Introduction. Ischemic heart disease (IHD) and chronic obstructive pulmonary disease (COPD) are currently major contributors to morbidity and mortality in the Russian Federation and worldwide. Preventive programs that include the use of pneumococcal vaccines, primarily the 13-valent pneumococcal conjugate vaccine, are widely recognized tools in managing patients with comorbid conditions. Aim. To assess the clinical efficacy of the 13-valent pneumococcal conjugate vaccine (PCV13) in patients with COPD and IHD over a 10-year follow-up period. Materials and methods. The study included a total of 500 male patients diagnosed with COPD and IHD who received treatment or were under observation at the Pulmonology Center in Chelyabinsk. Patients were divided into three groups. The first group consisted of 149 vaccinated patients with isolated COPD (without IHD); the second group included 175 vaccinated patients with both COPD and IHD; the third group comprised 176 unvaccinated patients with COPD. The 13-valent pneumococcal conjugate vaccine (Prevnar 13) was used. The primary endpoint over the 10-year follow-up was the number of developed pneumonias. Secondary endpoints included the number of exacerbations, hospitalizations, and all-cause mortality. Results and conclusions. Vaccination with PCV13 significantly improved patient survival over at least a 10-year observation period. The use of the conjugate pneumococcal vaccine led to a significant reduction in the incidence of community-acquired pneumonia in patients with COPD, as well as in those with combined COPD and IHD. Vaccination resulted in the stabilization of key clinical and functional parameters, even over a 10-year period. Including pneumococcal vaccines in clinical guidelines for patients with comorbid COPD and IHD should be mandatory and prioritized.

Introduction. Asthma in children is characterized by chronic inflammation of the lower airways. The verification of reliable pro-inflammatory biomarkers, particularly non-invasive ones, is crucial for the diagnosis and treat[1]ment of childhood asthma. Aim. To evaluate the levels of soluble receptors for advanced glycation end products (sRAGE) and soluble interleukin-4 receptor (sIL-4R) in blood plasma and exhaled breath condensate (EBC) as potential biomarkers of bronchial asthma severity in children. Materials and methods. The study enrolled 195 children aged 6-17 years: 104 children with asthma and 91 children without any history of atopic diseases at baseline or during examination. The diagnosis and severity assessment of asthma were determined according to the Global Initiative for Asthma guidelines (GINA, 2021). EBC samples were collected using RTube devices (Respiratory Research, USA). The levels of sRAGE and sIL-4R were measured using magnetic bead-based multiplex immunoassay (MAGPIX, Luminex, USA). Results. Among 169 analyzed EBC samples, sRAGE was not detected in any sample above the minimum detectable level (14 pg/mL). In contrast, sIL- 4R levels exceeding the minimum detectable level (3 pg/mL) were found in 166 samples (98%). Plasma sRAGE levels were significantly lower in children with asthma (197.7 pg/mL) compared to controls (229.0 pg/mL; p=0.017). Similarly, EBC sIL-4R concentrations were significantly lower in children with asthma (120.3 pg/mL) compared to the control group (165.4 pg/mL; p<0.001). A statistically significant correlation was observed between plasma sRAGE levels and asthma severity (p=0.013, Kruskal-Wallis test). Conclusion. The measurement of plasma sRAGE and EBC sIL-4R levels appears to be a promising approach in developing novel biomarkers for the diagnosis, severity assessment, and monitoring of bronchial asthma in children.

Introduction. The article proposes an approach to evaluating the main parameters of impulse oscillometry (IOS) in children with chronic nonspecific lung diseases (CNSLD) using multivariate statistical methods. Aim. To identify types of ventilatory disorders in children with CNSLD using cluster analysis based on impulse oscillometry data. Materials and methods. A total of 71 children were examined, including 10 conditionally healthy children and 61 patients with CNSLD. Lung function was evaluated using IOS. The analyzed parameters included: Z5Hz—total respiratory impedance at an oscillation frequency of 5 Hz; R5Hz—total resistance at 5 Hz; R20Hz—proximal airway resistance at 20 Hz; X5Hz—reactance at 5 Hz; frequency dependence of resistance—D(Rrs5–Rrs20); delta Xrs5; and resonance frequency (Fres). Results. Analysis of the IOS data allowed all subjects to be divided into three clusters. The first cluster included children with the highest values of the main parameters studied. The clinical course of the disease in this group was characterized by pronounced clinical symptoms. Median values of the main respiratory impedance parameters in children of the second cluster remained within normal ranges; however, 20% of the children in this group showed increased values of X5Hz, D(Rrs5–Rrs20), delta Xrs5, and Fres with slightly elevated or normal R20Hz and R5Hz values, indicating ventilatory disorders at the level of the distal airways. The health status of children in the third cluster was more favorable compared to patients in the first and second clusters, and their IOS parameters were 1.5–2 times lower than those of children in the first and second clusters, indicating the absence of airway dysfunction. Conclusion. The presented IOS parameters will enable the practicing physician to make informed decisions regarding individual patients for better assessment of disease progression and treatment efficacy.

