, number of accelerations, long-term variation, and short-term variation. Sensitivity and specificity of the method was calculated based on short-term variation and long-term variation. Results. Depending on the gestational age group, sensitivity ranged from 40 % to 100 %, while specificity ranged from 95% to 100 %. Conclusion. Diagnostic accuracy of a phonocardiography- and audiogram processing-based heart rate analysis increased with gestational age. Before 32 weeks, it accuracy remained low, requiring the use of additional fetal examination methods to make a decision on the need for delivery. This study demonstrates that the informativeness of phonocardiography with novel audio data processing methods can be comparable to cardiotocography, which is currently widely used in clinical practice.

Aim. To assess the effectiveness and safety of remote monitoring of physical rehabilitation using a mobile application in patients after coronary artery bypass graft (CABG) surgery in comparison with the traditional model of outpatient cardiac rehabilitation. Materials and Methods. A total of 150 patients undergoing outpatient rehabilitation after CABG surgery were included in the study. Patients were randomized into three groups: 1) those underwent rehabilitation using a mobile application; 2) those who used pedometers for home-based monitoring of physical activity; 3) those who received standard rehabilitation under the supervision of a healthcare provider at their place of residence. The effectiveness and safety of supervised training were assessed during follow-up clinic visits at 4 and 12 months after CABG surgery by determining clinical and functional indicators, including physical activity levels, quality of life, and the frequency and severity of complications. Results. Remote monitoring of outpatient cardiac rehabilitation, conducted at home using a smartphone-based mobile application, and pedometers to dose physical activity without the mobile application demonstrated safety, as confirmed by the absence of destabilization episodes. The use of the mobile application for outpatient rehabilitation monitoring showed comparable effectiveness to the pedometer-based program in achieving target blood pressure levels within one year after CABG surgery (96% and 89%, respectively, compared with 49% without monitoring; p = 0.03). Only the mobile application group demonstrated a significant reduction in resting heart rate (from 71 [CI 64–76] to 65 [CI 62–70] beats per minute). All outpatient rehabilitation programs, whether remotely monitored or not, proved ineffective in achieving target lipid profile values. Conclusion. Remote monitoring in cardiac rehabilitation contributes to improved blood pressure control, reduced heart rate, and increased exercise tolerance within one year after CABG surgery.

Aim. To analyse the electron microscopy signs of endothelial-to-mesenchymal transition (EndoMT) in endothelial cells (ECs) of native blood vessels and medical devices for cardiovascular surgery (including vascular patches, stents, and bioprosthetic heart valves) for assessing the role of EndoMT in the pathogenesis of implantation-associated long-term complications. Materials and Methods. To achieve this task, we interrogated internal thoracic artery used as a coronary bypass conduit, ovine carotid artery with a xenopericardial patch, stented human carotid artery, and bioprosthetic aortic valve. The tissues were stained with heavy metals, embedded into epoxy resin, grinded and polished, sputter coated with carbon, and visualised using backscattered scanning electron microscopy (EM-BSEM technique). Results. All samples contained both physiological ECs and the cells undergoing EndoMT. Physiological ECs retained apicobasal polarity, elongated nucleus, and intact basement membrane. Cells undergoing EndoMT had polymorphic nuclei, loss of apicobasal polarity, degraded and disintegrated basement membrane and internal elastic lamina, and migration into the vascular wall. Numerous immune cells (i.e., neutrophils, eosinophils, and macrophages) in the subendothelial layer indicated distinct stages of inflammation and vascular or valvular remodeling. Cell undergoing EndoMT migrated into the medial layer acquiring a myofibroblastic phenotype. Conclusion. These results confirm the role of EndoMT in the pathogenesis of the complications associated with the implantation of medical devices. Signs of dysfunctional ECs and EndoMT have been accompanied by inflammation, extracellular matrix degradation, and disruption of endothelial barrier altogether promoting intimal hyperplasia and restenosis as well as structural valve deterioration. These data require the detailed investigation of EndoMT molecular mechanisms and therapeutic approaches of its prevention in patients undergoing cardiovascular surgery interventions.

Aim. To investigate the effect of social isolation on social behavior and levels of psychoemotional markers (oxytocin and vasopressin) in mice with an injection-induced model of Alzheimer’s disease (AD). Materials and Methods. The study was conducted on CD1 male mice aged 3–4 months, which received intrahippocampal injection of either β-amyloid (in order to induce AD) or control phosphate-buffered saline (sham-operated mice). Subsets of experimental and control animals were subjected to social isolation for 21 days. To assess social behavior, a battery of neurobehavioral tests was applied, including the five-trial social memory/recognition test, the three-chamber social interaction test, and the extended open field test. Levels of oxytocin and vasopressin in specific brain regions were measured using enzyme-linked immunosorbent assay. Results. Neurobehavioral testing showed impaired socialization and reduced ability to memorize and recognize novel conspecifics in AD mice. Social isolation induced increased locomotor activity, diminished exploratory interest toward inanimate objects, and altered the character and frequency of social interactions. These transformations of emotional and social behavior were associated with dysregulation of the oxytocinergic and vasopressinergic systems in the amygdala. A reduction in oxytocin levels was observed in the olfactory bulbs of AD mice compared with controls. Isolated AD mice had elevated vasopressin levels and a trend toward decreased oxytocin levels in the amygdala as compared with the isolated control mice. Conclusion. Our results highlight the critical need to prevent social isolation in patients diagnosed with AD. The link between oxytocinergic and vasopressinergic systems and the progression of behavioral disorders underscores the importance of further studies on oxytocin and vasopressin as potential therapeutic molecules in Alzheimer’s disease.

