Aim. To quantify the parameters of unventilated lung volume and pulmonary ventilation heterogeneity and study their clinical significance in patients with a combination of idiopathic pulmonary fibrosis and pulmonary emphysema (CPFE).

Materials and methods. The case histories of 56 patients with CPFE and 48 patients with idiopathic pulmonary fibrosis (IPF) were analyzed. The study of respiratory function included the measurement of static lung volumes and capacities, speed indicators and diffusion capacity of the lungs. The unventilated volume (ΔTLC) and the fraction of non-ventilated space (PCF) were also analyzed.

Results. The respiratory mechanics parameters in the group of patients with CPFE were significantly higher compared to patients with IPF. The ratio of forced expiration volume in the first second (FEV1) to vital capacity (VC), (median – 0.76) and FEV1 to forced VC (FVC), (median – 0.78) parameters were lower, but in most cases (89.3%) remained normal. The values of ΔTLC and PCF were significantly higher in the group of patients with CPFE (p < 0.001), while statistically significant relationships were found between these parameters and the parameters characterizing bronchial patency (FEV1/VC (p = 0.001), FEV1/FVC (p = 0.003)). With an increase in ΔTLC of more than 500 ml, pulmonary hypertension was significantly more common (OR – 3.102, p = 0.045), and an increase in PCF of more than 15% was statistically more often detected before the onset of death (OR – 7.800, p < 0.001).

Conclusion. Our data indicate the importance of assessing ΔTLC and PCF in the complex diagnostics of the external respiratory system in the CPFE. Their relationships with other indices of airway patency, as well as the incidence of pulmonary hypertension and fatal outcomes, may be an important link in determining the volume of therapy prescribed to these patients.

Introduction. Patients with chronic lymphocytic leukemia (CLL) are at high risk of infectious complications due to secondary immunodeficiency. Aim. To study the dynamics of incidence and characterize the clinical features of bacterial and viral pneumonias in CLL patients undergoing programmed therapy.

Materials and methods. A retrospective analysis of medical records from 452 CLL patients treated at the State Budgetary Healthcare Institution "Irkutsk Regional Clinical Hospital" (Irkutsk) between 2012 and 2023 was performed.

Results. Bronchopulmonary infections predominated among intercurrent infections: bacterial pneumonias accounted for 31.7% and viral pneumonias for 20.7% of all infectious episodes. Bacterial pneumonia most frequently developed at advanced stages of tumor progression. A statistically significant decrease in the incidence of bacterial pneumonias was observed in the 2020–2023 patient cohort compared to earlier periods (p < 0.05). A high proportion of atypical pneumonia forms was identified: in 21% of cases, the course was oligosymptomatic with minimal physical findings and prominent extrapulmonary manifestations; in 28%, the pneumonia followed a masked course, with symptoms obscured by the clinical picture of the underlying disease. During 2020–2023, SARS-CoV-2–associated pneumonia ranked second among complications. Viral pneumonias were milder in patients receiving Bruton’s tyrosine kinase inhibitors (BTKi) compared to those treated with immunochemotherapy.

Conclusion. In diagnosing bacterial pneumonias in CLL patients, the possibility of atypical presentation during the early stages of the inflammatory process must be considered. In our opinion, the reduced frequency of bacterial pneumonias and the more favorable course of viral pneumonias are attributable to the introduction of BTKi into clinical practice, as well as preventive measures (pneumococcal vaccination and replacement therapy with intravenous immunoglobulins).

Introduction. Despite significant advances in understanding bronchial asthma (BA), disease control remains problematic, with comorbid conditions being one potential contributing factor.

Aim. To assess the prevalence ofmajor comorbid diseases in children with BA residing in the Priamurye.

Materials and methods. A retrospective analysis was performed using medical records of 315 pediatric BA patients (mean age 11.15 ± 0.21 years) observed at the Khabarovsk Branch of the Far Eastern Scientific Center of Physiology and Pathology of Respiration – Research Institute for Maternal and Child Health Protection between 2015 and 2025. The cohort included 57.8% boys and 42.2% girls. Disease severity was classified as mild in 29.5%, moderate in 61%, and severe in 9.5% of cases. Full asthma control was achieved in 31.7% of children, while 68.3% had uncontrolled disease.

