Background. Measles is one of the infections that have become more prevalent in the post-pandemic period. This highly contagious disease, characterized by a high risk of severe symptoms and complications, is now being reported more frequently, including in adults, and has acquired a number of clinical and laboratory features. Studying the current clinical manifestations of measles in adults and children will help improve the effectiveness of measures to combat this infection. Objective. Analysis of the current clinical manifestations of measles in patients of an infectious hospital during a tense epidemiological situation in the Kemerovo Region-Kuzbass. Materials and methods. A retrospective analysis of the clinical and laboratory manifestations of measles in patients of an infectious hospital with a verified diagnosis was carried out. The blood was tested for IgM antibodies to the measles virus using the ELISA method using the VektoKor-IgM test systems produced by Vector-Best (Russia). The protocols of the laboratory test results of the Testing Laboratory Center of the Federal State Budgetary Institution "Center for Hygiene and Epidemiology in the Krasnoyarsk Region" were used. Statistical analysis of the data was performed using the MedStat software.Pro v0.9.4 (Russian Federation). The normality of the distribution was checked using the Shapiro – Wilk criterion. To assess the accuracy of the proportion determination, a 95% confidence interval (95% CI) was constructed using the Wilson score interval. The statistical significance of the differences was assessed using the exact Fisher criterion or the chi-squared criterion (with the Yates correction for expected frequencies of less than 5). The level of statistical significance was taken at p < 0.05. Results. Unvaccinated patients prevailed in the structure of measles patients. Contacts were established in 80.3%. Children accounted for 60.66%, adults – 39.34%. A directional diagnosis in 66% did not suggest measles. The clinical picture corresponded to the typical course. Classical periods were traced in 83.6% of patients. Belsky – Filatov – Koplik spots were detected in 24.6%. The stage of the rash was recorded in 93.4%. The hemogram showed a moderate increase in ESR, leukopenia, relative lymphocytosis, and thrombocytopenia in adults, and normocytosis in children. The increase in CRP was observed in 72%, and a transient increase in liver enzymes was observed in 50% of adults (1.5-5 times the normal value or higher) and 60% of children (1.5-3 times the normal value). In complex therapy, human recombinant interferon alpha-2b with antioxidants (vitamins C and E) was used in the form of rectal suppositories in age-appropriate doses. The course of the disease was smooth, and complications were not observed. Conclusion. The emergence of measles outbreaks is associated with low vaccination coverage, high contact rates, and imported cases. The clinical presentation of measles is typical. In adults, the main symptoms are significantly more pronounced. Laboratory tests confirm the viral nature of the disease and reveal transient changes in liver enzymes, which are more pronounced in adults. The main preventive measures should focus on increasing vaccination coverage and strengthening epidemiological surveillance in the context of interregional population mobility.
The purpose of the research is to study the relationship among physical activity, infrastructure parameters of the area of residence, and modifiable cardiovascular risk factors in the population of the Kemerovo Region. Design and methods . The study started at the Research Institute for Complex Issues of Cardiovascular Diseases (Kemerovo) in 2015 and continues to this day. It includes 1,598 residents aged 35–70 as part of the epidemiological work “Study of the influence of social factors on chronic non-communicable diseases.” The researchers measure the participants’ physical activity using the Russian-language version of the international IPAQ questionnaire and assess the subjective attitude of citizens to the infrastructure parameters using the NEWS questionnaire. The study establishes associations between the participants’ physical activity, mediated by their subjective attitude towards the infrastructure parameters, and modifiable cardiovascular risk factors such as hypertension, obesity, abdominal obesity, and lipid and carbohydrate metabolism disorders. Results . The present study demonstrates a direct impact of the infrastructure parameters from the NEWS scales on the reduction in the participants’ physical activity: B (accessibility of infrastructure facilities) [OR = 1,51]; D (pedestrian accessibility) [OR = 1,52]; E (environment in the vicinity) [OR = 1,55]; H (satisfaction with living conditions) [OR = 1,37]. In the group of individuals with low physical activity, characteristics of the area of residence combined into scales B [OR = 1,44], D [OR = 1,43], and F [OR = 1,30] were associated with hypertension; B [OR = 1,42] and [OR = 1,53], C [OR = 1,39] and [OR = 1,37], D [OR = 1,43] and [OR = 1,32] respectively — with obesity and its abdominal type; B [OR = 1,65] and D [OR = 1,41] — with dyslipidemia. Conclusions . The formed sample of the Kemerovo Region associates an increase in cardiovascular risk factors with the low physical activity of the population and its subjective attitude to the social characteristics (infrastructure parameters) of the area of residence.
Background. A Russian phase IV observational study was initiated to evaluate the efficacy and safety of lenvatinib with pembrolizumab (Len-Pembro) in patients with advanced renal cell carcinoma (RCC) receiving therapy in real-world practice. This article is based on the results of the third analysis conducted with a median follow-up of 23.1 months and reflects data on the efficacy and safety of Len-Pembro in Russian patients. Aim. To evaluate the real-world efficacy and safety of Len-Pembro in patients with advanced RCC with a median follow-up increased to 23.1 months. The primary outcome of the study was progression-free survival (PFS), the secondary outcomes included overall survival (OS), progression-free survival on next-line therapy (PFS2), objective response rate (ORR), duration of response, as well as safety. Materials and methods. The study included data from 165 patients with verified advanced RCC who received Len-Pembro at 36 centers in the Russian Federation from February 05, 2018 to July 30, 2025. The median age was 60 (20–76) years, and 70.3% of the participants were male. Most patients (74.6%) presented with Karnofsky performance score of ≥80%, metachronous metastases (50.9%) of clear cell RCC (93.3%) in 1 organ (75.2%), and had not received any anticancer treatment (91.0%). The IMDC favorable prognosis group included 40 (24.2%), intermediate – 92 (55.8%), and unfavorable prognosis – 33 (20.0%) patients. The median follow-up reached 23.1 (0.5–72.9) months. A total of 110 (66.7%) patients completed Len-Pembro therapy, and 51 (30.9%) patients received next-line treatment. Results. Median PFS reached 25.8 (95% confidence interval – CI 17.0–34.5) months, 23-month PFS – 52.6%; median OS was 39.9 (95% CI 26.9–52.8) months, 23-month OS – 73.1%; median PFS2 was 33.2 (95% CI 23.4–41.1) months, 23-month PFS2 – 66.9%. The ORR was 49.1%, including 3.0% of complete responses, and the disease control rate was 89.1%. The median duration of response reached 29.7 (95% CI 24.9–34.6) months. The incidence of any adverse events (AEs) was 78.8%, severe AEs occurred in 29.1%, fatal AES – in 1.2%, immune-related AEs – 17.0%, severe immune-related AEs – 6.7%. Conclusion. In real-world practice, with increased follow-up duration, the values of PFS, OS, and PFS2 were comparable to those obtained in the registrational study, with a lower ORR and a satisfactory safety profile of the combination of Len-Pembro in advanced RCC.
