Introduction. Cervical cancer is a significant health concern, particularly in regions with limited access to healthcare services. The implementation of screening measures such as the Pap test has contributed to a reduction in the number of affected women. However, since the 1990s, an increase in disease incidence has been observed in the Russian Federation, due to shortcomings in preventive efforts. In 2022, standardized cervical cancer incidence exceeded figures from 1989, while changes in mortality rates were also noted, with a subsequent increase after a period of decline. This may be attributed to inadequate coverage and effectiveness of secondary and tertiary preventive measures.

The aim of this study is to analyze the level of cervical cancer morbidity and mortality, as well as factors that characterize the effectiveness of prevention efforts in the Russian Federation between 2007 and 2022.

Materials and Methods. A retrospective epidemiological analysis was carried out, during which the following indicators were considered: the number of patients with a newly diagnosed cervical cancer; the number of deaths from cervical cancer; distribution of malignant neoplasms by stages; the number of cases of preinvasive cervical cancer (in situ); total mortality and lethality within a year from the moment of diagnosis; the effectiveness of preventive examinations.

Results. The results of the study showed that the incidence of cervical cancer increased from 2007 to 2018. This may be due to the effectiveness of screening measures. However, during the COVID‑19 pandemic, the incidence dropped sharply. This was due to a decrease in the proportion of actively identified patients and an increase in the number of advanced stages of the disease. As the impact of the pandemic on cancer services decreases, the incidence of cervical cancer increased again in 2022. For the first time since 2015, mortality from this pathology has increased.

Conclusion. The analysis of the data indicates a deterioration in the epidemiological situation and an increase in the negative impact of cervical cancer on public health. In this regard, it is necessary to intensify preventive and diagnostic treatment to prevent an increase in morbidity and mortality from this disease.

Optimizing cervical cancer screening algorithms is the key to achieving increased coverage of women with secondary prevention activities.

The purpose of this study was to develop an approach to optimize cervical cancer screening based on a primary extended HPV-test.

Materials and methods. To develop a predictive model for assessing the risk of having severe cervical dysplasia women were examined using a cytological method (619), an extended HPV-test with genotyping (14 types) and quantitative determination of viral load (n=619) and a histological method (n=185) as indicated. To validate the developed prognostic model, data from examination of 3482 women using a cytological method and a molecular-biological method – an extended HPV test were calculated.

Results. The increase in the concentration of human papillomavirus with an increase in the degree of transformation of the cervical epithelium was shown for 14 types in total and 16, 33 and 58 types separately. The threshold for a high probability of severe cervical dysplasia is 4lg HPV DNA (14 HPV types in total and 16, 33, 58 types individually) per 105 human cells. The developed multifactorial prognostic model for the presence of high-grade squamous intraepithelial lesion is statistically significant and, according to the results of validation, showed Se=95,2 %, Sp=88,7 %, PPV=16,0 %, NPV=99,9 %, and diagnostic efficiency=88,9 %.

Conclusion. The proposed algorithm for primary sorting of patients, based on a single examination method – an extended HPV test, will make it possible to increase the specificity of the first stage of screening, reduce the level of overdiagnosis and the number of redundant examinations of women in the future.

Relevance. The COVID‑19 pandemic required a major reorganization of the entire healthcare system and optimization of epidemiological monitoring of healthscare-associated infections (HAIs) in hospitals repurposed for hospitalization of patients with a new coronavirus infection.

The purpose of the study. Determination of the epidemiological features of healthscare-associated infections in a multidisciplinary hospital during the spread of COVID‑19 in a megapolis.

Materials and methods. The study included 28,891 cases of infectious diseases detected when patients were admitted to a repurposed hospital for the treatment of COVID‑19, and 3,194 cases of HAIs in 2020–2024. The results of microbiological studies include the study of 49673 isolates of microorganisms isolated from patients, including 35633 isolates of bacteria of the ESKAPE group, of which 13669 are resistant to antibiotic. Research methods: retrospective epidemiological analysis, microbiological methods, statistical methods.