Results. Comorbid conditions were identified in 97.5% of BA patients. Allergic diseases were the most prevalent (78.7%), particularly allergic rhinitis (64.1%) and atopic dermatitis (14.3%). Chronic gastrointestinal disorders were present in 29.5% of patients, including gastroesophageal reflux disease (GERD) in 27.3%. Endocrine comorbidities were diagnosed in 23.5% of children, with obesity accounting for 18.7%. Comorbidity index analysis revealed that 22.8% of children had one comorbid condition, 29.6% had two, and 45.1% had three or more comorbidities.

Conclusion. Critically high prevalence of comorbid pathology was found among children with BA in the Priamurye, with nearly half exhibiting multimorbidity (three or more concurrent conditions). Allergic rhinitis, gastrointestinal disorders – particularly GERD – and obesity were the leading comorbidities. These findings help in choosing the most effective strategy for managing the patient, considering their comorbid conditions.

Aim. Based on the analysis of clinical and instrumental data in patients with mild obstructive sleep apnea (OSA) (n = 102), to identify markers associated with insulin resistance and evaluate their prognostic significance.

Materials and methods. The retrospective study included 102 men aged 30–55 years (median 44 [40–50]) with mild OSA (apneahypopnea index [AHI] ≥5 and <15 events/hour) and metabolic disorders, examined between 2018 and 2020. Markers of insulin resistance were identified using simple logistic regression with stepwise inclusion and exclusion of predictors.

Results. The most informative indicators of insulin resistance in patients with mild OSA were: excessive daytime sleepiness ≥9 points; AHI ≥11/hour; nocturnal desaturation index ≥3.6/hour; time spent with oxygen saturation below 90% ≥0.9% of total sleep time; mean nocturnal oxygen saturation ≤94%; minimum nocturnal oxygen saturation ≤85%; maximum nocturnal heart rate ≥95 bpm; and reactive hyperemia index ≤1.7.

Conclusion. These parameters may be considered accessible markers of insulin resistance in patients with mild OSA.

Introduction. The COVID-19 pandemic has revealed a high incidence of extrapulmonary complications, with cardiovascular and cerebrovascular events being the most prevalent. Of particular concern is the rising number of severe cardiovascular pathologies in young patients without prior cardiac history.

Aim. To investigate the phenotypic characteristics of peripheral blood monocytes in young patients (18–45 years) with COVID-19 and subsequent cardiovascular pathology (acute myocardial infarction or acute cerebrovascular accident).

Materials and methods. A prospective study included 202 participants: 28 apparently healthy individuals (control group), 143 patients with laboratory-confirmed SARSCoV-2 infection without complications, 19 with acute myocardial infarction, and 12 with acute cerebrovascular accident. Immunophenotyping was performed using multiparameter flow cytometry to assess the expression of CD14, HLA-DR, CD11b, CD206, FcγRII, TNFR1, TNFR2, CD68, TRAIL, and TGFβ1. Statistical analysis was carried out using the nonparametric Kruskal-Wallis test.

Results. Patients with COVID-19 exhibited significantly reduced HLA-DR expression on monocytes–79.0 (76.0; 83.7)% compared to 93.4 (90.9; 96.6)% in controls (p < 0.001)–alongside a progressive increase in the alternative activation marker CD206 (p < 0.001). A TNF-α receptor imbalance was observed: selective elevation of TNFR1 specifically in acute myocardial infarction and consistently increased TNFR2 expression across all patient groups relative to controls (p < 0.001). Levels of TRAIL and TGFβ1 were significantly elevated in all post-COVID patient groups, reaching their highest values in those with vascular complications (p < 0.001).

