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.
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.
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 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.
