Aim. To study the dynamics of the results of a skin test with a recombinant tuberculosis allergen (ATP) (Diaskintest^®) in children from tuberculosis infection foci against the background of preventive chemotherapy.

Materials and methods. A retrospective analysis of the medical records of 153 children (aged 1 to 17 years) registered at Saratov Regional Clinical Anti- Tuberculosis Dispensary in Group IVA, who had been in contact with tuberculosis patients excreting bacteria, was conducted. ATP skin test results were assessed at baseline and after a course of preventive therapy at follow-up points: 6 months and 1 year of observation.

Results. A significant reduction in the incidence of hyperergic ATP test results after a course of preventive chemotherapy was demonstrated, from 8.5% to 1.9% (4.5-fold) at 6 months and to 2.6% (3.3-fold) at 1 year of observation. Among positive results, papule size decreased in 35% of children at 6 months and in 50% at 1 year. Test negativity was achieved in 10% of children at 6 months and 1 year of observation.

Conclusions. The obtained results demonstrate the influence of preventive chemotherapy on changes in the sensitivity of ATP skin test and, therefore, the possibility of using the test to monitor latent tuberculosis infection in children and adolescents in tuberculosis foci. Children who did not convert from positive and hyperergic tests, and whose papule size did not change significantly, require further monitoring to prevent the development of active tuberculosis.

Introduction. Gastroenterological diseases in adolescents often occur against the background of anxiety-depressive symptoms and somatization. However, the role of rumination, cognitive and psychological flexibility, as well as subjective well-being in reducing the quality of life in this pathology in adolescents has not been studied enough.

Aim. To assess the relationship between emotional and cognitive factors and quality of life in adolescents aged 14–18 with functional and organic gastroenterological disorders.

Materials and methods. A one-stage comparative study was conducted with the participation of 222 adolescents aged 14–18 years: 117 patients with verified gastroenterological pathology (the main group) and 105 conditionally healthy individuals (the control group). The structure of the main group: functional dyspepsia – 39 people, irritable bowel syndrome – 30 adolescents, chronic gastritis and gastroduodenitis – 30, gastroesophageal reflux disease – 18 patients. The Hospital Anxiety and Depression Scale (HADS), the PHQ-15 questionnaire, and the short form of the SF-36 questionnaire and the Gastrointestinal Quality of Life Index (GIQLI) were used to assess quality of life. The Ruminative Response Scale (RRS), the CFI questionnaire in Russian translation, the AAQ-II questionnaire, the Satisfaction with Life Scale (SWLS), and the Affective Balance Scale (ABS) were also used.

Results. In the main group, most of the psychological indicators were significantly higher: anxiety (HADS-A: 9.2 ± 3.9 vs. 5.0 ± 2.7; p < 0.001), depression (HADS-D: 7.9 ± 3.7 vs. 3.9 ± 2.3; p < 0.001), somatization (PHQ-15: 11.7 ± 4.6 vs. 5.1 ± 2.8; p < 0.001), rumination (RRS. Rumination was correlated with anxiety (r = 0.49), depression (r = 0.42), and somatization (r = 0.31). Psychological inflexibility was associated with the mental component of quality of life (r = -0.50) and GIQLI (r = -0.31).

Conclusion. Adolescents with gastroenterological pathology differed from healthy peers in all the psychological indicators studied. Rumination, psychological inflexibility, and life satisfaction are associated with quality of life.

Introduction. Bronchopulmonary dysplasia is a major problem in the care of very preterm infants, as it determines the duration of respiratory support, length of hospital stay, and subsequent prognosis. In some very preterm infants, the need for respiratory support persists beyond 28 days of life, which makes evaluation of late therapeutic tauractant administration clinically relevant.

Aim. To evaluate the efficacy of tauractant administration after 28 days of life in very preterm infants with bronchopulmonary dysplasia and to compare outcomes according to different routes of pulmonary delivery.