Conclusion. In young patients, SARSCoV-2 infection induces persistent dysregulation of the monocyte phenotype, characterized by reduced expression of major histocompatibility complex class II molecules, a shift toward a reparative-fibrotic profile, and an imbalance between pro- and anti-inflammatory receptors. These phenotypic alterations may serve as differential immunological markers associated with the development of acute cardiovascular and cerebrovascular complications.

Aim. To identify the patterns of drug-induced nephropathy development during prolonged administration of a combination of antibacterial drugs (ABDs) and to determine the role of immune cell infiltration and epithelial-mesenchymal transition (EMT) in its progression.

Materials and methods. The study was performed on 50 male white outbred rats divided into control and experimental groups. Animals in the experimental groups received daily a combination of ABDs used for the treatment of drug-resistant tuberculosis: kanamycin, bedaquiline, linezolid, cycloserine, levofloxacin, para-aminosalicylic acid (PAS), and prothionamide. Euthanasia was performed on days 60 and 120. Blood biochemical parameters – creatinine, urea, and estimated glomerular filtration rate (GFR) – were assessed. Immunohistochemical analysis of CD3, CD20, and vimentin expression in kidney tissue was conducted to evaluate cellular infiltration and fibrotic processes.

Results. By day 60, experimental animals showed statistically significant increases in creatinine (108.03 μmol/L vs. 57.0 μmol/L in controls, p < 0.01) and urea (8.88 mmol/L vs. 5.31 mmol/L, p < 0.01), along with reduced GFR (1.22 mL/min/100 g vs. 1.49 mL/min/100 g, p < 0.01). By day 120, renal function further deteriorated: creatinine rose to 172.91 μmol/L, urea to 11.08 mmol/L, and GFR declined to 1.11 mL/min/100 g (vs. control values of 56.48, 5.43, and 1.49, respectively). Interstitial infiltration by CD3+ and CD20+ cells progressively increased: by day 60–to 26.5 and 31.6 cells/HPF, and by day 120–to 29.6 and 36.5 cells/HPF (p < 0.05), compared to control values of 3.1 and 2.4, respectively. The proportion of vimentin-positive tubules rose from 38.6% on day 60 to 65.7% on day 120 (p < 0.01), indicating active EMT.

Conclusion. Prolonged ABD administration induces chronic kidney injury characterized by azotemia and reduced GFR. The pathogenesis involves immune-mediated inflammation (CD3+ and CD20+ infiltration) and epithelial–mesenchymal transition (vimentin expression). These findings support the need for nephroprotective agents targeting these specific mechanisms.

Introduction. Experimental evidence has demonstrated that the cation channels TRPV1 and TRPV4 are involved in the development of various pathological processes characteristic of asthma and chronic obstructive pulmonary disease (COPD) and, therefore, may be considered potential therapeutic targets for these diseases.

Aim. To analyze the effects of the maintenance therapy drugs used for asthma and COPD – budesonide, formoterol, and tiotropium – on the expression of TRPV1 and TRPV4 proteins in peripheral blood mononuclear cells in vitro.

Materials and methods. Mononuclear cells for the experiment were isolated from the blood of 9 apparently healthy volunteers. The cells were incubated under control conditions or in medium containing budesonide, formoterol fumarate, or tiotropium bromide at concentrations of 1, 10, or 100 nM for 24 hours. After incubation, the cells were washed, and total TRPV1 and TRPV4 expression was analyzed by indirect flow cytometry. Expression values were presented as normalized median fluorescence intensity (nMFI).

