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Currently, there is no common understanding of the bioelement status of obese children and adolescents. In this regard, we have summarized the available data on open access and presented information on the role and content of bioelements involved in the regulation of free radical homeostasis in the genesis of childhood obesity. The literature review revealed modern ideas about obesity as a metabolic pathology. The multifactorial nature of the development of oxidative stress in obesity, including in children and adolescents, is considered, the role of bioelements in the regulation of free radical homeostasis is revealed and it is shown that they can act as cofactors of antioxidant enzymes and/or be initiators of oxidative reactions. The most significant bioelements involved in the regulation of free radical processes are copper, zinc, manganese, selenium and iron. The analysis of the literature shows that children and adolescents with obesity experience changes in the metabolism of the main bioelements involved in the regulation of redox homeostasis. The content of copper, zinc, selenium, manganese and iron may vary depending on the gender and age of the subjects, as well as the type of biomaterial being studied.

Influenza and acute respiratory viral infections (ARVI) impose a substantial damage to the population health in the Russian Federation due to their seasonal circulation and predominantly affect young children. A very few data on the cytokine profile, the nonspecific LPO — AOD system and their relationships with clinical characteristics in such diseases in preschool children are available. The aim of this study was to assess the cytokine profile, LPO — AOD system parameters and their relationship with the clinical and laboratory characteristics of diseases in preschool children with influenza and other ARVI. 86 preschool children (3–6 years old) were examined: with an established diagnosis of influenza (n = 31), non-influenza ARVI (n = 28), apparently healthy children (control group (n = 27). All pediatric samples were analyzed by enzyme-linked immunosorbent assay assessing blood serum concentrations of C-reactive protein and cytokines IL-1β, IL-4, IL-6, IL-8, TNFα, IFNα, IFNγ. Spectrophotometric, fluorometric and enzyme immunoassay methods to assess the state of the “LPO — AOD” system were used. In the group of children with influenza vs other ARVI, a higher incidence of intoxication syndrome was revealed. Cytokine profile in children from both clinical groups compared with control cohort was featured with higher indicators of both pro-inflammatory and anti-inflammatory origin. Children with non-influenza ARVI, had increased magnitude of LPO final products in the nonspecific LPO — AOD system along with lowered concentration of fat-soluble vitamins, general antioxidant activity, GSH level, and SOD activity. In the group with influenza, the level of primary and final lipid peroxidation products was increased, whereas that of for retinol,α-tocopherol, and total antioxidant activity was decreased paralleled with higher GSSG and SOD levels. Numerous correlations were noted in the group of children with ARVI: IL-1β/ketones, IL-6/ketones, IL-8/ketones, TNFα/ketones, IL-4/ketones, IFNg/shortness of breath, IFNα/cough, double bonds/fever, double bonds/AST, SO/intoxication, retinol/fever, GSSG/cough. The influenza group differed in the following relationships: IL-4/ketones, IL-4/fever, IFNα/ketones, CDs/AST. It can be concluded that in preschool children with ARVI and influenza, changes in the cytokine profile are accompanied by increased pro- and anti-inflammatory cytokine levels, increased intensity of lipid peroxidation reactions along with reduced magnitude of antioxidant factors. In the group with ARVI, there was a relationship between the final toxic products of lipid peroxidation — Schiff bases — and the intoxication index, as well as the presence of protective mechanisms in the form of connections between interferons and disease clinical manifestations. The group with influenza was distinguished by the presence of protective relations, which may have a beneficial effect in the context of developing pathological process. The data obtained will help expand the understanding of the pathogenetic mechanisms related to immune reactivity and nonspecific lipid peroxidation reactions in preschool patients and formulate appropriate measures for correction.

The leptin gene (LEP) is considered as a potential candidate gene affecting metabolic disorders associated with predisposition to overweight and obesity.The aim of the study. To search for single nucleotide polymorphisms (SNP) of the leptin gene and to assess their relationship with anthropometric and biochemical parameters in Russian and Buryat adolescents with different weight status.Materials and methods. The study included adolescents of two ethnic groups – Caucasoid (Russians) and Mongoloids (Buryats) – aged 11–17 years (mean age 14.8 ± 0.45 years) with different weight status. We assessed anthropometric parameters, determined biochemical parameters and leptin level in the blood plasma, and sequenced the leptin gene fragment localized in the 128253475–128255334 region (1859 bp) of this gene using the Sanger method.Results. The sequencing of the leptin gene fragment identified 10 single nucleotide substitutions (rs28954118, rs3828942, rs759854910, rs199893150, rs7788818, rs144755411, rs917105894, chr7:128255051, chr7:128255092, chr7:128254681), two of them (rs28954118, rs144755411) had a correlation with biochemical and anthropometric parameters. In the group of Russian adolescents with overweight and/or obesity, the carriers of the AT variant of rs28954118 had statistically significantly higher levels of triglycerides (TG), very low density lipoprotein (VLDL) cholesterol, skin fold thickness on the abdomen and fat mass percentage compared with carriers of the AA genotype. In the control group of Buryat adolescents, the parameters of waist width, skin fold thickness on the hip and waist width/height ratio are statistically significantly lower in carriers of the CT variant of rs144755411 compared with carriers of the CC genotype.Conclusion. AT genotype of rs28954118 was identified only in Russian adolescents with overweight and/or obesity, and was accompanied with statistically significantly high values of TG, VLDL cholesterol, skin fold thickness on the abdomen and fat mass percentage. The SNPs we identified do not affect the concentration of leptin.

Background. Within the framework of the regional pilot project on selective exome screening of newborn children, which is carried out on the basis of the National Medical Research Center for Obstetrics, Gynecology and Perinatology named after Academician V.I. Kulakov, we conducted molecular genetic testing of children who meet the criteria for inclusion in the increased group of hereditary diseases. We examine not only children with suspected genetic etiology of the condition, but also children with borderline clinical and laboratory manifestations and minor developmental anomalies.The aim of the study. To describe the clinical and phenotypic features of a patient with a previously undescribed Xq12q13.2 duplication detected in the neonatal period.Materials and methods. The child was examined within the framework of a regional pilot project on selective exome screening of newborn children. DNA was isolated from a biological sample of venous blood of the newborn, and whole exome sequencing and chromosomal microarray analysis were performed. Signed informed voluntary consent for the publication of the examination data and a photograph of the child were obtained from the legal representatives of the proband.Results. Data in favor of the presence of a previously undescribed Xq12q13.2 duplication, confirmed by the reference method were obtained in a patient included in the project in accordance with the clinical criteria for the formation of a risk group according to the data of the conducted whole exome sequencing. Discussion. Xq12q13.2 duplication was detected in the proband from the present clinical observation with non-specific clinical manifestations in the neonatal period. Similar duplications have been described in the literature in three patients with congenital malformations, epilepsy and psychomotor retardation. Early diagnosis of such a copy number variation disorder before the appearance of severe clinical signs of the disease will allow determining the prognosis and tactics of observation and treatment of the patient.Conclusion. The described case of Xq12q13.2 duplication in a patient demonstrates the importance of timely genetic analysis to optimize medical genetic counseling, reduce diagnostic search and improve prognosis for patients.