Results and discussion. When patients were admitted to the hospital in 2020–2024, more than 20 nosologically forms of infectious diseases were detected, the main share was COVID‑19 and community-acquired pneumonia. The maximum incidence of HAIs caused by SARS-CoV‑2 was observed in 2021, the minimum in 2023–2024 years. In the group HAIs lower respiratory tract infections were the most relevant. The overall structure of pathogens isolated from patients with HAIs was dominated by bacteria of the ESKAPE group (71.7 %). Antibiotic–resistant pathogens were most often detected among Acinetobacter baumannii – up to 84.81 %, Pseudomonas aeruginosa – 70.83 % and representatives of Klebsiella spp. – 58.91 %. A statistically significant trend towards an increase in the frequency of detection of resistant pathogens among Pseudomonas aeruginosa and Enterococcus faecium has been established.

Conclusion. In the repurposed hospital, the most relevant HAIs were COVID‑19 and lower respiratory tract infections. There is a decrease in the incidence of HAIs, during the period of decreasing intensity of the epidemic process COVID‑19 in the megapolis. It is necessary to strengthen the surveillance of HAIs pathogens resistant to antibiotics.

Objective. The purpose of our study is to reveal the epidemic process features of healthcare-associated infections (HAI) among maternity patients in maternity hospitals of the city with population exceeding one million.

Materials and methods. A retrospective epidemiological analysis of the morbidity of HAI in four maternity hospitals in Yekaterinburg was carried out in 2012–2021. The data on 191875 maternity patients was analyzed. Statistical processing of the material was performed with Microsoft Office Word and Excel 2007 programs.

Results. Healthcare-associated infections varied from 306–505 cases in maternity hospitals of Yekaterinburg from 2012 to 2021. The percent of localized forms was 99.7 % in average. In 2013 and 2020 years generalized forms of infection were not registered. Among the localized forms of postpartum endometritis prevailed in average 20.5 cases per 1000 births. The etiology of individual HAI in maternity hospitals (n=1607) was determined, E. coli (n=576) amounted 35.8 %, Enterococcus spp. – 25.3 % (n=406), S. aureus – 15.1 % (n=242), other microorganisms amounted 23.8 % (n=383). In terms of etiology of postpartum endometritis E. coli amounted 37.7 %, Enterococcus spp. – 26.8 % and they were dominants. Among infections after surgical intervention S.аureus amounted 38.4 %; in postpartum mastitis S.аureus was 89.8 %. The etiological agent of generalized forms of HAI in maternity hospitals E. coli was presented in 62.5 % mainly. The proportion of staphylococci isolated from hospital environment objects (air, flushes) was 51.8 % but enterobacteria, non-fermenting gram-negative bacteria, anaerobes were found rarely.

Conclusions. Endometritis prevailed among the localized forms. The cause of postpartum endometritis was E. coli and Enterococcus spp., which were dominants. As for postpartum mastitis and infections after surgical interventions caused by S.аureus were prevailed. Staphylococci were found while air and dust sampling from environmental objects in hospitals had been studied.

Objective: to identify the presence and qualitative of microbial biofilms on epidemiologically significant surfaces of medical organizations, as well as to evaluate the factors contributing to the formation of biofilms.

Materials and methods: 253 epidemiologically significant objects of the medical environment were examined from March to November 2023, after disinfection in four hospitals of various profiles using a catalase rapid test and subsequent application of the bacteriological method, in order to establish the species of microorganisms included in biofilms.

Results: a positive result of the catalase rapid test was recorded on 36 (14.2 %) surfaces. Bacteriological confirmation of the presence of microorganisms and identification of their type were obtained in 29 cases (80.5 %). Biofilms were found in 13.4 % of medical environment objects with a high risk of HAIs and 14.9 % of objects with a low risk of HAI. In our study, monospecies biofilms were found formed by the following types of bacteria: Staphylococcus aureus (41.7 %), Acinetobacter baumannii (22.2 %), Enterococcus faecium (16.7 %), with a predominance of gram-negative bacteria in high-risk surfaces and gram-positive – at low-risk facilities for HAIs. The main factors for the occurrence of biofilms on epidemiologically significant surfaces have been identified: non-observance of the sanitary and epidemiological regime in the departments of medical institutions; use of outdated medical equipment; non-observance of the concentration of the active substance of the finished working solution of the disinfectant; use of a concentrate and/or working solution of a disinfectant outside the expiration date; the use of disinfectants with fixing properties (aldehydes, alcohols) without preliminary mechanical cleaning of surfaces. Recommendations are given to prevent the formation of biofilms in medical environments.