Introduction. It is known that bitter taste receptors (TAS2R) are localized in many organs and tissues including the respiratory tract. The functional characteristics of some TAS2R indicate their significant impact on the activity of mucociliary transport, cytokine production, and smooth muscle tone. Thus, TAS2R are often considered as promising targets for the therapy of asthma. Aim. To determine the effect of TAS2R20 polymorphisms on the development of asthma and the characteristics of the disease course. Materials and methods. The study included 230 patients with asthma of varying severity and 208 relatively healthy volunteers. Asthma control was determined using the Asthma Control Questionnaire and lung function were measured by spirometry. Single nucleotide polymorphisms (SNPs) TAS2R20 rs79420812, rs10845281, and rs61912291 were genotyped by PCR with melting analysis of oligonucleotide probes or amplification products. Total immunoglobulin E (IgE) levels in serum were determined using enzyme immunoassay. Results. Carriage of the TT genotype for rs61912291 was associated with uncontrolled asthma after adjustment for gender, age, and smoking status (OR 2.6, 95%CI (1.30-5.07), p=0.007). The same genotype was associated with signs of bronchial obstruction: a decrease in FEV₁ to less than 80% (OR 5.42, 95%CI (1.48-19.87), p=0.01) and FEV₁ /FVC to less than 70% (OR 2.44, 95%CI (1.43-4.18), p=0.001) after adjustment for gender, age, and smoking status. In addition, the homozygous state for the T allele for rs61912291 SNP was more common in asthma patients with IgE level of more than 100 IU/ml (OR 2.6 95%CI (1.22-5.54), p=0.01 after adjustment for gender, age and smoking status). Conclusion. SNPs of TAS2R20 do not affect the development of asthma but may be associated with the features of the disease course. Carriage of the TT genotype for rs61912291 SNP adversely affects the control of asthma, airway patency and is accompanied by an increased IgE level.

The pathogenesis of asthma may involve allergic inflammation of the "low Th2" subtype, which differs from the "high Th2" subtype by the dominant profile of intercellular signaling molecules. Aim. To study the types of immune response in patients with asthma and airway hyperresponsiveness to cold and osmotic stimuli by analyzing the levels of interleukins (IL)-17A, IL-17F, IL-22, IL-6, IL-4, IL-13, interferon (IFN)-γ, and patterns of bronchial inflammation. Materials and methods. Sixty-five patients with mild persistent asthma were examined. Induced sputum collection, blood sampling for biochemical studies, spirometry, bronchial provocation tests with isocapnic hyperventilation of cold (-20 °C) air (IHCA), and ultrasonic inhalation of distilled water (UIDW) were performed. The cellular composition of sputum (in percentages) was analyzed, and cytokine profiles in peripheral blood serum (IL-17A, IL-17F, IL-22, IL-6, IL-4, IL-13, IFN-γ, in pg/mL) were determined. Results. Group 1 (n=18) included patients with bronchial hyperresponsiveness to the IHCA; Group 2 (n=18) comprised patients with airway hyperresponsiveness to the UIDW; Group 3 (n=29) consisted of non-responders to the triggers. Patients in Groups 1 and 2 had lower baseline bronchial patency indicators. In the sputum of patients in Group 1, higher numbers of neutrophils and proportions of desquamated epithelial cells were recorded, with a correlation observed between the cell content and the airway response to the IHCA. These patients exhibited higher serum concentrations of IL-17A, IL-22, IL-6, IL-4, and IFN-γ. Correlation analysis showed an association between IL-17A levels and airway response to the IHCA: ΔFEV_1IHCA (Rs=-0.33; p=0.049); ΔMEF_50IHCA (Rs=-0.50; p=0.030); between IL-17F levels and ΔFEF_25-75IHCA (Rs=-0.38; p=0.037); ΔMEF_50IHCA (Rs=-0.40; p=0.029). IL-17A levels correlated with IL-17F levels (Rs=0.53; p=0.022), and IL-4 concentrations correlated with IFN-γ levels (Rs=0.53; p=0.0004). Conclusion. Patients with asthma and cold airway hyperresponsiveness are characterized by more pronounced impairments in airway patency, increased neutrophil counts in sputum, and elevated serum levels of IL-17A, IL-22, IL-6, IFN-γ, and IL-4. The immune response in these patients is associated with Th2/Th17 and/or Th1/Th17 types, whereas in individuals with osmotic airway hyperresponsiveness, it is more associated with the Th2 type of inflammation.