Therapeutic drug monitoring is the practice of measuring the concentration of a drug in patient’s biological fluids to assess the effectiveness and safety of drug therapy. The results of determining the drug level in biological fluids can also indicate noncompliance of therapy regimen and low adherence to therapy.The aim. To compare the concentrations of some antiretroviral drugs (lopinavir, ritonavir, lamivudine, abacavir, zidovudine) in children living with HIV infection of different age groups.Methods. We examined 184 children with perinatal HIV infection who underwent therapeutic drug monitoring of nucleoside reverse transcriptase inhibitors (lamivudine, abacavir, zidovudine) and protease inhibitors (lopinavir, ritonavir). Children were divided into four age groups. Group 1 included children 1–2 years old (n = 7); group 2 – children 3–5 years old (n = 14); group 3 – children 6–11 years old (n = 78); group 4 – children 12–17 years old (n = 85). The concentration of antiretroviral drugs in blood plasma was determined using high-performance liquid chromatography with mass selective detection.Results. The lowest lopinavir concentration was found in children 12–17 years old (3782 [2117–5046] ng/ml), which was statistically significantly different from the similar values in children 6–11 years old (5614 [3521–7264] ng/ml; p = 0.011). For other antiretroviral drugs, no statistically significant differences in blood plasma concentrations were found in children of different age groups.Conclusion. The lowest lopinavir concentrations are detected in children older than 11 years. For the other studied antiretroviral drugs, this pattern was not revealed

Background. In recent years, special attention has been paid to the studying the consortia of probiotic bacteria. In these associations, the properties of individual microorganisms can be enhanced, in particular, their antagonistic activity which is an effective indicator for screening of probiotic potential. The development of probiotics based on such consortia with antibacterial properties is critical in the light of the growing problem of drug resistance in microorganisms.The aim of the work. To study the antagonistic activity of monocultures and consortia of lactobacilli against multidrug-resistant isolates of opportunistic bacteria. Materials and methods. The antagonistic activity of lactobacilli monocultures and their consortia was assessed simultaneously by two methods: the cross streak method and the well diffusion method.Results. All strains of lactobacilli and their consortia, depending on the research method, had varying degrees of antagonistic activity. Five consortia had stronger antagonism to test cultures as compared to monocultures, while in one consortium, the effect of antagonistic activity was reduced compared to monocultures. The results of studying the antagonistic activity of two consortia (Limosilactobacillus fermentum 44/1 and Lacticaseibacillus rhamnosus 12L, Latilactobacillus curvatus LCR-111-1 and Lactiplantibacillus plantarum 8PAZ) contradict data on the biocompatibility of strains in these consortia. Differences in the degree of antagonistic effects of lactobacilli on gram-positive and gram-negative species of opportunistic bacteria were revealed.Conclusion. The study showed that both the biocompatibility of the probiotic strains and the antagonistic activity of the consortium are the important requirements for creating a probiotic consortium with effective probiotic potential. To study the antagonistic properties of lactobacilli, the number of isolates of target gram-positive and gram-negative bacteria and normobiota should be increased. This will allow us to determine effective strategies for using probiotics in conditions of the spread of drug resistance of microorganisms.

Introduction. Influenza remains a serious viral infection in children and has consequences for the organism.The aim of the study. To analyze the lipid peroxidation products and antioxidant defense (AOD) components level in children of two age groups with seasonal influenza.Materials and methods. We examined 141 children aged from 1 month to 6 years with a diagnosis of influenza (subgroup 1 – 1 month – 2.11 years (n = 78); subgroup 2 – 3–6 years (n = 63)), 47 children of control group (subgroup 3 – 1 month – 2.11 years (n = 17); subgroup 4 – 3–6 years (n = 30)). Spectrophotometric, fluorometric and statistical methods were used.Results. In subgroup 1 of children with influenza, there were higher levels of compounds with double bonds (p = 0.001), conjugated dienes (CDs) (p < 0.0001), ketodienes and conjugated trienes (KD and CT) (p = 0.004); in subgroup 2 of children with influenza – increased values of CDs (p < 0.0001), KD and CT (p < 0.0001) and thiobarbituric acid reactants (p < 0.0001) compared to the control. The AOD system in subgroup 1 was characterized by a decrease in the level of α-tocopherol (p < 0.0001), retinol (p < 0.0001) and higher oxidized glutathione (GSSG) values (p = 0.002) compared to the control. Children of subgroup 2 had lower values of the level of α-tocopherol (p < 0.001), retinol (p = 0.012) and total antioxidant activity (p < 0.0001) and higher values of GSSG (p = 0.035) compared to the control.Conclusion. In children with influenza, regardless of age, there is a higher level of production of lipid peroxidation indicators, a lack of fat-soluble vitamins and higher values of oxidized glutathione than in healthy children

The aim of this article was to show the labor valour during the Great Patriotic War of the employees of the first research institute in Irkutsk, which began its history in 1912, as well as their success of the present time. The oldest scientific institution in the Irkutsk region was originally created on the initiative of the Siberian Medical Society as a laboratory and was transformed into the Chemical and Bacteriological Institute in 1918, and in 1930 it became the Institute of Epidemiology and Microbiology of the People’s Commissariat of Public Health of Russia.By the beginning of the Great Patriotic War, the institute had an epidemiological department and a microbiological laboratory that carried out epidemiological surveillance and diagnosis of a wide range of infections in Siberia. During the war years, the manufacturing sector with the production of vaccines and serums acquired particular importance. By the end of the war, 285 employees worked at the institute, 32 of them had higher education. During the war years, the production of vaccines against typhoid, paratyphoid, dysentery, diphtheria, tuberculosis, and smallpox was significantly increased. Serums against tetanus and measles, and a dysentery bacteriophage were produced. At the same time, research projects and thesis works were carried out. The employees of the institute received national and departmental awards, commendations, honorary distinctions, and rewards for their scientific work and production excellence.Currently, the institute continues the glorious traditions of the past and demonstrates truly heroic efforts in the development of virology and microbiology, working in priority areas of medical and biological science. Of course, the works of scientists of the present time will be appreciated only by descendants, as is now happening with the assessment of the work of the Institute of Epidemiology and Microbiology during the Great Patriotic War.

This literature review was compiled according to the data of search engines PubMed, eLIBRARY.RU, Google Scholar using key words influenza, cytokines, children. The article highlights the participation of pro-inflammatory and antiinflammatory cytokines in the pathogenesis of influenza, compares the cytokine profile in different strains of the virus, with concomitant pathology, as well as attempts to find an answer to the question: “Why are young children more susceptible to this infection?” The article contains information about the creation of express systems for diagnosing cytokine storm in patients with influenza and other acute respiratory viral infections, taking into account a complex of clinical and laboratory data that comes to the aid of a practicing physician. It should be noted that there are different opinions among authors regarding the early markers of severe and complicated influenza in childhood. This information makes the topic of studying the significance of cytokines in influenza in children relevant, but it requires continuation and clarification of knowledge on this issue.

Background. Adequate sleep ensures a person’s physical and psycho-emotional well-being. Adolescence is one of the critical stages of life. The exclusive attention of specialists and leveling the impact of adverse factors on the body during this period is the key to the proper development and preservation of the health of adolescents. Meanwhile, sleep problems in teenage girls remain poorly understood.The aim. To study the features of the sleep regime and quality of sleep of teenage girls in the city of Irkutsk.Materials and methods. A survey of 422 teenage girls in the city of Irkutsk was conducted using a translated version of a questionnaire about adolescent sleep habits to subjectively assess their sleep and wakefulness. Two groups were formed: group I – girls with sleep problems (n = 171); group II – girls without sleep problems (n = 251).Results. Sleep disorders among teenage girls in the city of Irkutsk occurred with a frequency of 40.52 %. In most cases, a complex effect of various unfavorable factors on the sleep process has been identified. The adolescents with sleep disorders we examined were characterized by higher rates of sleep latency, later bedtime, earlier awakening, decreased time of night sleep, as well as changes in the sleep shift indicator towards its increase. These violations were noted both on weekdays and on weekends.Conclusions. Sleep problems were reported in 40.52% of respondents. The complex impact of various unfavorable factors on sleep quality has been revealed. The features of sleep hygiene of teenage girls are reflected. The group of girls with sleep problems was characterized by increased sleep latency, later bedtime, earlier awakening, reduced sleep time, and an increase in sleep shift.

Introduction. Respiratory diseases occupy a leading place in the structure of pathology of childhood. The proportion of influenza and acute respiratory viral infections among all infectious diseases is 90 %. The literature describes gender differences in the immune response to respiratory infections in children, but there is a gap in the description of the cytokine profile in children with influenza depending on gender and age.The aim. To analyze clinical and laboratory parameters as well as cytokine profile parameters in children with influenza.Materials and methods. A single-stage descriptive study was conducted with the participation of 50 children from 1 to 11 years of age with a diagnosis of influenza who were on inpatient treatment at the Irkutsk Regional Infectious Diseases Clinical Hospital from December 2018 to January 2019. The clinical and laboratory features of the course of influenza in children, the duration of treatment were determined. The concentration of cytokines interleukin (IL) 1β, IL-4, IL-6, IL-8, tumor necrosis factor alpha (TNF-α), interferon alpha and gamma (INF-α, INF-γ) in blood plasma was determined by enzyme-linked immunosorbent assay (ELISA) using diagnostic test systems manufactured by Vector-Best (Novosibirsk, Russian Federation) on the analyzer Multiscan EX (Thermo Electron, Germany).The control group consisted of practically healthy children without signs of acute respiratory viral infection (n = 50; mean age 5.3 ± 2.6 years).Results. When comparing clinical and laboratory data and cytokine profile parameters in children with influenza, no gender differences were found. There was a statistically significant increase in the level of pro-inflammatory cytokines IL-1β, IL-6, IL-8, TNF-α, INF-α, as well as CRP, anti-inflammatory cytokine IL-4 in influenza in all age categories, in contrast to the control group (p < 0.05).Conclusion. Influenza in children of different sexes proceeds classically without a statistical difference in clinical and laboratory parameters and in the level of cytokines.