Results. Budesonide, formoterol, and tiotropium significantly reduced TRPV1 expression in lymphocytes and monocytes at all analyzed concentrations. For example, baseline TRPV1 expression in lymphocytes was 5.3 (4.9; 5.6), whereas exposure to 10 nM budesonide reduced it to 3.0 (2.6; 3.9) (p = 0.008), formoterol – to 2.8 (2.7; 3.6) (p = 0.01), and tiotropium – to 2.8 (2.4; 3.0) (p = 0.008). The corresponding values for monocytes were 4.9 (4.6; 6.8) (p = 0.02), 4.4 (4.1; 6.4) (p = 0.02), and 4.3 (3.6; 4.7) (p = 0.01), respectively, compared with baseline expression of 10.2 (8.0; 10.3). At the same time, the inhibitory effect of the drugs on TRPV4 expression was observed predominantly in lymphocytes: 10 nM budesonide, formoterol, and tiotropium reduced channel expression from 1.4 (1.3; 1.6) to 1.1 (1.0; 1.5) (p = 0.04), 1.0 (0.9; 1.4) (p = 0.04), and 1.0 (0.9; 1.3) (p = 0.03), respectively.

Conclusion. It was established for the first time that budesonide, formoterol, and tiotropium can reduce the expression of TRPV1 and TRPV4 cation channels in peripheral blood mononuclear cells in vitro. The obtained results expand current understanding of the pharmacological effects of asthma and COPD maintenance therapy and suggest the existence of an additional common component of their pharmacological action associated with the regulation of TRPV1/TRPV4 channels.

Introduction. Bronchopulmonary dysplasia (BPD) is a common chronic lung disease in preterm infants, associated with a high risk of respiratory and neurological complications and mortality. Inhaled tauractant administration has recently been proposed as a novel preventive strategy.

Aim. To evaluate the effect of inhaled tauractant on clinical and ultrasound characteristics of respiratory status in newborns at risk of BPD.

Materials and Methods. The study was conducted at the Sverdlovsk Region State Healthcare Institution "Yekaterinburg Clinical Perinatal Center" from January 27, 2024, to December 31, 2025. Thirty-one infants with gestational age <30 weeks receiving nasal continuous positive airway pressure (CPAP) or mechanical ventilation (MV) on days 8–14 of life were included. Lung ultrasound scores (LUS) were recorded daily before and after tauractant inhalation.

Results. Among 10 episodes of respiratory support modality change during days 1–5 of treatment, de-escalation occurred in 9 cases; in 6 of these, respiratory improvement was observed within the first 1–2 days of therapy. Statistically significant reductions in LUS were documented over days 1–5 in the overall cohort and specifically in the CPAP subgroup (p < 0.001). No significant changes were observed in the MV subgroup (p > 0.05).

Conclusion. A five-day course of inhaled tauractant prophylaxis in preterm infants at risk of BPD was associated with early trends toward respiratory support de-escalation and marked improvement in lung ultrasound findings among infants on nasal CPAP, whereas no pronounced effect was observed in those receiving mechanical ventilation.

Introduction. Oxidative stress during gestation is a physiological adaptive process: in early pregnancy, it regulates trophoblast invasion, spiral artery remodeling, and organogenesis. Iron deficiency (ID), as a multifunctional trace element, is associated not only with the risk of hemogenic and tissue hypoxia but also with an imbalance between free radical oxidation (FRO) and antioxidant defense (AOD) systems.

Aim. To identify the characteristics of FRO and AOD processes in iron-deficient states among pregnant women of indigenous and non-indigenous populations of the Amur region at initial antenatal visits corresponding to the conditional waves of cytotrophoblast invasion (first and second trimesters).

 Materials and methods. The study included 177 pregnant women newly registered in the first or second trimester, residing in urban (Khabarovsk city) and rural areas (Nanai District) of the Amur region. Three groups were formed based on residence and ethnicity: Group 1 – urban non-indigenous women of European descent (n = 59); Group 2 – rural non-indigenous women of European descent (n = 60); Group 3 – rural indigenous women (Nanai, small-numbered ethnic groups of the Amur region, Mongoloid race) (n = 58). Serum ferritin was measured by enzyme-linked immunosorbent assay. FRO parameters–total intensity of reactive oxygen species generation (S_sp), rate of peroxyl radical formation (S_ind1), and lipid hydroperoxide content (h₁) and AOD parameters–antiradical defense activity (S_ind2) and substrate peroxide resistance (h₂) were assessed using chemiluminescence analysis.