Aim: To assess the densitometric parameters of lung tissue indicative of small airway involvement and the morphometric parameters of large bronchi in patients with community-acquired pneumonia before and after treatment, and to analyze their diagnostic and clinical significance in comparison with spirometric parameters. Materials and methods. The authors analyzed CT and spirography data of 44 patients with community-acquired pneumonia before and after treatment with an interval of 10-14 days between the studies. Patients were divided into 2 groups according to the change in airflow according to the primary CT data. Lung function was assessed by forced expiratory flow spirometry. All examined patients underwent CT of lungs in the inspiratory phase with measurement of volumes in 3 density ranges, morphometric indices of large bronchi. Results. After the course of anti-inflammatory therapy there was a recovery of lung inflation in both groups. It was found that inflation was disturbed in both lungs, regardless of the localization of changes (unilateral, bilateral), which is associated with bronchial lesions. In the group with decreased inflation there was a positive correlation between the internal diameter of B10 of the right lung and forced expiratory volume in 1 sec (FEV₁ ) (r=0,51, p<0,0001), negative correlation - between the thickness of B10 wall of the right lung and FEV₁ (r=-0,53, p<0,0001). In the group of patients with lung hyperinflation, positive correlations were found between B10 inner diameter and FEV₁ (r=0,46, p=0,0001), between the index of inspiratory inflation and FEV₁ (r=0,80, p<0,0001). Conclusion. X-ray functional assessment of ventilation disorders by high-resolution CT with postprocessing allows to determine the type and reversibility of lung ventilation dysfunction and thereby significantly complement the visual characterization of lung lesions in community-acquired pneumonia.

Introduction. Monitoring infectious complications during the programmed therapy of hematological malignancies remains a critical issue in modern hematology. Aim. To examine the frequency and nature of infectious complications in patients with multiple myeloma (MM) treated at the Irkutsk Regional Clinical Hospital from 2016 to 2023. Materials and methods. A total of 450 medical records of MM patients who underwent programmed chemotherapy (CT) from 2016 to 2023 were analyzed. Among these, 213 patients (47%) were diagnosed with various infectious complications. These patients were divided into two groups: Group 1 consisted of 100 patients who received CT from 2016 to 2019, while Group 2 included 113 patients treated from 2020 to 2023. Results. The most common infectious complications associated with MM were bacterial pneumonia (41% in 2016-2019 and 18% in 2020-2023), fever of unknown origin (20% in 2016-2019 and 22% in 2020-2023), urinary tract infections (20% in 2016-2019 and 8.8% in 2020-2023), cytomegalovirus (CMV) infection (9% in 2016-2019 and 18.5% in 2020-2023), and in 2020-2023, the emergence of novel coronavirus infection (observed in 17% of MM patients). The majority of infectious complications occurred during the remission induction phase. A significant decrease in bacterial pneumonia (p<0.001) and urinary tract infections (p=0.020) was observed in 2020-2023 compared to 2016-2019, while an increase in CMV infection was noted (p=0.045). Other infectious complications, including gastrointestinal infections, mucositis, herpes infections, and skin and ENT infections, were infrequently reported during the study period. Conclusion. The study revealed new data that can be used to predict the development of infectious complications at various stages of programmed therapy for MM and to formulate effective preventive measures in clinical practice.