Background. Bedaquiline is a new and promising anti-tuberculosis drug, but longterm use requires resistance. This is due to mutations in the atpE and mmpR genes in M. tuberculosis (MBT).The aim of the research was to test a system for automated interpretation of results for predicting resistance to bedaquiline by the molecular data.Materials and methods. DNA was isolated from strains of M. tuberculosis in the Irkutsk region and Yakutia. The total quantity of DNA samples was 27 strains from Yakutia and 21 strains from the Irkutsk region. The study of MBT genomes was carried out on the DNA previously obtained by the authors in the territories of the Irkutsk region (n = 5), Yakutia (n = 4), Buryatia (n = 3), Zabaykalskiy kray (n = 4) and the Far East (n = 8). We used the BSATool program to detect bedaquiline resistance based on Sanger and genomic data. Sanger sequencing analyzed the atpE and mmpR genes, and whole genome sequencing examined mutations in the same sequences, as well as additionally in mmpL5, mmpS5, Rv0678, Rv1979c, and pepQ.Results. Complete agreement between the phenotypic and genotypic analysis of resistance to bedaquiline was found for three strains from Yakutia. One genome with significant mutations to bedaquiline was identified. A conclusion was made about the importance of molecular analysis of target genes with subsequent detection of resistance to bedaquiline in silico.

Background. The rational nutrition of the child population is given great medical importance as a factor in preserving the health and development of the child. A complete and balanced diet in terms of the content of basic nutrients ensures the normal growth and development of the child’s body.The aim. To analyze of the actual nutrition of adolescents living in rural areas of the Irkutsk region.Materials and methods. The study involved 69 rural adolescents aged 11–17 years (34 boys, 35 girls). The actual nutrition was studied by the method of 24-hour nutrition reproduction. The energy value of the diet was determined, the nature of the provision of the diet with basic macro- and microelements was studied. The obtained values were compared with the norms of physiological needs for energy and nutrients in 2008 and 2021.Results. The analysis of actual nutrition revealed deviations from the principles of healthy nutrition: insufficient energy value of the diet, deficiency of proteins and fats. The diet of adolescents was characterized by an insufficient content of the main groups of macro- and micronutrients – vitamins A, C and D, essential trace elements, and a deficiency of dietary fiber. The diet of adolescents was characterized by increased sodium intake. The calculated ratio of proteins, fats, carbohydrates indicated a carbohydrate type of diet.Conclusion. Despite the great attention to the problem of balanced nutrition of adolescents, the question of the impact of nutrition on the health of a teenager, considering the regional factor, remains open. Recommendations for the development of a regional program for the organization of proper nutrition for school-age children are of great practical importance.

Background. Vaccination coverage of children in India is not sufficient since the COVID-19 pandemic (less than 90 %). This may lead to low adherence of parents to children’s vaccination.The aim. To study parental attitudes and awareness towards children vaccination programs in India at the COVID-19 pandemic background.Methods. Two hundred and fourteen participants from Kerala state (India) took part in the descriptive cross-sectional study via survey method. The survey was prepared with Google form according the principles of anonymity.Results. Indian parents demonstrated good adherence towards children’s vaccination, 98.6 % (95% confidence interval (CI): 95.9–99.5) of them vaccinated their child, and if vaccination appointment had to be rescheduled 84.6 % (95% CI: 79.1–88.8) of them vaccinated children after. Most of Indians (68.7 %; 95% CI: 62.1–74.5) preferred to vaccinate children in state clinics, however, 28.5 % (95% CI: 22.8–34.8) chose private clinics. Information about diseases that vaccines can prevent, vaccine safety, and side effects 47.2 % (95% CI: 40.6–53.8) of parents got from public pediatricians, 50.9 % (95% CI: 44.2–57.5) – from private pediatricians, and 10.3 % (95% CI: 6.8–15.0) – from complementary and alternative medicine practitioners. Over 80 % of Indians were informed about vaccination through mass media (83.6%; 95% CI: 78.1–87.9). Indian parents showed low awareness about vaccination, because 63.1 % (95% CI: 56.4–69.2) of parents wanted to know more about vaccination. Moreover, before vaccination 21.5 % (95% CI: 16.5–27.4) of them were not informed by a doctor about health benefits and possible risks for their children.Conclusion. In the COVID-19 pandemic Indian parents showed good attitude towards vaccination and low awareness in vaccination questions.

Background. The study of the lower respiratory tract microbiome has been actively developed inrecent years with the help of whole genome sequencing (WGS) methods. Due to this, it became clear that the nature of the lungs microbiota is very different from other microbial communities inhabiting the human body. One of the important directions in the study of pathological lungs biocenosis is the study of the role of the satellite microbiota of the tuberculosis focus. The aim of the work. To isolate and characterize oxygen-tolerant anaerobes from the necrotic contents of tuberculomas. Materials and methods. Biopsy material from 5 patients with pulmonary tuberculosis was obtained during a planned surgical treatment of tuberculoma. A pure culture was isolated from one sample during anaerobic cultivation. Lipase activity of strain was determined by plating on brain heart infusion agar (HIMEDIA, India) supplemented with 0.1 % Tween-80 and 10 mM of CaCl2. Antibiotic susceptibility was determined by RAPMYCO and SLOWMYCO of TREK Diagnostic Systems (Thermo Fisher Scientific, USA). DNA from the sediment of the broth culture was isolated by the CTAB chloroform method. Whole genome sequencing was performed on a DNBSeq-G400 NGS sequencer by Genomed (Russia). Results. Based on WGS results and phylogenetic analysis, the strain was identified as Corynebacterium kefirresidentii. The strain was characterized by high lipase activity and resistance only to Isoniazid, Ethionamide and Trimethoprim/Sulfamethoxazolin. Conclusion. The isolation of a lipophilic anaerobic representative of the Corynebacterium tuberculostearicum species complex from a tuberculous focus indicates a possible role of the non-tuberculous microbiota in the liquefaction of caseous necrosis. We assumed that in some cases, favorable conditions are created inside the tuberculous focus for the development of satellite anaerobic lipophilic microbiota.

Background. Obesity is a significant social problem among the population of the world. The leptin gene (LEP) is currently considered as a potential candidate gene influencing metabolic disorders associated with predisposition to overweight and obesity. Leptin plays an important role in body weight homeostasis by influencing food intake and energy expenditure and maintaining constant energy stores. A defect in the leptin gene may be one of the causes of obesity and, as a result, of various obesity-associated pathologies. The aim of the study. To search for single-nucleotide polymorphisms (SNP) of the leptin gene in adolescents with different weight status. Methods. The study involved 20 adolescents aged 11–17 years with normal body weight and overweight/obesity. Research methods: assessment of clinical status with anthropometry; Sanger sequencing of the leptin gene fragment localized in the intron of this gene – (5’-AGCCTTGTTTTCATCATCTGGA, 3’-TGGGAGGAATCGCTCTCAGA). We also carried out bioinformatic processing of sequencing results. Results. As a result of the study, the optimal conditions for amplification of the 891 bps leptin gene region were selected for the above mentioned primer pair of the LEP gene (s16_L891, s16_R891). Based on the results of sequencing, 45 single nucleotide substitutions of the LEP gene were identified, including 23 single nucleotide substitutions which were not previously registered in GenBank. In the group of adolescents with overweight and obesity, 14 unregistered single nucleotide substitutions of the LEP gene and 13 registered SNPs were identified in the GenBank database. In the group of adolescents with normal body weight, these SNPs were not found.