Materials and methods. A retrospective single- center comparative study was conducted. The study included 64 infants with a gestational age of less than 28 weeks and a birth weight of less than 1 500 g who required respiratory support at 28 days of life. The main group comprised 32 infants who received tauractant, the comparison group included 32 infants who did not receive tauractant and were matched according to key clinical and anamnestic characteristics. In the main group, three subgroups were identified: endotracheal administration (n = 11), inhaled administration (n = 10), and inhaled administration combined with budesonide (n = 11).

Results. The groups were comparable in terms of baseline demographic, perinatal, and initial respiratory characteristics. The need for respiratory support at 36 weeks postconceptional age (PCA) was less frequent in infants treated with tauractant: 17/32 (53.1%) versus 27/32 (84.4%); RR 0.630; 95% CI: 0.44–0.90; p = 0.014. The need for respiratory support at 36 weeks PCA was lowest after inhaled tauractant combined with budesonide: 18.2% versus 72.7% after endotracheal administration and 70.0% after inhaled tauractant alone; p = 0.030. No deaths occurred.

Conclusion. Late tauractant administration in very preterm infants with bronchopulmonary dysplasia was associated with a lower need for respiratory support by 36 weeks PCA. Inhaled tauractant combined with budesonide appeared to be the most promising approach in this cohort.

This article discusses the differential diagnosis of treatment-resistant neck pain. Traditionally, cervicalgia is considered a nonspecific musculoskeletal pain successfully treated with standard treatment (NSAIDs, muscle relaxants) for 2–4 weeks. However, in the two presented clinical cases of middle-aged patients (45 and 48 years old) with subacute, intense pain lasting 1–2 months, standard therapy proved ineffective, necessitating a revision of the diagnostic framework. This description is of interest because it demonstrates a rare cause of secondary cervicalgia–vertebrobasilar dolichoectasia–simulating nonspecific musculoskeletal pain. Key “red flags” for further investigation included: reluctance to treatment, persistent pain, dissociation between pain severity and local muscle tension, and phenotypic features of connective tissue dysplasia (positive Beighton criteria). MR angiography verified compression of the medulla oblongata and pons by a tortuous, dolichoectatic left vertebral artery. As a result, the diagnosis was revised from nonspecific to secondary pain due to neurovascular conflict, and the patient was referred to a neurosurgeon. Therefore, in cases of prolonged neck pain associated with connective tissue dysplasia that is refractory to standard therapy, vascular anomalies must be excluded to promptly adjust the management strategy for this patient population.

Introduction. The triple combination of CFTR modulators (ivacaftor/tezacaftor/elexacaftor plus ivacaftor) is considered a modern and highly effective pathogenetic therapy for cystic fibrosis in patients with CFTR genotypes sensitive to this regimen.
Aim. To assess the efficacy and safety of pathogenetic therapy with a triple fixed-dose combination during a sequential switch from the originator product (Trikafta®) to the generic product (Trilexa®) within the same INN (ivacaftor/tezacaftor/elexacaftor plus ivacaftor) in patients with cystic fibrosis treated in routine clinical practice in the Yaroslavl and Tula regions.
Materials and methods. A retrospective analysis of clinical data from 18 patients with cystic fibrosis living in the Yaroslavl and Tula regions was performed. Outcomes were evaluated at four time points: initiation of Trikafta® therapy, after 12 months of Trikafta®, initiation of Trilexa®, and 12 months after the switch. Sweat chloride concentration, body mass index (BMI), forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC), and treatment safety were assessed.
Results. Sweat chloride concentration decreased from 107.22 ± 16.27 to 73.39 ± 16.30 mmol/L after one year of Trikafta® therapy, and from 67.28 ± 25.47 to 60.76 ± 13.20 mmol/L after 12 months of Trilexa®. BMI increased from 15.74 ± 1.88 to 17.03 ± 2.07 kg/m² and then to 18.88 ± 2.18 kg/m² with the originator and generic products, respectively. FEV1 rose from 107.11 ± 24.75 to 119.10 ± 21.75% predicted on Trikafta® and to 121.81 ± 21.55% predicted after 12 months of Trilexa®. One transient episode of skin rash was observed during Trikafta® therapy. No adverse events were reported with Trilexa®.
Conclusion. Switching from the originator to the generic triple pathogenetic therapy ivacaftor/tezacaftor/elexacaftor plus ivacaftor was associated with maintenance of the achieved clinical response and a favorable safety profile