Introduction. Chronic Obstructive Pulmonary Disease (COPD) is a widespread heterogeneous disease, with smoking and exposure to air pollutants being the main etiological factors. Monocytes and macrophages are among the most important cells involved in the pathogenesis of COPD. It has been established that TRP channels can be activated in response to cigarette smoke in models of respiratory diseases. Previously, we identified the influence of TRP channels on the progression of bronchial obstruction and the peculiarities of their expression on peripheral blood leukocytes in patients with COPD. Aim. To study the features of TRPV1 and TRPV4 channels expression on subpopulations of peripheral blood monocytes in patients with COPD. Materials and methods. The study included 47 patients with COPD of varying severity and 25 individuals in the control group. Monocytes subpopulations and the expression of TRPV1 and TRPV4 receptors were determined by flow cytometry. Results. The TRPV1 channels had higher expression on monocytes of COPD patients (99.1 [98.6–99.6]% vs. 97.7 [95.6–99.5]%, p = 0.07). Analysis of monocyte subpopulations revealed that TRPV1 expression was increased on non-classical monocytes of COPD patients (94.5 [91.5–97.2] vs. 88.0 [71.5–95.1], p = 0.04). An increase in TRPV1 and TRPV4 expression on non-classical monocytes was associated with a decrease in the number of CD115 receptors on these cells. Correlations between TRPV1 and CD115 expression, expressed as a percentage, were ρ = -0.31, p = 0.07. Correlations for the TRPV4 channel with CD115 expression were ρ = -0.31, p = 0.08. An increased CD116/CD115 ratio on non-classical monocytes was also accompanied by a rise in TRPV1 channels expression on these cells (ρ = 0.35, p = 0.04). Conclusion. The study established that COPD patients, as compared to the control group, exhibit higher TRPV1 expression on non-classical monocytes. It was also determined that increased expression of TRPV1 and TRPV4 is associated with the formation of a pro-inflammatory phenotype of monocytes.

Introduction. Granulocyte-macrophage (GM-CSF) and macrophage (M-CSF) colony-stimulating factors are produced by various cells and regulate the proliferation and differentiation of monocytes and macrophages. Concentrations of these substances may vary significantly in many diseases including chronic obstructive pulmonary disease (COPD). Aim. To analyze the concentrations of GM-CSF and M-CSF in the blood plasma of COPD patients and individuals without bronchial obstruction and to determine the patterns of change in these factors in COPD. Materials and methods. The study included 53 smokers with COPD and 24 subjects without bronchial obstruction of which 46% were smokers. Parameters of lung function were measured by spirometry. The concentrations of GM-CSF and M-CSF were determined in the blood plasma using enzyme-linked immunosorbent assay. Cytokines (interleukin (IL)-4, IL-2, IL-1β, tumor necrosis factor (TNF)-α, chemokine C-C motif ligand (CCL) 2, C-X-C chemokine (CXCL)-10, IL-17A, IL-6, IL-10, interferon (IFN)-γ, IL-12p70, IL-8) were determined by multiplex immunofluorescence analysis. Results. The level of M-CSF was significantly reduced in patients with COPD compared to the control group (0.99 (0.39-2.10) pg/ml vs. 2.18 (0.55-3.43) pg/ml, p= 0.04). The median value of GM-CSF, on the contrary, was higher in COPD, although the differences with the control group were not significant (0.57 (0.0-2.49) pg/ml vs. 0.28 (0.0-1.81) pg/ml, p=0.73). The GM-CSF/M-CSF ratio was 0.17 (0.0-2.30) in patients with COPD and 0.15 (0.0-0.80) in those without bronchial obstruction (p=0.85). Concentrations of M-CSF and GM-CSF did not correlate with each other, and were also not associated with age, smoking index, and lung function parameters. Direct correlations were revealed between GM-CSF and percentage of circulating classical monocytes in COPD (ρ=0.38, p=0.008). Conclusion. Considering the important role of M-CSF in the differentiation of anti-inflammatory M2 macrophages, a decrease in the level of this factor may be associated with pro-inflammatory cell polarization in COPD.