Background. Using probiotic preparations based on consortia of microorganisms not only helps to restore the balance of the intestinal microbiota, but also increases the therapeutic effect of probiotics. Promising sources for obtaining probiotic consortia are milk products that have undergone natural fermentation with the help of spontaneously formed microbial consortia. The aim. To study the structure of five microbial consortia with probiotic properties from naturally fermented milk products and to assess in vitro their antagonistic activity against opportunistic bacteria and a representative of the human normobiota – Escherichia coli. Materials and methods. The structure of bacterial consortia was analyzed by sequencing methods. The antagonistic activity of the consortia was assessed by the disk diffusion method. Results. It has been established that the studied microbial consortiums are represented by Enterococcus spp. and Streptococcus spp. bacteria. In consortiums No. 1, No. 2, and No. 3, Enterococcus bacteria dominated, while in consortiums No. 4 and No. 5, Streptococcus dominated. Antagonistic activity was shown against four isolates of opportunistic bacteria: Klebsiella pneumoniae No. 493, Enterobacter hormaechei No. 372, Staphylococcus aureus No. 4 and Pseudomonas aeruginosa No. 25 IMB, as well as against one representative of the human normobiota – Escherichia coli No. 495. The highest growth delay zone is found in E. coli No. 495 isolate. Three test cultures (K. pneumoniae No. 509, E. coli ATCC25922 and P. aeruginosa No. 3 IMB) exhibited more dense growth around probiotic consortia. Conclusion. The results of the study showed that the effect of probiotic consortia differing in the composition of microorganisms can be neutral and bactericidal. The presence of antagonistic activity in the studied microbial consortia against multiresistant isolates of opportunistic bacteria is a prospect for creating probiotics with antibacterial properties.

The aim. To assess the thyroid status and its relationship with tumor necrosis factor alpha (TNF-alpha) in post-reproductive women in the acute phase of the COVID-19 of moderate course and 12 months after the disease.Materials and methods. 85 women aged 45 to 69 years were divided into groups: women without COVID-19, not vaccinated, with no antibodies to COVID-19 (IgG) – control group (n = 15); women in the acute phase of COVID-19 of a moderate course, accompanied by pneumonia – main group (n = 57); patients from the main group who agreed to be examined 12 months after having COVID-19 (n = 14); women with IgG in blood who deny any symptoms of COVID-19 in the last 12 months – asymptomatic COVID-19 (n = 13). Using hormone replacement therapy and the presence of thyroid disease in history were the exclusion criteria from the study.Results. 75.4 % of patients with COVID-19 had euthyroidism, 12.3 % had subclinical hyperthyroidism. An increase of free thyroxine (free T4) level in women with COVID-19 as compared to the control group (p = 0.004) and the group with asymptomatic COVID-19 (p = 0.054) was found. There was no statistically significant difference in the level of thyroid stimulating hormone between the groups. The level of C-reactive protein in women with COVID-19 was naturally higher as compared to the control group (p = 0.009) and the group of asymptomatic patients (p = 0.001). A lower TNF-alpha level was found in the group of patients without clinical signs of COVID-19 as compared to the control group (p = 0.007) and the group with COVID-19 (p = 0.00007). The analysis of correlation relationships revealed a positive correlation between of free T4 and TNF-alpha levels in women with COVID-19 (r = 0.38, p = 0.004).Conclusions. The moderate course of COVID-19 in the post-reproductive women is associated with an increase of free T4 level, which positively correlates with TNF-alpha level. Twelve months after COVID-19, thyroid status in women remains at the level of the acute phase of the disease.

Background. The neuropsychological approach suggests that differences in cognitive processes are associated with the variability of combinations of signs of partial dominance of certain brain structures, manifested in the form of individual laterality profiles. However, the problem of identifying and studying the relationship between interhemispheric asymmetry and cognitive functions in adolescents with a high level of intelligence remains not fully resolved, which determines the relevance of this study.The aim of the research was to describe the relationship between the type of profile of interhemispheric asymmetry with the characteristics of cognitive functions in adolescents with average and high levels of intelligence.Materials and methods. The sample included 52 people aged 12–15 years: 26 adolescents with high level intelligence (main group), 26 adolescents with an average level of intelligence (control group). The following research methods were used: Wechsler test (WISC-IV), method for studying the profile of interhemispheric asymmetry (Khomskaya E.D., Efimova I.V.); method “Correction test” by B. Bourdon; method ”Story on a given topic”.Results. The majority of adolescents with a high level of intelligence revealed the severity of right-lateral features, which were traced in the manual, auditory and visual spheres of sensorimotor asymmetry. At the same time, the severity of right-lateral and ambilateral features is accompanied by more pronounced indicators of the development of cognitive functions. Adolescents with the type of profile of interhemispheric asymmetry “Left-handed” were characterized by an insufficient level of attention stability and a reduced ability for detailed speech utterance, regardless of the level of intelligence.Conclusions. The data obtained show that the peculiarity of individual profiles of interhemispheric asymmetry determines the uneven development of a number of mental functions in adolescence and the different readiness of brain mechanisms to support various cognitive processes. We assume that the results of the work will expand the understanding of the role of interhemispheric asymmetry of the brain in the organization of cognitive functions in adolescents with a high level of intelligence.

Background. Currently, there are two main areas of study of the impact of a new coronavirus infection on mental processes: the first is in connection with the regime of self-isolation and restrictions in a pandemic; the second – with the impact of the pathological process itself and the post-covid syndrome on the central nervous system. The results of the studies indicate the relationship of this infection with local lesions of the brain and the corresponding disturbances in the functioning of mental processes.The aim of the research. To systematize and analyze the results of studies on the main routes of penetration of the SARS-CoV-2 virus into the central nervous system, cognitive and emotional disorders in people who have recovered from COVID-19, and to discuss the areas of psychological rehabilitation for this group of patients.Materials and methods. Information search was carried out using Internet resources (PubMed, Web of Science, Scopus, bmj.com, eLibrary.ru, frontiersin.org, sciencedirect. com, ncbi.nlm.nih.gov), literature sources were analyzed for the period from May of 2020 to November of 2021 for the following keywords: COVID-19, SARS-CoV-2, cognitive functions, cognitions, cognitive impairments, emotional dysfunction, affective dysfunction.Results. According to the analysis of the literature, most researchers identify the neurogenic pathway of SARS-CoV-2 penetration into the CNS, as well as penetration through the bloodstream or through cerebral lymphatic drainage, which are a possible cause of mental disorders of a neurological nature. Correction of these violations involves the creation of a comprehensive system of rehabilitation with the inclusion of psychotherapeutic methods.Conclusions. Despite the lack of a single picture describing the specifics of cognitive and affective symptoms in COVID-19, in the most general terms, there is a certain consensus. So, quite often, post-COVID cognitive symptoms are characterized by impaired memory and attention, and post-COVID affective symptoms are characterized by increased levels of anxiety, depression, and fatigue. The issues of diagnosis and correction of disorders in post-COVID syndrome and the admissibility of the existence of this diagnosis are still relevant.

Background. Russian Federation is included in the list of 30 countries with the highest burden of tuberculosis, including MDR tuberculosis. The most important part of this problem is the primary MDR/XDR TB in children.The aim: a comparative analysis of the phenotypic and genotypic profile of drug resistance to anti-tuberculosis drugs (ATP) according to whole genome sequencing of M. tuberculosis strains from children.Materials and methods. Whole genome sequencing (WGS) results of 61 M. tuberculosis isolates from children with tuberculosis in 2006–2020 in the Russian Federation were analyzed for anti-TB drug resistance mutations, according to the WHO catalog and were compared with the results of phenotypic drug sensitivity.Results. The M. tuberculosis belonged to two genetic groups: Beijing genotype – 82 % (50/61) dominant Central Asian Russian (31/50) and B0/W148 (16/50) subtypes, and non-Beijing (Ural, S, LAM) – 18 % (11/61). Three isolates belonged to Asian Ancestral subtype (3/50). Of the 61 isolates, only 14.7 % (9/61) were sensitive to antiTB drugs, 49.2 % (30/61) were MDR and 14.7 % (9/61) were pre-XDR. Comparison of the resistance profile (MDR/pre-XDR) with genotype revealed an upward shift for Beijing isolates, in particular Beijing B0/W148 (15/16) subline compared to other Beijing (19/34) (Chi-square with Yates correction = 5.535; p < 0.05) and nonBeijing (5/12) (Chi-square with Yates correction = 6.741; p < 0.05) subtypes. Discrepancies between genotypic and phenotypic drug resistance profiles were found in 11.5 % (7/61) of cases.Conclusions. Based on the analysis of WGS data, the genotypic characteristics of M. tuberculosis and the most complete set of drug resistance mutations were obtained, indicating a significant prevalence in MDR and pre-XDR TB of cases caused by epidemic subtypes of Beijing (B0/W148 and Central Asian Russian). The molecular mechanisms of adaptation of M. tuberculosis to the treatment of anti-TB drugs are not unique for the child population but reflect the general processes of the spread of MDR/XDR in Russia.