Introduction. Highly effective CFTR modulators have substantially reshaped the clinical phenotype of cystic fibrosis, including nutritional status. However, real-world evidence on anthropometric changes in children receiving sequential originator-to-generic ivacaftor/tezacaftor/elexacaftor/ivacaftor therapy remains limited.
Aim. To assess nutritional and anthropometric outcomes in children with cystic fibrosis from the Republic of Bashkortostan treated with ivacaftor/tezacaftor/elexacaftor/ivacaftor, with particular attention to treatment duration and sequential switching from Trikafta® to Trilexa®.
Materials and methods. This retrospective cohort study included 38 pediatric patients with cystic fibrosis. Body weight, height, body mass index (BMI), and nutritional status categories were evaluated during Trikafta therapy at 6, 12, 18, and 24 months and after switching to Trilexa at 6 and 12 months.
Results. BMI increased progressively during Trikafta therapy, reaching +0.67 kg/m² at 6 months, +1.01 kg/m² at 12 months, +1.29 kg/m² at 18 months, and +1.62 kg/m² at 24 months relative to pretreatment baseline. The incremental BMI gain over consecutive 6-month intervals was 0.67, 0.34, 0.28, and 0.33 kg/m², respectively. Following the switch to Trilexa, BMI increased by a further 0.28 kg/m² at 6 months and 0.77 kg/m² at 12 months. The proportion of patients with protein-energy malnutrition declined from 28.9% at treatment initiation to 23.6% after 6 months, to 18.4% at the time of switching, and to 13.1% after 6 months of generic therapy. The proportion of patients with normal BMI increased from 50.0% at baseline to 63.0% after 6 months of originator therapy, then to 68.4% at switching and to 70.1% after 6 months of generic therapy.
Conclusion. Ivacaftor/tezacaftor/elexacaftor/ivacaftor therapy was associated with improved nutritional status and anthropometric outcomes in children with cystic fibrosis. Sequential switching from the originator to the generic formulation was not associated with loss of nutritional benefit, and favorable anthropometric trends were maintained over follow-up.

Introduction. The combination of esophageal pathology and bronchial asthma is frequently encountered in clinical practice, but in some cases it may remain unrecognized due to diagnostic difficulties and a lack of clinical suspicion.

Aim. To evaluate the structural, functional, and laboratory abnormalities detected in patients with bronchial asthma combined with esophageal pathology.

Materials and methods. The study was conducted at the Allergology Department of the Krasnoyarsk Regional Clinical Hospital. Sixty-nine patients admitted for inpatient treatment with a diagnosis of bronchial asthma were examined. Based on clinical and anamnestic data, the patients were divided into two groups: those with bronchial asthma without esophageal pathology (Group 1: 38 patients (55.07%)) and those with bronchial asthma combined with esophageal pathology (Group 2: 31 patients (44.93%)). The examination methods included: anamnestic analysis, physical examination, completion of the ACQ-5, ACT, GERDQ, and dysphagia questionnaires, instrumental tests (spirography with a bronchodilator, fibrogastroduodenoscopy), laboratory tests, and esophageal morphological examination.

Results. Patients with asthma combined with esophageal pathology had a significantly higher number of daytime and night-time attacks and, consequently, a higher need for SABA. According to spirometry data, fixed airway obstruction was significantly more common among patients in Group 2. Immune status showed a significant decrease in NKT cells in Group 2 patients. A decrease in NKT cells in patients with bronchial asthma combined with esophageal pathology, as well as a negative association with fungal esophagitis, may indirectly indicate a decrease in epithelial barrier function and, consequently, a greater vulnerability to environmental factors, as also confirmed by the AQLQ questionnaire scores in the “environment” domain.

