Aim. To assess the associations of regional living conditions with the probability of hypertension (HTN), disease awareness, pharmacotherapy, and blood pressure monitoring in the elderly population, taking into account comorbidity. Material and methods. The analysis utilized individual data obtained from the ESSE-RF3 cross-sectional epidemiological study, conducted between 2020 and 2022. Regional living conditions were assessed using socio-geographic, demographic, economic, and production and environmental indices. The "Comorbidity of Patients with Noncommunicable Diseases in General Practice: Eurasian Guidelines" document was used to assess comorbid conditions. Logistic regression was used to evaluate associations, calculating odds ratios (OR) and 95% confidence intervals (CI). Results. In the sample with comorbid conditions, the HTN probability is associated with an increase in the Demographic Index (OR 1,37; 95% CI: 1,21-1,57). An increase in the Economic Index is associated with a decrease in HTN awareness (OR 0,68; 95% CI: 0,54-0,86). A decrease in pharmacotherapy is associated with an increase in the Production and Environmental Index (OR 0,91; 95% CI: 0,82-1,00). Improvement in blood pressure monitoring is observed with an increase in the SocioGeographical Index (OR 1,21; 95% CI: 1,11-1,32). In a sample without comorbidity, the HTN probability is associated with an increase in the Socio-Geographical Index (OR 1,24; 95% CI: 1,16-1,33), Demographic Index (OR 1,12; 95% CI: 1,04-1,21), and Production and Environmental Index (OR 1,08; 95% CI: 1,02-1,14). Higher awareness is observed with an increase in the Socio-Geographical Index (OR 1,29; 95% CI: 1,121,49). Improved blood pressure monitoring is noted with an increase in the Socio-Geographical Index (OR 1,17; 95% CI: 1,02-1,33). Conclusion. Regional living conditions are associated with the probability, awareness, pharmacotherapy, and monitoring of HTN in the elderly population.
Mycobacteriophages have attracted substantial interest for their potential in phage therapy, molecular biology, and biotechnology. The effectiveness of their isolation is largely determined by the characteristics of ecological biotopes and reservoirs that ensure the preservation, concentration, and circulation of phage particles in the environment. This review systematizes current data on the main ecological sources of mycobacteriophages, including soil and aquatic ecosystems, biofilm communities, rhizosphere and agroecological microenvironments, as well as biological and extreme reservoirs. The functional characteristics of ecological reservoirs of mycobacteriophages and their significance for the effectiveness of phage screening are discussed. Special attention is given to serial and exploratory approaches to the selection of sources for mycobacteriophage isolation. It is shown that the rational combination of standardized and ecologically specific biotopes contributes to the expansion of the genetic diversity of isolated mycobacteriophages and increases the efficiency of forming representative phage collections.
AIM: to evaluate the effectiveness of an organizational and managerial model for CRC screening based on the integration of questionnaire for primary risk stratification and relevant systemic solutions. PATIENTS AND METHODS: the pilot CRC screening project involved 960 patients — employees of industrial and educational institutions. The organizational and managerial model algorithm included: coordination and monitoring, work with project participants, controlled quality at all stages, identification of “anchor” medical organizations, and interdisciplinary interaction via telemedicine technologies. Participant stratification for subsequent colonoscopy was performed using an original questionnaire developed by the staff of the National Medical Research Center for Coloproctology. For comparative analysis, a quantitative faecal immunochemical test (FIT) was also used in all cases. RESULTS: after educational lectures, 872 (90.8%) respondents expressed willingness to further participation in the screening program. Of the 280 individuals invited to the second stage, 164 participants (58.6%) consented to participate. All second-stage participants (n = 164) underwent colonoscopy. Indications for deep checkup were present in 127 out of 164 individuals (77.4%). Indications were high risk according to the questionnaire (n = 100), positive FIT result (n = 34). In 7 patients, a combination of positive results was detected for both stratification methods. The remaining 37 out of 164 participants (22.6%) had no formal indications for colonoscopy (negative