Bacterial ecosystem of the gut plays a fundamental role in the normal functioning of the metabolic and immune systems. Functional bowel disease and obesity are highly prevalent in the population and place a heavy burden on healthcare system. Both comorbidity and multimorbidity are considered to be common for obesity and intestinal functional disorders. Changes in the microbiota can be both the cause and consequence of each disease: intestinal functional disorder changes the composition of the microbiota, resulting in obesity, and vice versa. Intestinal functional disorders and obesity are characterized by a similar type of dysbiosis.The aim of the review is to analyze the research findings available to date in order to establish the relationship between the gut microbiome, functional bowel disease and obesity. The researches have shown that patients with intestinal functional disorders have a different gut microbiome than healthy individuals. For intestinal functional disorders, the general patterns of the intestinal microbiota composition were described, and the characteristic taxonomic groups of bacteria were identified. On the other side, it must be noted that there is no clear correlation between intestinal functional disorders and obesity in terms of the microbiota. This can be explained by the high heterogeneity of intestinal functional disorders, as well as by the lack of a unified approach to creating a study design, by different sizes of population samples and also by different diagnostic criteria. The necessity to determine the criteria in the development of the design of future studies is discussed.

Background. Smell disorder is a recognized clinical symptom of COVID-19 infection. The problem of the loss of sense of smell in the structure of COVID-19 pathogenesis during pregnancy remains unresolved. The aim of the study. To determine the sense of smell and taste in pregnant women with COVID-19, as well as to evaluate the relationship between the sense of smell and the number of SARS-CoV-2 genome equivalents in the nasopharyngeal secretion. Material and methods. In the case-control study, 121 pregnant women participated: 40 of them were infected with COVID-19; 81 were not infected with COVID-19 earlier and at the time of the study. The survey was conducted in July 2021. Sense of smell was assessed using the Connecticut Chemosensory Clinical Research Center (CCCRC) olfactory test, which includes olfactory threshold determination and odor identification assessment. Taste was measured according to the O. Massarelli method. Viral load was calculated using a standardized method for determining the numberof SARS-CoV-2 RNA copies in 1 ml of nasopharyngeal secretion. Results. The incidence of olfactory disorders (moderate / severe and anosmia) in pregnant women with COVID-19 is 62.5 % compared to 22.23 % among pregnant women who have never had COVID-19 (p = 0.002). No significant taste disorders were identified. The threshold value for the manifestation of olfactory disorders was 17794 RNA copies of the SARS-CoV-2 virus, which corresponds to the 37th threshold cycle (Ct). Conclusion. During pregnancy in the acute phase of COVID-19, sense of smell is significantly impaired, but not sense of taste. Decreased sense of smell is associated with SARS-CoV-2 viral load.

Background. The vaccine preventable diseases outbreaks have become more frequent in recent decades and the lack of global vaccine awareness has been increasing and deteriorating vaccine compliance. The aim. To assess the attitude towards vaccination of parents from India and Russia. Methods. 1620 parents from Russia (Irkutsk city) and 214 parents from India (Kerala state) took part in the international cross-sectional multicenter study via survey method. Results. Parents from both countries showed good adherence to vaccination, only 1 % of Indians and 2 % of Russians did not vaccinate their children. More than 90 % of Russians took information from pediatricians compared with other sources with a prevalence of pediatricians working in the public health system 91.7 % (95 % CI: 90.2–92.9), whereas only 50 % of Indians were informed about vaccination from pediatricians (p < 0.0001). The main source of vaccine information for Indian parents was Internet (52.8 %; 95 % CI: 46.1–59.3) and mass-media (83.6 %; 95% CI: 78.1–87.9), whereas Russians resorted to this source much less (0.3 %; 95 % CI: 0.1–0.7 for Internet; and 4.3 %; 95 % CI: 3.4–5.4 for mass-media; p < 0.0001). Interestingly, while the vast majority of Russians received information about vaccination from a pediatrician, 71.2 % (95 % CI: 68.9–73.3) wanted to know more. Indians suffered from a lack of information too, but not as much (63.1 %; 95 % CI: 56.4–69.3; p = 0.01). Conclusion. Despite of a good attitude to vaccination of parents from India and Russia the lack of vaccine information was registered.

The gut microbiota is the largest human microbial community, comprising more than 1000 species of various microorganisms. It has been established that these are the gut microorganisms that play a decisive role in maintaining health, participating in the metabolism of proteins, carbohydrates, lipids, bile acids and the synthesis of vitamins. It has been shown that changes in the balance in the gut microbiocenosis lead not only to pathologies of the gastrointestinal tract, but also increase the risk of developing diseases of the cardiovascular and endocrine systems, and cause disturbances in the psycho-emotional state. To restore, correct and maintain the gut microbiota, probiotic preparations are recommended. In connection with the obvious relevance of the use of probiotics, this review aimed to describe the history of the emergence of the first probiotic products, current trends in the development of the concept of functional foods enriched with probiotics, as well as the prospects for developing probiotic preparations in the Russian Federation and abroad. This article presents an analysis of the market for probiotic preparations and dietary supplements, as well as functional food products that are produced in the Siberian Federal District. For an objective assessment of the development of the market for probiotic products, a generalization of analytical data from marketing services that monitor the movement of medicines in pharmacy chains and analyze consumer reviews was carried out.

Background. With the increased use of combination antiretroviral therapy, the mortality of people living with HIV has decreased significantly, which has led to an increase of comorbidity and secondary HIV-related pathology in both adults and also in children and adolescents living with HIV infection. The incidence of children and adolescents with HIV infection and those in the general population varies significantly.The aim. To assess the frequency and range of chronic comorbidities in children and adolescents with perinatal HIV infection Methods. We carried out an observational study. Data on the incidence of 161 children with perinatal HIV infection registered in the Irkutsk Regional AIDS Center were copied.Results. Overall incidence of tuberculosis (18633.5 per 100 000 children), diseases of the digestive system (24844.7 per 100 000 children), diseases of the eye and adnexa (28571.4 per 100 000 children), diseases of the nervous system (18012.4 per 100 000 children), mental and behavioral disorders (13,664.6 per 100 000 children) in children with perinatal HIV infection is the higher than in children of comparable age. The overall incidence values of the endocrine system diseases, eating and metabolic disorders, diseases of the ear and mastoid process, diseases of the circulatory system, diseases of the genitourinary system, as well as congenital disorders and chromosomal disorders in children and adolescents with and without perinatal HIV infection are comparable.Conclusion. The prevalence of diseases of the circulatory, respiratory and genitourinary systems in children with perinatal HIV infection is comparable to that in the corresponding population. Prevalence of tuberculosis, anemia, diseases of the gastrointestinal tract, diseases of the eye and adnexa, diseases of the nervous system, mental and behavioral disorders is higher compared to children not exposed to HIV.

The aim. To assess the general condition, laboratory parameters, quality of life of women of post-reproductive age after asymptomatic COVID-19 and 12 months after moderate COVID-19. Material and methods. We examined 47 women (45–69 years old), divided into 3 groups: those who did not have COVID-19, not vaccinated (group 1 – control; n = 15); women 12 months after moderate COVID-19, accompanied by pneumonia (group 2; n = 19); women with IgG in their blood who deny any symptoms of COVID-19 (group 3; n = 13). Results and discussion. An assessment of the general condition of women in post-reproductive age was carried out. In women 12 months after COVID-19 we found a lower level of total bilirubin compared to the group with asymptomatic COVID-19 (p = 0.004). An increase in thrombin time was determined in the groups of patients with symptomatic (p = 0.014) and asymptomatic (p = 0.025) COVID-19 course compared with the control group. Patients with asymptomatic COVID-19 course had a higher level of high-density lipoprotein cholesterol compared with the control group (p = 0.016) and the group 2 (p = 0.006). Compared with the control group, the group 2 had lower scores for general health (p = 0.006), vital activity (p = 0.013), general physical well-being (p = 0.039), physical functioning (p = 0.046); and the group 3 had higher scores in role functioning due to physical condition (p = 0.049). When comparing groups 2 and 3, lower scores in the group of women who recovered from the moderate COVID-19 were found in physical functioning (p = 0.002), pain intensity (p = 0.034), role functioning due to physical condition (p = 0.049), general health (p = 0.003), vital activity (p = 0.018), general physical well-being (p = 0.001). Conclusion. 12 months after moderate COVID-19, there is a pronounced deterioration in physical and emotional health; and in asymptomatic patients, better protective functions of an organism can be assumed.