Conclusion: detection of biofilms on epidemiologically significant surfaces is an important part of industrial control aimed at preventing HAIs.

The aim is to assess the prevalence and significance of resistance to meropenem among conditionally pathogenic microorganisms detected in various biological materials in children's hospital patients.

Materials and methods. The results of microbiological studies of 43936 samples of biological material taken from 41287 children hospitalized in 2023 with various pathologies aged from birth to 18 years were studied.

Results. Among all samples of biomaterial, certain bacteria were detected in 16034 cases (36 %). In 5431 samples, Klebsiella pneumoniae, Escherichia coli, Acinetobacter baumannii, Pseudomonas aeruginosa with different sensitivity to meropenem were detected. The largest number of samples containing meropenem-resistant colonies was found among Klebsiella pneumoniae (471), and the largest number of cases of resistance was found among Acinetobacter baumannii (183 out of 433). Resistance to meropenem in Escherichia coli was detected only in isolated cases (12 samples – 1,4 %).Conclusions. 1. Among the microorganisms detected in samples of various biomaterials, 4 microorganisms (Klebsiella pneumoniae, Escherichia coli, Acinetobacter baumannii, Pseudomonas aeruginosa) with potential resistance to meropenem were found in 34 %, more often – Escherichia coli (in 43 %). 2. The most common colonies resistant to meropenem were identified among Klebsiella pneumoniae (in 26 %), more often in feces and rectal smears. 3. The highest proportion of meropenem-resistant colonies was found among Acinetobacter baumannii (43 %). 4. The high frequency of detection of resistant strains requires further monitoring and prescribing antibacterial therapy regimens, taking into account the results of laboratory assessment of their sensitivity.

The article presents a comprehensive analysis of the incidence of cutaneous forms of lupus erythematosus (CLE) in Moscow for the period from 2017 to 2022, emphasizing the dynamics and key characteristics of the spread of this chronic autoimmune disease. Lupus erythematosus (LE) can manifest as an independent skin disease or as part of systemic lupus erythematosus (SLE), with varying probabilities of transition from one form to the other. The study highlights specific clinical forms of CLE, such as acute, subacute and chronic cutaneous lupus, as well as discoid lupus and other subtypes, discussing their likelihood of progression to SLE. The authors focus on the epidemiological aspects of CLE, pointing out the influence of gender, age, ethnicity and race, as well as the role of geographic factors in the spread of the disease. Considerable attention is paid to the potential impact of SARS-CoV‑2 infection and the effects of COVID‑19 vaccination on the development and exacerbation of CLE, emphasizing the need for additional research to understand the relationship between COVID‑19 and autoimmune reactions. The article is based on the analysis of data from medical databases and a retrospective review of patient charts, which allowed the authors to notice a steady increase in the incidence of CLE during the study period, especially among women. The observed increase in incidence may be associated with a number of factors, including changes in diagnostics, access to medical care, as well as the COVID‑19 pandemic as a possible provoking factor. The study emphasizes the importance of the obtained results for the medical community, focusing on the need to develop targeted strategies for the diagnosis, treatment and control of CLE to improve the quality of life of patients. The authors call for future studies to deeply study the dynamics of the incidence and its relationship with various factors, including the COVID‑19 pandemic.