Results. Iron deficiency was significantly more prevalent in the second trimester across all groups, particularly among rural non-indigenous and indigenous women. An environmentally favorable FRO–AOD profile was observed in rural non-indigenous pregnant women: in the first trimester, they exhibited significantly lower FRO values (S_sp, S_ind1, especially h₁) alongside high antiradical defense activity and peroxide resistance. This pattern was less pronounced in the second trimester. Ethnic-specific features were noted in indigenous women, characterized by higher FRO (S_sp, S_ind1) and lower AOD (S_ind2, h₂) in the first trimester compared to the second.

Conclusion. The identified eco-ethnic characteristics of the FRO–AOD system under iron deficiency highlight the need to consider these findings when designing preventive and therapeutic strategies for pregnant women in the Russian Far East. 

Introduction. Human papillomavirus (HPV) infection negatively affects the female immune system, with severity exacerbated by microbiome disruption and concomitant sexually transmitted infections (STIs).

Aim. To assess the levels of immunoglobulins (Ig) A, G, and M in cervicovaginal secretion and blood serum in women with monoand mixed HPV infection in Amur region.

Materials and methods. A prospective comparative study included 134 women of reproductive age: 100 with confirmed HPV infection (38 with mono-infection and 62 with mixed infection) and 34 HPV-negative controls. Comprehensive analysis included clinical and anamnestic data, polymerase chain reaction–based HPV genotyping and viral load assessment, and enzyme-linked immunosorbent assay (ELISA) for IgA, IgG, and IgM in both serum and cervicovaginal secretion.

Results. The most prevalent HPV types were 16 (26%), 51 (24%), 56 (20%), and 18 (18%). Co-infection with two or more genotypes was detected in 31% of cases. High viral load was observed in 62% of HPV-positive women. Concomitant STIs (chlamydia, cytomegalovirus, herpes simplex virus type 2) were diagnosed in 25%, and significant dysbiosis was present in 26% of HPV-infected women. In cervicovaginal secretion, IgA levels were reduced 1.4-fold in mono-infection and 1.7-fold in mixed infection compared to controls (p < 0.001); in mixed infection, IgA was 1.3-fold lower than in mono-infection (p < 0.05). Similarly, serum IgA decreased 1.6-fold and 1.7-fold, respectively (p < 0.001). IgG in secretion was 1.6-fold lower in mono-infection and 1.7-fold lower in mixed infection; in serum, reductions were 1.8-fold and 2.0-fold, respectively (p < 0.001). IgM levels in the mixed infection group were 1.7- fold higher than in the mono-infection group (p < 0.001).

Conclusion. HPV infection, particularly in mixed form, is associated with marked suppression of both local and systemic humoral immunity. Alterations in IgA, IgG, and IgM levels correlate with infection pattern: mixed infection creates conditions favorable for prolonged viral persistence.

Introduction. The development of the immune system of the fetus and newborn is a complex, multifactorial process in which heredity plays a key role.

Aim. To study the influence of single nucleotide polymorphisms (SNPs) in genes of innate immunity and inflammatory response on humoral and cellular parameters of umbilical cord blood of newborns.

Materials and methods. The study sample consisted of venous umbilical cord blood from 80 infants born at 38-40 weeks of gestation. Total immunoglobulin (Ig) G, M, and A concentrations in plasma were determined using enzyme-linked immunosorbent assay. Lymphocyte subpopulation composition was assessed using flow cytometry. SNP analysis of target genes was determined using polymerase chain reaction (PCR) with high-resolution melting (HRM) analysis or linear-after-the-exponential PCR (LATE-PCR) with fluorescent probes.

Results. Carriage of the G allele of IL6 rs2069837 SNP is associated with a lower concentration of total IgG (β = -1.81, p = 0.03). The minor G allele of TLR4 rs4986790 is associated with an increased level of total IgM in cord blood (β = 0.36, p = 0.04). The C allele of IL10 rs3024498 SNP is associated with an increase in the proportion of total T-lymphocytes (p = 0.006) and T-helpers (p = 0.04) along with a decreased content of NK cells (p = 0.02) in the umbilical cord blood of newborns.