Background. The incidence of diseases associated with impaired transport and oxidation of fatty acids is from 1:5,000 to 1:9,000 newborns. High morbidity, risk of death in the absence of timely correction, non-specificity of clinical manifestations define the importance of their timely laboratory diagnosis based on the determination of free carnitine and acylcarnitines in the blood. Reference values for free carnitine and acylcarnitines vary in different populations. The aim. To determine the reference intervals of free carnitine and acylcarnitines in newborns of the Irkutsk region and to compare them with similar reference intervals in newborns in other countries. Methods. The analysis of 229 samples of drу blood spots of healthy newborn children of the Irkutsk region aged from 0 to 7 days was carried out. Analysis of acylcarnitine concentrations was performed using high performance liquid chromatography with tandem mass spectrometry. Results. 2.5 and 97.5 percentiles (µmol/l) were calculateed for 13 acylcarnitines: C0 – [8.78; 38.08]; C2 – [3.55; 19.09]; C3 – [0.33; 1.96]; C4 – [0.08; 0.51]; C5 – [0.06; 0.44]; C5DC – [0.03; 0.17]; C6 – [0.01; 0.07]; C8 – [0.01; 0.07]; C10 – [0.02; 0.07]; C12 – [0.04; 0.51]; C14 – [0.07; 0.24]; C16 – [0.58; 3.25]; C18 – [0.35; 1.16]. Conclusion. Differences in acylcarnitine reference intervals were found: compared with other countries, the concentrations of reference intervals for C0, C2, C3, C5DC, C8, C10, C14, C16 and C18 were lower in our study, reference intervals for C5 and C12 were higher in our country.

Introduction. According to the literature, it is known that clinical signs and symptoms of influenza may differ depending on age, the state of the human immune system, the serotype of the virus and its virulence. Intoxication, catarrhal and hyperthermia are main symptoms of influenza, but the disease does not always proceed classically, it may hide under the mask of other infections. The aim was to conduct a comparative analysis of clinical, laboratory and instrumental parameters in children with influenza A(H1N1) and A(H3N2). Materials and methods. A single-stage retrospective comparative study was carried out with the participation of 96 children from 1 month of age up to 13 years old with a diagnosis of influenza, who were hospitalized at the Irkutsk Regional Infectious Clinical Hospital from December 2018 to January 2019. Clinical and laboratory features of the course of influenza in children were determined depending on a viral strain. Results. The structure of morbidity: influenza A(H1N1) – 70 people (73 %), influenza A(H3N2) – 20 children (21 %), influenza A clinically unvaccinated – in 3 people (3 %), mixed viral infection influenza H1N1 + adenovirus infection – 2 cases (2 %), mixed viral infection H1N1 flu + RS-virus – 1 case (1 %). In the clinic of both strains of the virus, symptoms prevailed: runny nose, dry cough, fever, intoxication. Muscle pain and pharyngeal hyperemia were significantly more common in influenza A(H1N1), the duration of symptoms did not differ. Lymphocytosis was more often observed in influenza A(H1N1), monocytosis – in influenza A(H3N2) (р < 0.05). In 64 % of cases, patients with influenza A(H1N1) had a high leukocyte index of intoxication (odds ratio – 2.2). Conclusion. The symptoms of different influenza A viral strains virus in children are the same, however, muscle pain and hyperemia of the pharynx prevails in children with influenza A(H1N1).

Polymorphic variants of the multidrug resistance gene (ABCB1 or MDR1) are associated with changes in the absorption and transport of drugs in the body. One of the substrates of the ABCB1 transporter is an antiretroviral drug from the class of protease inhibitors, lopinavir. The aim. To research the effect of polymorphic variants C1236T and C3435T in the ABCB1 gene on the plasma concentration of lopinavir / ritonavir in children and adolescents living with HIV infection. Methods. The genotypes of polymorphic variants of the ABCB1 gene were identified in 136 HIV infected children and adolescents; median age – 10 [7–12] years. The plasma concentration of lopinavir / ritonavir was measured from blood taken during the next scheduled appointment as part of dispensary observation at the Irkutsk Regional AIDS Centre using high performance liquid chromatography. Results. The average duration of lopinavir/ritonavir use as part of an antiretroviral therapy was 55 months. Median viral load in patients was 1 [1–2.03] log 10 copies/ mL; the number of CD4 + T cells – 38.36 %. The frequency of occurrence of the 3435T and 1236T alleles of the ABCB1 gene was ~50 %. In carriers of the 3435TT genotype, the median lopinavir concentrations 2 and 12 hours after drug intake were 5050.8 [3615.8–5847.7] and 2665.5 [216–4896.3] ng/mL, respectively. In carriers of the 1236TT genotype, median lopinavir concentrations 2 and 12 hours after drug intake were 4913.5 [3355.1–5733.7] and 3290.6 [159.1–4972.5] ng/mL, respectively. Conclusions. The study did not reveal a significant relationship between the carriage of the C3435T and C1236T genotypes of the ABCB1 gene and the concentrations of lopinavir and ritonavir 2 and 12 hours after drug intake.

The aim of the study was to reveal the relationship between the parameters of actual nutrition and the lipid peroxidation and antioxidant defense system in adolescents aged 14–17 in a rural area. Material and methods. 76 adolescents aged 14–17 of the Irkutsk region were examined by the cross-sectional study method. Actual nutrition was studied by the 24-hour nutrition reproduction method. The content of substrates with unsaturated double bonds (DB), diene conjugates (DC), ketodienes and conjugated trienes (KD and CT), thiobarbituric acid reacting species (TBARS), α-tocopherol, retinol, reduced (GSH) and oxidized glutathione (GSSG), total blood antioxidant activity (TAA), superoxide dismutase (SOD) activity in blood by spectrophotometry and fluorometry methods were analyzed. Results. The adolescents’ diet did not meet the principles of a balanced diet – there was reduced protein intake, an imbalance of unsaturated fatty acids, A, C, D, B vitamins deficiency. An excessive element in the diet was sodium. The content of substrates with DB, KD and CT and TBARS increased significantly in the studied group of adolescents, the concentration of DC decreased. Parameters of antioxidant defense both decreased (TAA, retinol content) and increased (α-tocopherol, GSH concentration). Correlation analysis showed relationships between DB and vitamin B1, B2 content; DC level and calories, carbohydrate and vitamin B1 content; concentration of KD and CT and fats, TAA and vitamin A and β-carotene level; level of α-tocopherol in blood and vitamin E in food; GSH and vitamin K; SOD activity and vitamin H content. Multiple negative correlations were between GSSG and fat, vitamins B1, B9, C, K food concentration were found.Conclusions. The calculated vitamin consumption indicators allow to reveal nutritional deviations in adolescents and to connect them with the real provision of the body with these metabolites.

Background: Studies of the relationship between obesity and functional bowel disorders, carried out in different age groups, provide conflicting results. It remains unclear what factors are responsible for the transition from a tendency to constipation in children to a tendency to diarrhea in adults with obesity.Aim: To establish factors related to stool consistency as a surrogate marker of colon transit in adolescents with obesity.Materials and methods: A single-center observational cross-sectional study was carried out. We consecutively recruited adolescents, aged 11–17 years with obesity. Socio-demographic characteristics, lifestyle and nutritional characteristics were assessed using questionnaires. Bowel symptoms were assessed using questionnaires and interviews. Stool consistency was assessed using the Bristol Stool Form Scale. Serum concentrations of ALT, AST, bilirubin, cholesterol, glucose, HbA1c, leptin, and insulin were determined. The HOMA-IR index was used to determine insulin resistance.Results: One hundred and ten adolescents with obesity were enrolled in the study. Of these, 69.1% had a pathological consistency of feces, with the prevalence of forms characterizing delayed gut transit (49.1%). The predominance of loose stools was reported by 5.5% of patients. The combination of different forms of stool (unstable stool) was described by 14.5% of adolescents. Hard stools were common among adolescents from single-parent families and adolescents who rarely consume dairy products. The presence of loose stools has been associated with insulin resistance.Conclusion: Most obese adolescents who do not have abdominal complaints have colon transit disorders. Medical professionals should actively ask these patients about stool frequency and properties. With constipation, dietary correction is justified. Research is needed to investigate in-depth gut microbiota as a possible link between obesity and diarrhea.