The late diagnosis of scabies in severe neurological patients may be related to the peculiarities of their general condition and lifestyle. Comorbid patients take a large number of medications for a long time, including hormonal ones, which can mask the classic manifestations of scabies. Due to the probability of the absence of characteristic complaints in patients with severe neurological pathology, we present the following clinical case. We observed patient N., who was in the department of anesthesiology-intensive care with intensive care and intensive care wards at the Federal State Budgetary Institution «FCMN» of the FMBA of Russia. Diagnosis upon admission: repeated multifocal cerebral infarction in the vertebrobasillary basin with the presence of foci of infarction in the acute/superacute stage in the basins of the main artery, right middle cerebral artery, right anterior choroidal artery, left middle cerebral artery, left superior cerebellar artery from 08/09/2024, 08/12/2024. An unspecified pathogenetic variant of TOAST. The modified Rankin scale is initially 5 points. At the time of hospitalization, 5 points (ICD 10 I63.5). Upon admission, the patient was found to have a rash, and therefore he was immediately consulted by a dermatovenerologist. Based on a set of clinical data and laboratory detection of the pathogen, patient N. was diagnosed with B 86 – scabies. At the prehospital stage, scabies was not diagnosed in a timely manner. Late diagnosis of scabies leads to the spread of the disease and the maintenance of an unfavorable epidemiological situation.

The scientific article is a systematic review of the indicators of the heart rate automatism function, which is an important factor affecting heart activity and the general condition of the body.

The aim of the study is to evaluate the distribution and prediction of indicators of the heart rate automatism function in students of higher educational institutions.

Materials and methods of research. Students of the University of Humanities took part in the study. A total of 425 students participated, who were divided into three groups according to the courses of educational activities, taking into account gender distribution, and a control group of subjects was also formed. The method of variational heart rate monitoring was used to assess the function of automatism. To process electrocardiography data, a program for processing variational heart rate indicators was used, developed by the Institute of Biomedical Problems of the Russian Academy of Medical Sciences. The subjects were also offered a survey that allows them to establish a list of risk factors that affect the indicators of automatism.

Results. The analysis of the indicators of the automatism function allowed us to establish the dominance of the absence of rhythm disturbances (62.4 % and 62.56 % in the control group and the group of students, respectively). Most students do not suffer from cardiac arrhythmias. Some students have moderate rhythm disturbances and slight fluctuations in heart rate stability. The absence of rhythm disturbances is typical for 62.33 % of 1st year students, 50 % of 3rd year students and 70.31 % of sixth year students. The most common indicator in the control group is moderate dysregulation – 11.46 %, and in students this indicator is 20.11 %.

Conclusions. Most students do not encounter serious changes in functioning, however, preventive measures and regular medical examinations are important components, including during academic activities. Heart rate analysis can help prevent the development of diseases.

The review provides a brief description of the current state and problems of tuberculosis infection in the first quarter of the 21 st century during the HIV epidemic and the coronavirus pandemic. The rise in tuberculosis incidence expected by many epidemiologists and tuberculosis specialists during the coronavirus pandemic did not happen; its steady decline continues, which could have been positively influenced by a reduction in contacts. However, it cannot be ruled out that an extreme increase in the influence of stressful social factors can lead to an exacerbation and increase in the number of cases of latent tuberculosis. The emergence of bacterial adaptation as a component of virulence is QUORUM SENSING – quorum sensing, which allows mycobacteria to behave like multicellular organism and form a protective biofilm, which serves as a direct obstacle to the action immunocompetent cells, antibacterial and disinfectant substances, and also greatly increases drug resistance. A major health problem in many parts of the world is the comorbidity of tuberculosis and HIV. This causes an increase in the importance of latent tuberculosis in the emergence of new cases of the disease due to changes in the immune status of the population and the reactivation and the persistent Mycobacterium tuberculosis in the body of people living with HIV. At the same time, the number of severe forms of the disease caused by drug-resistant strains of Mycobacterium tuberculosis continues to increase. Multidrug resistance, which WHO has designated as a global threat, and the crisis of classical antibacterial therapy dictate the need to develop a new strategy for the diagnosis and treatment of infectious diseases, which consists of influencing the genetic and enzymatic targets that determine the virulence of the pathogen.