FIT and low risk according to the questionnaire) and underwent the examination at their own request. According to colonoscopy findings, neoplasms were detected in 95 out of 164 cases (57.9%) (malignant in 2.4%, benign in 55.5%). For the questionnaire method, sensitivity was 73.7% (95% CI: 63.6–82.2), and specificity was 56.5% (95% CI: 44.0–68.4). For the faecal immunochemical test (FIT), sensitivity was 24.2% (95% CI: 16.0–34.1), and specificity was 84.1% (95% CI: 73.3–91.8). As an independent stratification method, the questionnaire identified 3 out of 4 cases of malignant neoplasms (75.0%), whereas FIT identified 2 out of 4 cases (50.0%). The most significant advantage of the questionnaire was demonstrated in the context of secondary prevention of colorectal cancer. Using the questionnaire, polyps were diagnosed in 67 out of 91 patients (73.6%), while FIT detected polyps in only 21 out of 91 patients (23.1%), p < 0.001. In 5 patients (5.5%), positive results were found for both methods. Additionally, in 8 patients with benign neoplasms who underwent colonoscopy at their request, stratification results were negative (low risk according to the questionnaire and negative FIT). CONCLUSION: the implementation of a combination of widely available primary risk stratification tools (questionnaire) and high-tech solutions (artificial intelligence for endoscopic data analysis) will optimize the approach to screening programs for large populations and enhance their effectiveness.
Abstract. Eosinophilic otitis media (EOM) is a rare and clinically complex condition in the practice of otolaryngologists, characterized by a progressive course. Diagnosis of the disease is based on a combination of bronchial asthma and polypous rhinosinusitis, along with the presence of eosinophilic discharge in the middle ear. A distinctive feature of EOM is its relentless progression, which can lead to gradual hearing loss, up to complete deafness. This condition is typically associated with the development of sensorineural hearing loss, predominantly affecting high frequencies, and this process occurs over a shorter period compared to chronic otitis media. The rarity of this disease accounts for the absence of standardized treatment algorithms. This review summarizes current data on the etiology, pathogenesis, clinical presentation, diagnosis, and treatment of EOM. The work describes the etiology, pathogenesis, clinical symptoms, diagnostic approaches, and existing treatment regimens for eosinophilic otitis media.
Introduction . Cystic fibrosis is a hereditary disease associated with progressive damage to the bronchopulmonary system and the risk of disability. The introduction of triple CFTR modulators (ivacaftor/tezacaftor/elexaftor and ivacaftor) has significantly improved the prognosis. However, the high cost of the original drug Trikafta® and limited healthcare resources have driven interest in the bioequivalent generic drug Trilexa®. Aim . To evaluate the efficacy and safety of the pathogenetic therapy drugs Trikafta and Trilexa in children with cystic fibrosis in the Chechen Republic, as well as the transition from the original to the generic version within the same INN (ivacaftor + tezacaftor + elexacaftor and ivacaftor), in routine clinical practice. Materials and methods . A retrospective, single-center observational study was conducted in the Chechen Republic. The analysis included 22 patients under 18 years of age with a genotype corresponding to the indications for triple CFTR modulator therapy. Three groups were formed: Group 1 (n = 5) – treatment with Trikafta only; Group 2 (n = 2) – treatment with Trilexa only; Group 3 (n = 15) – patients switched from Trikafta to Trilexa. Changes in sweat chloride concentrations, body mass index (BMI), pulmonary function parameters (FEV₁, FVC), the frequency of pulmonary exacerbations, and the safety profile were assessed. Results . A decrease in sweat chloride concentrations was noted in all groups, indicating restoration of CFTR function. In Group 3, sweat chloride levels decreased from 91.0 to 41.0 mmol/L while on Trikafta and remained stable after switching to Trilexa. BMI significantly increased from 14.9 to 15.7 kg/m² during the Trikafta phase (p = 0.002) and continued to increase after switching to Trilexa. FEV₁ and FVC remained consistently high after switching (p > 0.05). The incidence of pulmonary exacerbations decreased and remained minimal while on Trilexa. Conclusion. The use of both the original drug and generic Trilexa in children with CF is associated with clinical improvements in key efficacy indicators and a favorable safety profile.