Background. Obstructive sleep apnea (OSA) is a chronic condition characterized by repetitive collapse of the upper airway during sleep leading to intermittent hypoxia, excessive arousals and disrupt of sleep homeostasis. OSA is associated with obesity as well as pathological dynamics of cerebral beta-amyloid and dementia.The aim. Comparative assessment of the plasma beta-amyloid 42 levels in adolescents, depending on the presence or absence of OSA and obesity.Materials and methods. Seventy-four obese and non-obese male adolescents were included in the study. All participants underwent polysomnography to verify OSA and measure sleep parameters, and venipuncture for the assessment of betaamyloid 42 by enzyme-linked immunosorbent assay (ELISA).Results. After polysomnography all adolescents have been divided into four study groups: OSA obese (group 1; n = 28); non-OSA obese (group 2; n = 20); OSA non-obese (group 3; n = 11), and non-OSA non-obese (group 4 – control; n = 15). OSA obese adolescents had significant elevations in beta-amyloid 42 plasma levels compared with participants from three other groups (р = 0.007, p = 0.047 and p = 0.0002, correspondingly). Compared to both OSA non-obese adolescents and the control group, non-OSA obese patients had similar beta-amyloid 42 blood concentrations (p = 0.167 and p = 0.155, correspondingly). However, patients from the group 3 showed significantly higher beta-amyloid 42 plasma levels than controls (p = 0.004).Conclusions. Thus, OSA, accompanied by intermittent nocturnal hypoxia, and particularly OSA and obesity comorbidity, in adolescents is associated with increased beta-amyloid 42 circulating concentrations, which has a major role in pathogenesis of dementia. Beta-amyloid 42 plasma level may be recommended for use as early biomarker of cognitive impairment and neurodegenerative diseases, but future researches are needed.

The aim. To study the features of the course of the neonatal period in children, perinatally exposed to HIV, who receive an enhanced regimen of chemoprophylaxis of HIV mother-to-child transmission.Patients and methods. A retrospective longitudinal cohort study of mother – child pairs for the period from 2017 to 2019 was carried out. The clinical observation group included HIV-positive women with a high risk of vertical transmission of the immunodeficiency virus (n = 213) and their newborn children (n = 214), who were prescribed an enhanced chemoprophylaxis regimen of HIV transmission from mother to child. Results. According to the results of the study of HIV-positive mothers we revealed a high prevalence of secondary diseases and a high per partum viremia – 1700 (222–18342) copies/ml. 35.9 % of children were born prematurely, 27.5 % – had low birth weight by gestational age. In newborns, diseases of the respiratory (24.3 %) and nervous (17.2 %) systems prevailed. 17.2 % of children developed intrauterine infection; HIV RNA was detected in 3.7 %. Congenital malformations were observed in 7.4 % of children. Symptoms of enteropathy were noted in 24.7 % of newborns. A decrease in red blood counts was found in all children by the 28th day of life (pw < 0.001).Conclusion. The study confirms the need for increased attention and improvement of approaches to medical support of children who were perinatally exposed to high risk of vertical HIV infection.

In the final issue of the Acta biomedica scientifica in 2021, the main attention is drawn to the series of articles devoted to infectious diseases.

Background. The COVID-19 pandemic has raised the importance of this problem to the first stage and has affected healthcare system around the world. Despite the more favorable COVID-19 course, the child population should be at focus of special attention, due to the active participation in its distribution. The course of COVID-19 includes a cascade of pathological processes accompanied by the generation of reactive oxygen species, which can have extremely negative consequences for the developing organism. The research of these processes in children is vital and will improve the effectiveness of preventive and therapeutic measures. The aim: to analyze changes in enzymatic and non-enzymatic links in the antioxidant defense in children and adolescents with diagnosed COVID-19 infection.Materials and methods. 17 children and adolescents (average age – 12.35 ± 4.01 years) were examined, including 8 boys (47 %) and 9 girls (53 %) with COVID-19 infection. The control group of children and adolescents (practically healthy) according to the «copy-pair» principle was selected. We used spectrophotometric methods.Results. In the group of children and adolescents with diagnosed COVID-19 infection, there were lower levels of total antioxidant activity (p < 0.0001), superoxide dismutase activity (p < 0.0001), content of reduced glutathione (p = 0.048) and retinol (p = 0.015), increase in glutathione reductase activity (p = 0.015) relative to the control.Conclusion. The obtained data indicate the insufficiency of antioxidant system components number in children and adolescents with diagnosed COVID-19 infection and indicate the advisability of antioxidant therapy using to stabilize these indicators.

Antiretroviral therapy has markedly reduced morbidity and mortality for persons living with human immunodeficiency virus (HIV). HIV can now be classified as a chronic disease; until a cure is found, patients are likely to require life-long therapy. However, despite these undoubted advances, there are many issues that need to be resolved, including the problems associated with long-term efficacy and toxicity. Moreover, pharmacotherapy of patients infected with HIV is challenging because a great number of comorbidities increase polypharmacy and the risk for drug-drug interactions. There is considerable interindividual variability in patient outcomes in terms of drug disposition, drug efficacy and adverse events. The basis of these differences is multifactorial, but host genetics are believed to play a significant part. HIV-infected population consists of ethnically diverse individuals on complex and potentially toxic antiretroviral regimens on a long-term basis. These individuals would benefit greatly from predictive tests that identify the most durable regimens. Pharmacogenetics holds that promise. Thus, detailed understanding of the metabolism and transport of antiretrovirals and the influence of genetics on these pathways is important. To this end, this review provides an up-to-date overview of the metabolism of antiHIV therapeutics of the protease inhibitors Lopinavir and Ritonavir and the impact of genetic variation in drug metabolism and transport on the treatment of HIV.

Background. Obesity is a multifactorial disease that is one of the important public health problems in the 21st century. Functional bowel disorders in obese children and adolescents are one of the most common pathologies of the digestive tract. The aim: to characterize the bacteriological composition of the colon microbiota in obese adolescents and identify its associations with the clinical manifestations of functional bowel disorders.Materials and methods. The study included 20 adolescents aged 11–17 years. Stool consistency was assessed using the Bristol Stool Scale. The study of biological material was carried out using standard bacteriological methods. To assess the strength of the relationship between the nominal variables, Cramer’s V test was used.Results. It has been shown that in adolescents with obesity and functional bowel disorders, there is a decrease in the number of representatives of bifidoflora, an increase in the microbial density of Escherichia coli with altered enzymatic properties and an excessive growth of potentially pathogenic enterobacteria. In obese adolescents with functional bowel disorders, abdominal pain associated with the act of defecation is associated with the presence of enterobacteria and E. coli with altered enzymatic properties. Rare bowel movements are associated with an increased abundance of Enterococcus spp. and the presence of opportunistic Enterobacteriaceae microorganisms. Frequent bowel movements are associated with the presence of E. coli with altered enzymatic properties and Clostridium spp. In the presence of loose stool, Clostridium spp. is present; unstable stool (alternation of hard and liquid stools in one patient) is associated with a decrease in the number of lactobacilli and E. coli with normal enzymatic properties, the appearance of E. coli with altered enzymatic properties, opportunistic microorganisms of Enterobacteriaceae family and Clostridium spp. Conclusion. The relationship between the clinical symptoms of functional bowel disorders and changes in the composition of the gut microbiota in obese adolescents may be a justification for conducting in-depth studies aimed at finding early predictors of functional bowel diseases associated with obesity in the adult cohort.