Introduction. Parameters that characterize the intensity of peroxidation processes and genotoxicity in individuals with asthma, including under the influence of unfavourable environmental factors, can serve as indicators of the disease course. Therefore, there is a need to detail these parameters in asthma patients of different severity and control levels. Aim. To establish the characteristics of disruptions in oxidative homeostasis and genomic apparatus damage in individuals with mild-to-moderate asthma under the in vitro exposure to solid suspended atmospheric particulate matter (SPM). Materials and methods. An in vitro study included 244 asthma patients and 60 conditionally healthy individuals. Model suspensions (MS) simulating multicomponent atmospheric air pollution were used as the exposure load. We investigated total antioxidant activity (AOA), levels of malondialdehyde (MDA), 8-hydroxydeoxyguanosine (8-OHdG), thioredoxin-1 (Trx-1), total glutathione (GSH), and oxidized glutathione (GSSG). Ratios of MDA/AOA and GSH/GSSG were calculated. The effects of SPM are presented as indices reflecting the parameters under the influence of MS and without it. Results. In moderate asthma, more pronounced changes in oxidative homeostasis indicators were registered under SPM exposure compared to mild asthma. In controlled asthma, the maximum differences in indices between groups with mild and moderate severity were observed in the levels of GSSG (1.6-fold increase) and Trx-1 (1.3-fold increase). In partially controlled asthma, the greatest changes were found in the MDA/AOA ratio (2.7-fold increase) and 8-OHdG levels (1.6- fold increase). Conclusion. As asthma severity worsens, there is an increase in oxidative damage to bioorganic molecules and the initiation of genomic damage, which activates the thioredoxin link of the antioxidant system responsible for repairing damaged DNA. Under SPM exposure, more pronounced disruptions of oxidative homeostasis and increased genotoxicity occur with asthma severity, despite the stimulation of reparative processes. Significant elevations in 8-OHdG and Trx-1 levels with increasing asthma severity and SPM exposure may indicate the potential use of these markers to assess disease progression in technogenic environmental conditions.

Introduction. Lipid metabolism is a key component in many pathophysiological processes, and its disruption can play a significant role in the development of chronic inflammation in asthma. Aim. To determine the nature of the interaction between fatty acids (FAs) and their derivatives with cytokine parameters of the immune system and their contribution to systemic inflammation in patients with asthma. Materials and methods. The spectrum of FAs in the plasma of patients with asthma was analyzed using gas chromatography-mass spectrometry. Levels of endogenous fatty acid ethanolamides (NAEs) were measured using high-performance liquid chromatography with mass spectrometry. Cytokine levels were determined by enzyme-linked immunosorbent assay (ELISA). The degree of interaction between the parameters was assessed using systemic analysis based on the integral coupling index (D). Results. It was established that the immune system response was most strongly associated with the relative content of n-6 polyunsaturated fatty acids. Modification of the FA composition was most significantly linked with interleukins (IL) 17A, 10, 4, and 6. Endogenous NAEs—arachidonoylethanolamide (AEA, 20:4n6) and docosahexaenoylethanolamide (DHEA, 22:6n3)—showed significant involvement in cytokine regulation in mild asthma. NAE 20:4n6 had the strongest association with IL-17A, interferon-γ, tumor necrosis factor (TNF)-α, and IL-2; NAE 22:6n3 was associated with IL-17A, IL-6, and TNF-α. Conclusion. The study established the contribution of disturbances in trigger parameters of lipid metabolism to systemic inflammation. Modification of FA composition and disruption of the synthesis of their mediators lead to dysregulation of the cytokine network of the immune system, which may contribute to the development and chronicity of systemic inflammatory reactions in patients with asthma.

Introduction. Bronchial obstruction syndrome remains a significant issue in pediatrics. One of the non-invasive diagnostic methods in children is the determination of local nonspecific immune defense indicators. Aim. To study the role of surfactant protein SP-D in the functioning of the innate and adaptive immunity in children with bronchial obstruction. Materials and methods. A total of 183 children were examined: Group 1 consisted of patients with SP-D protein concentrations ranging from 100 to 500 ng/mL (n=21), Group 2 with less than 100 ng/mL (n=92), and a control group of healthy children with SP-D levels above 500 ng/mL (n=70). All children underwent enzyme-linked immunoassay to determine the concentrations of surfactant protein SP-D in exhaled breath condensate, and levels of IgA, IgM, IgG, IgE, and α-defensins 1-3 in serum. Results. The content of IgA was found to be 44.4% and 33.3% lower in the first and second groups, respectively, compared to the control group. Higher levels of IgE were detected in Groups 1 and 2 compared to healthy children. No differences were observed in IgM and IgG levels among the study groups. The concentration of α-defensins 1-3 was 6.8 times lower in Group 1 compared to the control group, and 1.7 times lower in Group 2. Conclusion. Reduced levels of SP-D affect both innate and adaptive immunity indicators. Low SP-D protein values were associated with decreased IgA and α-defensins levels, as well as high IgE concentrations.