Conclusions. The obtained data indicate the possible contribution of some SNPs of the IL6, TLR4 and IL10 genes to changes in humoral and cellular parameters of the umbilical cord blood of newborns, which justifies the need for further research aimed at confirming the identified associations and developing prognostic models for assessing the immune status of children at risk.

Introduction. The relevance of this study stems from the need to evaluate the impact of COVID-19 on the blood oxygen transport system in women infected during pregnancy.

Aim. To determine the integrated optical density (IOD) of hemoglobin derivatives as part of a comprehensive assessment of anemia risk in postpartum women following SARS-CoV-2 infection.

Materials and methods. The study included 76 postpartum women (main group) infected with SARS-CoV-2 during the third trimester of pregnancy: 46 with mild COVID-19 (subgroup 1) and 30 with moderate disease (subgroup 2). The control group consisted of 33 women with no history of COVID-19 before or during pregnancy. Hemoglobin concentration and erythrocyte count were measured using the automated hematology analyzer Mindray BC- 5150. Induced optical density (IOD) of hemoglobin derivatives was assessed using the automated microscopy system "MEKOS-Ts2".

Results. A severity-dependent reduction in erythrocyte count and hemoglobin concentration was observed. Compared to controls, erythrocyte counts decreased by 1.13-fold (subgroup 1) and 1.23-fold (subgroup 2) (p < 0.001), while hemoglobin levels declined by 1.13-fold and 1.24-fold, respectively (p < 0.001). Subgroup 2 showed significantly lower values than subgroup 1 (by 1.09- and 1.10-fold, respectively; p < 0.001). IOD analysis revealed reduced oxyhemoglobin (HbO2) in subgroups 1 and 2 by 1.61- and 1.92-fold (p < 0.001), and deoxyhemoglobin (HHb) by 1.52-fold (p = 0.007) and 1.89-fold (p < 0.001), respectively, versus controls, with no significant difference between subgroups. Methemoglobin (MetHb) IOD increased by 1.54-fold (subgroup 1) and 1.76-fold (subgroup 2) compared to controls (p < 0.001); the difference between subgroups was 1.14-fold (p = 0.028). Significant inverse correlations were found between hemoglobin levels and MetHb IOD in both subgroups (ρ = –0.81 and ρ = –0.90; p < 0.01), described by linear regression equations—indicating that hemoglobin decline was accompanied by MetHb IOD elevation. ROC analysis confirmed that elevated MetHb IOD is a prognostically significant predictor of anemia (AUC = 0.820; 95% CI: 0.708–0.932; p < 0.001), with a cutoff value of 16.59 µm2, sensitivity of 75%, and specificity of 79%.

Conclusion. Combined analysis of hemoglobin derivatives’ IOD and hematological parameters enables assessment of the oxygen transport system status and elucidates mechanisms underlying anemia development in postpartum women after COVID-19. Incorporating these parameters into clinical practice will allow precise risk stratification and personalized patient management.

Introduction. As evidence on the pathogenesis of COVID-19 in pregnancy accumulates, researchers increasingly focus on the destabilization of various metabolic pathways, including lipid profile disturbances and the initiation of oxidative stress.

Aim. To comparatively analyze plasma concentrations of palmitic and stearic saturated fatty acids (SFAs) and assess their role in the development of oxidative stress in pregnant women with moderate COVID-19 during the second trimester.

Materials and methods. A case–control study included 39 women in the second trimester with confirmed moderate COVID-19 (main group) and 40 pregnant women with no history of or current SARS-CoV-2 infection (control group). The concentrations of primary (dienic conjugates) and end products (thiobarbituric acid-reactive substances, TBARS) of lipid peroxidation were studied in peripheral blood plasma using spectrophotometric methods. Enzyme-linked immunosorbent assay (ELISA) was employed to determine 8-isoprostane levels and total antioxidant capacity (TAC). Quantitative analysis of SFAs was performed by gas chromatography.