Inherited metabolic diseases are a large group of inherited monogenic diseases. Metabolic disorders can cause child disability and mortality. Tandem mass spectrometry is a powerful technology that allows to diagnosis a large number of hereditary metabolic diseases. Clinical manifestations are variable, but more often the damages of nervous system, heart, liver, kidneys, hyperammonemia, hypo/hyperglycemia take place. The disease can make its debut at any age, but the severe forms of the disease manifest at infancy. Early diagnosis and treatment can significantly improve the prognosis; many countries expand the list of diseases included in screening programs. At the beginning of 2021 in most regions of the Russian Federation mass newborn screening is carried out for five hereditary metabolic diseases. The age and the range of clinical manifestation are variable; therefore, knowledge of this pathology is very important both for pediatricians and therapists, and for specialized doctors. The article presents a brief description of next groups of metabolic diseases: aminoacidopathies, organic acidurias and fatty acid oxidation defects.

Background. The diet of adolescents is an important factor in their future health. The diet is formed under the influence of biological, personal, family, socio-economic, environmental, and cultural factors.The aim: to study the diet of adolescents in rural areas of Buryatia and compare the dietary intake of the Russian and Buryat ethnic groups.Materials and methods. The study included 92 rural adolescents 11–17 years old (44 boys, 48 girls); 49 of them were Buryats, 43 – Russians. Dietary intake was assessed by the food record method. The intake of energy, macronutrients (proteins, fats and carbohydrates) and micronutrients (major groups of vitamins and trace elements) of the diet was determined. The values obtained were compared with references to daily energy and nutrient intake, and between groups of adolescents of different ethnicity.Results. The diets of rural adolescents were not balanced. Only 7.6 % of adolescents include fish in their diet. Milk and dairy products are consumed by 38 % of the respondents. Daily energy intake was significantly lower the recommended guidelines. The diet is characterized by a deficiency of vitamins of groups A, C, and D, group B (with the exception of cobalamin), niacin, biotin, essential trace elements (calcium, phosphorus, iodine), high sodium intake. A significant deficiency of dietary fiber has been noted. The Buryats showed a shift in the ratio of proteins, fats and carbohydrates in the diet towards carbohydrates (1 : 1.2 : 5.3).Conclusion. The results indicate significant disturbances in the composition of the diet in rural adolescents in Buryatia, more pronounced in the Asian subgroup. This can be a rationale for the development of targeted nutrition monitoring programs aimed at preserving the health of the youth.

Background. In modern society, the growth of the overweight and obese population increase every year. This confirms the status assigned to the problem under consideration as a non-infectious epidemic of the 21st century. At the same time, the amount of scientific information about the influence of excess weight on various aspects of human life is actively increasing. This undoubtedly requires a systematic generalization of the available data.Aims. The presented literature review is devoted to the analysis of modern scientific research on the specificity of cognitive impairment in overweight and obese people.Materials and methods. Information search was carried out using Internet resources (PubMed, Web of Science, eLibrary.ru, frontiersin.org, sciencedirect. com, ncbi.nlm.nih.gov), literature sources were analyzed for the period from 2001 to 2020 for the following keywords: obesity, overweight, cognitive functions, cognitions, cognitive impairments.Results. As a result of the literature review, the main directions of research on the relationship between cognitive impairment and overweight, as well as the relationship between cognitive dysfunction and obesity, were identified. The specificity of diametrically opposed opinions within the framework of each consecrated trend is presented. According to the results of the analysis of the identified areas, in the scientific community the most common point of view is the presence of a connection between obesity and cognitive impairment. In this connection, the authors identified the main cognitive impairments associated with excess weight and their mediating mechanisms. And also the age specificity of the problem under study is indicated.Conclusions. Despite the fact that the problem of the relationship between obesity, overweight and cognitive functions is comprehensively studied, there is a shortage of data on the state of thinking, attention, praxis, gnosis, and speech in overweight people.

The pandemic of the new coronavirus infection COVID-19 in 2020 has become the main health problem across the globe. A special characteristic of the SARSCoV-2 virus is tropism to the vascular endothelium with the development of endotheliitis, which entails a number of typical disorders of the blood coagulation system: coagulopathy with increased thrombin generation, D-dimer, decreased fibrinolysis and prolonged prothrombin time. The coagulation disorder in COVID-19 is called thromboinflammation. Hyperinflammation, increased blood levels of von Willebrand factor, coagulation factor VIII, neutrophil extracellular traps, platelet activation, microvesicles play a significant role in the pathogenesis of hypercoagulation in COVID-19. To date, it is known that cases of COVID-19 in children and adolescents constitute a small part of the total number of patients with diagnosed COVID-19, and disorders of the blood coagulation system are similar to those in adults. The degree of hypercoagulable syndrome and the risk of thrombosis depend on the severity of COVID-19. And for children they are most expressed with the development of a hyperinflammatory immune response, called multisystem inflammatory syndrome. At the same time, clinical studies of the pathogenesis of COVID-19 in adults and children and the search for optimal methods of therapy for thrombus inflammation, which underlies the pathogenesis of COVID-19, continue.

Obesity and functional bowel disease (FBD) are affecting a large number of people worldwide. They have psychosocial consequences and associated with considerable healthcare resource use. The purpose of this review was a comprehensive study of the relationship between obesity and FBD, as well as mechanisms to explain this relationship. An analysis of the literature provides strong evidence of a link between obesity and diarrhea, but there is currently insufficient data to speak confidently about the link between obesity and irritable bowel syndrome. Most studies suggest that adult obesity is not associated or negatively associated with constipation. The association of obesity with diarrhea is most convincingly explained through diet, eating behavior, changes in the metabolism of bile acids, accelerated colonic transit, altered intestinal microbiota and associated inflammation and increased intestinal permeability. Medicines taken by patients, as well as non-alcoholic fatty liver disease, can play their own role.Planning and conducting studies, including longitudinal ones, based on valid diagnostic criteria and taking into account the widest possible range of confounders, will allow a deeper study of the problem of comorbidity of obesity and FBD. This will help optimize the treatment of these diseases.

Last year the COVID-19 pandemic caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) has started. The new coronavirus is highly contagious and causes severe complications. The mechanisms of humoral immunity and kinetics of SARS-CoV-2 specific antibodies in a population are not well understood. Therefore, we aimed to summarize and analyze numerous global and Russian serological studies for understanding dynamics of the SARSCoV-2 humoral immune response and getting an accurate picture of the seroprevalence to SARS-CoV-2 in the world population. The PubMed and e-library databases were searched from February 2020 to March 2021 using terms “SARSCoV-2”, “antibodies”, “humoral immunity”. At the beginning of the pandemic first studies were cross-sectional by design and were responsible for determination of the seropositivity and for understanding the fundamental humoral immunity parameters of SARS-CoV-2. Since then, longitudinal seroepidemiological studies have been studying antibody kinetics. Seroconversion time for IgM, IgG antibodies varies, but most researchers report the seroconversion of IgM from the 1st to 14th days after the onset of clinical manifestations, and the seroconversion for IgG is around the 14th day with a concentration peak by the 21st day. Regarding seroprevalence we may say about low herd immunity at the COVID-19 pandemic. Thus, global seroprevalence is about 10 %, and more than 20 % for regions with high incidence and among healthcare workers. Seroprevalence studies have to be continued for more accurate monitoring of long-term humoral immunity to SARS-CoV-2, because the majority of the world’s population is still susceptible to SARS-CoV-2 infection.

Background. The mechanism of the immune response in patients with COVID-19 is still poorly understood and differs from other respiratory infections. Immunodeficiencies and age-related characteristics of immunity can be regarded as factors influencing reinfection and a predisposition to prolonged persistence of SARS-CoV-2. Most of the studies report about post-infection immunity to SARS-CoV-2 for adults and less for children. However, understanding the dynamics of antibody production to SARS-CoV-2 among children as well as other unique features of immune response is extremely important, because this provides to avoid possible complications and long-term outcomes of COVID-19, and predict the epidemic spread of the new coronavirus in the organized groups of children such as kindergartens, schools, study groups and clubs.Aim: to evaluate the humoral and cellular immunity after SARS-CoV-2 infection in children.Materials and methods. We reported data of the first phase prospective cohort study of immunity among 60 children living in Irkutsk, Russia within a month after SARS-CoV-2 infection, which took place in October and November 2020.Results. Immunity of children one month after SARS-Cov-2 infection was characterized by suppressed cell-mediated and humoral immunity, and phagocytosis dysfunction. Reduced phagocytosis by neutrophils was noted for 61.6 % of individuals.Conclusions. Children after COVID-19 had impaired immunity to SARS-CoV-2, which may be a predictor of chronic infection and other long-term outcomes of COVID-19.