Introduction. Current literature widely addresses issues related to the pathogenesis of COVID-19 during pregnancy. However, the problem of dysfunction in the monocyte/macrophage system in pregnant women, particularly concerning the influence of changes in the lipid membrane microenvironment caused by SARS-CoV-2, remains unresolved. Aim. To conduct a comparative study and explore the association of lipid rafts with the expression of CD receptors on monocytes involved in forming the immune response in women who had COVID-19 during pregnancy. Materials and methods. The study included women with mild (n = 25) and moderate (n = 27) severity of COVID-19 in the third trimester of pregnancy, and 25 women not infected with SARS-CoV-2 during pregnancy. Using flow cytometry, lipid rafts on blood monocytes were identified by the intensity of the cholera toxin B-subunit (CTB)/ganglioside GM1 complex formation, as well as the expression of Fcγ receptor II (CD32), mannose receptor (CD206), tumor necrosis factor receptors type 1 (TNFR1) and type 2 (TNFR2), interleukin 17 receptor (IL17R), and TNF-related apoptosis-inducing ligand (TRAIL). Lipid raft microscopy was performed using a fluorescent microscope. Results. An increase in the distribution density and number of rafts in the monocyte membrane was established, which were 1.6 times higher (p < 0.001) in moderate disease severity compared to mild cases. The expression levels of CD206 increased by 1.8 times (p < 0.001), CD32 by 1.05 times (p < 0.05), TNFR1 by 1.2 times (p < 0.001), IL17R by 1.7 times (p < 0.001), and TRAIL by 1.4 times (p < 0.001) compared to mild disease. No differences in TNFR2 expression were found between subgroups (p = 0.781). A direct correlation was identified between lipid raft expression levels and CD206 (ρ = 0.70, p < 0.01), CD32 (ρ = 0.77, p < 0.01), TNFR1 (ρ = 0.63, p < 0.01), IL17R (ρ = 0.60, p < 0.01), and TRAIL (ρ = 0.70, p < 0.01). An inverse correlation was also established between the gestational age at delivery and the expression of rafts (ρ = -0.53, p < 0.01), CD206 (ρ = -0.36, p = 0.008), and CD32 (ρ = -0.32, p = 0.02). However, the gestational age at the time of illness was not associated with changes in the expression of lipid rafts and CD receptors. Conclusion. In women who had COVID-19 during the third trimester of pregnancy, monocytes predominantly exhibit a pro-inflammatory phenotype expressing increased amounts of pre-activation markers CD206 and CD32, as well as cytokine receptors TNFR1, IL17R, and TRAIL. It can be hypothesized that the increased expression of CD206, CD32, and IL17R—which directly correlated with the number of lipid rafts—may be directly related to monocyte activation and, thus, to the severity of the infection and the development of complications during pregnancy.

In recent years, the role of oxidative stress and oxylipins in the pathogenesis of various diseases, including those affecting the female reproductive system and pregnancy complications, has been actively discussed. However, the role of 8-isoprostane and 15-hydroxyeicosatetraenoic acid (15-HETE) in the pathogenesis of pregnancy loss during COVID-19 has not been definitively established. Aim. To analyze the levels of 8-isoprostane and 15-HETE in peripheral blood and assess their prognostic significance in early pregnancy loss during COVID-19. Materials and methods. The study involved the main group of 48 women with a confirmed diagnosis of moderate COVID-19 (community-acquired pneumonia) in the first trimester (6–9 weeks). The control group consisted of 45 pregnant women who had not had COVID-19 previously and at the time of examination. The levels of 8-isoprostane in peripheral venous blood were measured using Cayman Chemical (USA) reagent kits, and 15-HETE was measured using Enzo 15(S)-HETE ELISA kits (USA) through an enzyme-linked immunoassay (ELISA). Results. Patients with moderate COVID-19 exhibited a significant increase in 8-isoprostane levels to 379.27±9.04 pg/mL (p<0.001) and 15-HETE to 3.66±0.12 ng/mL (p<0.001), compared to the control group values of 178.3±1.40 pg/mL and 1.57±0.06 ng/mL, respectively. To analyze the selected evaluation criteria, a discriminant function with a probability of differences of at least 95% was determined by deriving a discriminant equation, which for this study was as follows: PI = -59.765 + 0.261 × 8-isoprostane + 4.798 × 15-HETE, where PI is the prognostic index with a threshold value of 3.027. A PI equal to or greater than 3.027 indicated a risk of pregnancy loss in women with moderate COVID-19, while a PI lower than this threshold predicted a normal course of the first trimester of gestation. Conclusion. These findings suggest that elevated levels of 8-isoprostane and 15-HETE in women with moderate COVID-19 are pathologically significant in the development of early pregnancy loss.