Conclusions. The obtained data confirm the aggravating effect of esophageal pathology on the course of bronchial asthma and also indirectly indicate changes in the mucosal immune system, which may lead to combined damage to the mucous membranes of the esophagus and respiratory tract.

Introduction. Current treatment options for locally advanced and metastatic рrostate cancer offer high survival rates, making quality of life and management of comorbidities, which are often the primary cause of mortality in this cohort, a priority. Metabolic disturbances are one of the most common adverse effects of androgen deprivation therapy. Various treatment options have been described, but no single strategy has been proposed.

Aim. To update and systematize modern data on the pathogenesis of metabolic disorders induced by androgen deprivation therapy, and to analyze multidisciplinary approaches to their correction.

Materials and methods. A search, analysis, and systematization of relevant publications were conducted in the PubMed, Google Scholar, elibrary.ru, and cyberleninka.ru databases using the following keywords: “prostate cancer” “androgen deprivation therapy”, “metabolic disorders”, “sarcopenia”, “osteoporosis”, and “insulin resistance”. Conference abstracts, dissertation abstracts, and editorial comments were excluded. As a result, 79 of the 158 publications were selected and included in this review. 19 sources were used for the introduction, 60 sources for the main body, and 7 sources, previously mentioned in the main body, for the discussion.

Results. Based on this review, we propose recommendations for additional screening of prostate cancer patients receiving androgen-deprivation therapy and present promising approaches to reducing metabolic disturbances and increasing cancer-specific survival. Thus, glucagon-like peptide-1 receptor agonists and statins can not only correct metabolic disorders but also influence carcinogenesis. RANKL inhibitors also have a dual effect, breaking the vicious cycle of bone resorption in metastases. The positive impact of physical activity and nutritional modification on the quality of life and life expectancy of this patient cohort has been demonstrated. Modifications to androgen deprivation therapy through the use of an intermittent regimen or the use of releasing hormone antagonists can also reduce the risk of metabolic complications.

Conclusions. An integrated approach to monitoring and treatment improves the quality of life and life expectancy of prostate cancer patients receiving androgen deprivation therapy, as well as the outcomes of systemic antitumor therapy.

Immunotherapy with immune checkpoint inhibitors has dramatically shifted the prognosis for outcomes of melanoma treatment. However, enhancing the efficacy of dual blockade immunotherapy targeting PD-1/PD-L1 and CTLA-4 while reducing immune-mediated toxicity remains a clinically significant challenge. This article presents a systematic review of data on the first homegrown fixed-dose combination of dual immune checkpoint inhibitors: anti-CTLA-4 + anti-PD-1 (Nurulimab) + Prolgolimab (Nurdati, BCD-217). We searched articles in the PubMed/MEDLINE, eLIBRARY, ClinicalTrials.gov, Cochrane Library databases, and specialized oncology congress records, using the following keywords in different combinations: unresectable/metastatic melanoma, immunotherapy, checkpoint inhibitors, nurulimab, prolgolimab, Nurdati. A total of 146 articles and information sources were identified at the first stage. After removing duplicates and materials irrelevant to the review topic 118 records were selected for screening, of which 54 were included in the qualitative analysis. The final review included articles and records covering the molecular and pharmacological properties of nurulimab and prolgolimab, the results of the BCD-217 clinical development, comparative efficacy and safety data, and a cost-effectiveness analysis. The excluded articles got the following reasons in favour of exclusion: inappropriateness, lack of clinical data, duplicate results, and limited access to the full text. In the randomized phase III OCTAVA study, the combination of nurulimab plus prolgolimab demonstrated significantly superior efficacy over prolgolimab monotherapy in terms of median progression-free survival (PFS) with comparable cumulative incidence rates of grade 3–4 AEs. Nurdati is a homegrown innovative medicine that is based on a low-dose CTLA-4 blockade and standard anti-PD-1 therapy, demonstrating durable disease control in a patient with BRAF-wild-type acral melanoma in the presented clinical case.