Results. The main group showed statistically significant increases in palmitic acid (1.33-fold; p < 0.001) and stearic acid (1.34-fold; p < 0.001), alongside intensified lipid peroxidation: elevated diene conjugates (1.9-fold; p < 0.001), TBARS (2-fold; p < 0.001), and 8-isoprostane (>2-fold; p < 0.001), coupled with a 1.62-fold reduction in plasma TAC (p < 0.001). Strong positive correlations were found between palmitic and stearic acid levels and both TBARS (rs = 0.72 and rs = 0.68, respectively; p < 0.001) and 8- isoprostane (rs = 0.74 and rs = 0.72, respectively; p < 0.001). Statistically significant inverse correlations were also observed between these SFAs and TAC (rs = –0.70 and rs = –0.67, respectively; p < 0.001).

Conclusion. Moderate COVID-19 during the second trimester of pregnancy is associated with a significant elevation in plasma palmitic and stearic acid concentrations. The identified correlations suggest that SFA imbalance and pro-oxidant burden form a unified pathogenetic cascade in moderate COVID-19 during mid-gestation.

Introduction. Multiple myeloma (MM) is one of the most common hematologic malignancies.

Aim. To demonstrate the potential of using the targeted monoclonal antibody daratumumab in patients with newly diagnosed MM.

Materials and methods. Two clinical cases illustrating the efficacy and safety of daratumumab-based regimens in newly diagnosed MM are presented.

Results. Both patients received first-line therapy including daratumumab. The first patient was treated according to the Dara-Vd protocol (daratumumab, bortezomib, dexamethasone), while the second received Dara-Rd (daratumumab, lenalidomide, dexamethasone). The choice of regimen was guided by baseline disease status and the presence of osteolytic bone lesions. Both patients achieved a partial response, followed by autologous stem cell transplantation (aHSCT). Subsequently, consolidation therapy with daratumumab-containing protocols was administered, resulting in complete remission of MM.

Conclusion. These clinical cases illustrate the high efficacy of daratumumab in first-line treatment of MM in aHSCT-eligible patients and the possibility of achieving a response after 3–6 cycles of therapy.

Human viruses cause a wide range of respiratory diseases, from the common cold to pneumonia and severe acute respiratory syndrome. A key factor determining the outcome of the disease is the nature of the subject's innate immune response, which is influenced by various external factors, such as the virus encountered, the season of the year with prolonged exposure to low temperatures, endogenous factors such as the body's susceptibility to infection, existing chronic respiratory diseases, the severity of non-specific respiratory defense mechanisms, immunodeficiency states, and the expression of genes that increase vulnerability to both the underlying disease and viral invasion, as well as their upregulation against the background of local cooling of the respiratory tract. This review presents an analysis of scientific literature data on the prevalence, some antiviral defense mechanisms, and conditions of increased susceptibility to viral upper respiratory tract infections associated with cooling.

The aim of the review is to analyze how physiological, psychological, and sociocultural factors influence the quality of life (QoL) in children with asthma. The review systematizes current data on methodological approaches to assessing health-related QoL in children with asthma, and provides a detailed overview of current tools, including general and specific questionnaires, emphasizing the importance of a comprehensive assessment of QoL in parents and caregivers. It discusses results from numerous studies, including randomized controlled trials that examine various aspects of QoL in children with asthma. The review highlights key factors that affect QoL. Special attention is given to psychological aspects of the disease during childhood and adolescence, which play a critical role in QoL formation. It is emphasized that negative psychological and sociocultural factors have a significant impact on QoL in children. Children with asthma are more likely to be obese or overweight and have poor sleep quality, tend to have poorer academic performance and lower socioeconomic status than healthy children. Unfavorable family and social relationships negatively influence disease control and QoL. The review identifies treatment adherence as a crucial factor for improving QoL. Enhancing adherence through educational programs and written management plans is vital for better disease control and overall QoL improvement.