In the 21st century, humanity has made a significant leap in the development of information and computational technologies, leading to the active advancement of artificial intelligence (AI). Initially, AI had primarily an entertainment character, but now technologies based on AI are actively being integrated into various professional fields. The Russian Federation is also increasing its research volume, including the application of these technologies in medical activities. This article examines some of the issues related to the active implementation and use of AI and AI-based products in medical practice in Russia. Literature data on existing legislation and legal practice are presented, along with discussions on ethical and deontological issues of AI use in medicine. Problems of information security and material-technical support are also highlighted. Based on the analysis conducted, we have formulated conclusions pointing to the controversial aspects of AI-based technologies' application in current medical activities. It is important to note that the authors do not oppose the integration of AI-based technologies into medical activities but have merely analyzed the problematic issues. The formulated conclusions and identified problems can help form a unified trajectory for the development and integration of AI into practical healthcare in Russia.

The factors shaping the effects of the COVID-19 pandemic are more pronounced, more widespread, and longer lasting than just the somatic effects of infection, with serious deterioration in people's actual and perceived quality of life (QoL). The COVID-19 pandemic has shown great potential to directly impact on the QoL of the general population, causing psychological distress, disrupting full participation in daily life and reducing the sense of connection to society. The aim of this review was to assess the impact of Long-COVID and related factors on the population's QoL, its physical, emotional and social aspects. High levels of fatigue after COVID-19 reduce work capacity, account for the loss of social ties, and increase depressive symptoms and lead to lower long-term QoL. Studies have shown that QoL is significantly lower in women than in men, and male gender is one of the risk factors for a severe course of COVID-19. Deterioration in health-related CV throughout the pandemic was noted in children and adolescents, who were particularly vulnerable to social distancing. Vaccination against COVID-19 was a significant predictor of higher physical QoL. The majority of those who underwent medical rehabilitation also have a high level of physical functioning, although some patients continue to report some functional problems. Published scientific papers demonstrate a number of unresolved methodological and methodological issues in assessing changes in health-related QoL as a result of the COVID-19 pandemic. Due to the high heterogeneity of studies, there is a need to develop approaches to reduce heterogeneity, use validated assessment tools, widely accepted questionnaires and specific follow-up timeframes. Standardized and long-term COVID-19 studies will undoubtedly be invaluable in understanding the epidemiology and impact of the burden of Long-COVID on health-related QoL.

Introduction. Laser therapy is a pathogenetically justified method for treating diseases of the bronchopulmonary system. With the advent of the Multiwave Locked System (MLS therapy), which combines continuous (808 nm) and pulsed (905 nm) emission modes, the possibilities of laser therapy for bronchopulmonary diseases have expanded. The aim of this review is to present the capabilities of laser therapy using the Multiwave Locked System (MLS therapy) in pulmonology. Materials and methods. A literature search was conducted in the PubMed/MedLine and eLIBRARY databases for the period from 2010 to 2024. Results. The analysis of literature data showed that the use of MLS therapy in bronchopulmonary diseases is a justified and effective treatment method. The use of MLS therapy in the comprehensive medical rehabilitation of pulmonary patients not only provides pronounced anti-inflammatory, anti-edematous, analgesic, and immunomodulating effects, but also improves lung function, peripheral oxygen saturation, increases exercise tolerance, and prevents the development of fibrosis.