Aim. To study the associations between IgA and IgG autoan tibodies against estradiol and progesterone (IgA1-E2 and IgA1 Pg; IgG1-E2 and IgG1-Pg) and the corresponding anti-idiotyp ic IgG autoantibodies (IgG2-E2 and IgG2-Pg) with tumor Ki-67 expression in breast cancer patients. Materials and Methods. Idiotypic and anti-idiotypic antibodies specific to steroid hor mones were studied in the sera of 1,115 postmenopausal women with breast cancer (stage I: 525 patients, stages II–IV: 590 pa tients) prior to treatment by enzyme-linked immunosorbent as say. Tumor Ki-67 expression was determined by an immunohis tochemical staining. Associations were analyzed using CART (Classification and Regression Tree) analysis. Results. Among patients with stage II–IV breast cancer, six groups with distinct individual combinations of antibody levels (immunological phe notypes) were identified, each associated with Ki-67 expression in tumors. High levels of Ki-67-positive cells in tumors (> 20 %) were found in: 1) 53.3 % patients with IgG₂-Pg ≤ 1.9+ IgA₁-Pg ≤ 2.2 + IgG2-E2 ≤ 4.1; 2) 85,0 % patients with IgG₂-Pg ≤ 1.9 + IgA₁-Pg ≤ 2.2 + IgG₂-E2 > 4.1 (p = 0.011 vs 1 group); 3) 87.2 % patients with IgG₂-Pg ≤ 1.9 + IgA₁-Pg > 2.2; 4) 82.7 % patients with IgG₂-Pg > 1.9 + IgA₁-Pg < 0.7; 5) 58.5 % patients with IgG₂-Pg = 1,9–4,1 + IgA₁-Pg > 0,7 (p = 0.012 vs 4 group); 6) 39.7 % patients with IgG₂-Pg > 4.1 + IgA₁-Pg > 0.7 (p = 0.008 vs 5 group). An increased proportion of patients with Ki-67 > 20 % at stages II–IV compared with stage I (p < 0.001) was ob served in groups 2, 3, 4, and 5. Suppression of tumor cell prolif eration was seen in groups 1 and 6. Conclusion. Enzyme-linked immunosorbent assay measurements of IgG₂-Pg, IgA₁-Pg, and IgG1-E2 may be useful for predicting tumor proliferative activ ity in stage I breast cancer patients during further disease pro gression.

Aim. To study clinicopathological and echocardiographic da ta and long-term outcomes of patients hospitalized with decom pensated type 1 diabetes mellitus (T1DM), and to analyze pos sible associations of these factors with adverse outcomes during follow-up. Material and Methods. Here we analyzed case his tories of 502 patients with decompensated T1DM admitted to Vinogradov City Clinical Hospital (Moscow) between Febru ary 2022 and January 2024. Vital status during the long-term follow-up was determined through phone contact with patients or their close relatives. Associations between clinical data and long-term outcomes were assessed using univariate regression analysis. Follow-up outcomes were determined at 18.5 [12.4; 24.0] months after discharge. Patients were divided into two groups: survivors (n = 476) and patients with fatal outcomes (n = 26). Results. Survivors were characterized by younger age, low er glycated hemoglobin levels, and shorter T1DM duration (p < 0.05). Older age (Hazard Ratio (HR) 1.085; 95 % Confidence Interval (CI) [1.058–1.113]), arterial hypertension (HR 3.180; 95 % CI [1.457–6.939]), higher glycated hemoglobin level (HR 14.0; 95 % CI [6.6–29.5]), and longer duration of T1DM (HR 1.063; 95 % CI [1.020–1.107]) were significantly associated with mortality in the long-term period (p < 0.05). Percutaneous coronary intervention (HR 5.183; 95 % CI [1.223–21.956]) and chronic heart failure (HR 9.172; 95 % CI [3.830–21.963]) had a negative prognostic impact on long-term outcomes (p < 0.05). Conclusion. Older age, longer disease duration, higher glycated hemoglobin levels, and arterial hypertension are significant pre dictors of long-term mortality in patients with T1DM. A history of percutaneous coronary intervention and chronic heart failure further worsen the long-term prognosis in this patient popula tion.