Vol 68, No 7 (2013)

OBSTETRICS AND GYNAECOLOGY: CURRENT ISSUES
PROGNOSTIC VALUE OF UTEROPLACENTAL CIRCULATION IMPAIRMENT IN 1ST TRIMESTER OF PREGNANCY IN PATIENTS WITH COMPLICATED OBSTETRIC HISTORY
Savel'eva G.M., Bugerenko E.Y., Panina O.B.

Abstract

One of the urgent problems of modern obstetrics is the early detection of irregularities in the development of the uteroplacental vessels system in patients with severe disorders in the history. Aim: to evaluate the predictive value of re-development of obstetric pathology on the basis of the uterine artery Doppler on 11–14 weeks of pregnancy. Patients and methods. 410 patients in I trimester of pregnancy were examined with fetal growth restriction, preeclampsia and/or fetal death and/or a history of preterm delivery were. The influence of physical factors and obstetric history on the state of uterine blood flow in the I trimester of pregnancy was studied. Results. The optimal Doppler indexes was calculated; a high predictive ability of the pulsation index in the uterine arteries with respect to pregnancy complications with early clinical manifestation, severe preeclampsia and combined obstetric complications was detected. Conclusions. Our data support the possibility of preclinical diagnosis of obstetrical complications in patients with complicated obstetric history.

 

Annals of the Russian academy of medical sciences. 2013;68(7):4-8
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ANDROLOGY: CURRENT ISSUES
GLUTATHION AS AN IMPORTANT COMPONENT OF THIOSULFID SYSTEM OF INFERTILITY PATHOGENESIS IN OVERWEIGHT MEN
Kolesnikova L.I., Vanteeva O.A., Kurashova N.A., Vlasov B.Y.

Abstract

Aim: to study the glutathionic part of thiosulfid system and oxidative stress in infertile men with different body mass index. Patients and methods: examined 60 infertile men with normal and overweight, and 40 healthy men with proven fertility. Active components of the antioxidant defense system of the body was assessed by the level of reduced and oxidized glutathione by the method of PY Hissin, determination of TBA-active products was carried out by the method VB Gavrilova. In the analysis of inter-group differences for independent samples was used parametric Student criterion. Results: the oxidative stress in obese men was characterized by significant elevation of oxidized form of glutathione (GSSG) in comparison with its reduced form. We discussed our results in the context of GSSG «quantivalence» to numerous of cellular processes in the setting of metabolic disorders in infertile and obese men. The ratio of reduced glutathione to oxidized infertile men decreased by 1,5 times in patients with obesity and 1,2 times in those with normal body mass index. Conclusions: Glutathione is the most important link in the study of oxidative stress in men with infertility. Raising the level of oxidized glutathione is due to the presence of his additional functions that are implemented at higher values of body mass index, especially in association with infertility.

 

Annals of the Russian academy of medical sciences. 2013;68(7):9-12
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CARDIOLOGY AND CARDIOVASCULAR SURGERY: CURRENT ISSUES
Lipid, Adipokine аnd Ghrelin Concentrations in Myocardial Infarction Patients with Insulin Resistance
Gruzdeva O.V., Karetnikova V.N., Akbasheva O.Е., Fedorova T.S., Belik E.V., Palicheva E.I., Uchasova E.G., Dyleva Y.A., Brazovskaya N.G., Barbarash O.L.

Abstract

Aim. The estimate insulin resistance in myocardial infarction. Patients and methods. The study involved 200 patients with myocardial infarction, in which on the 1st and 12th day of hospitalization measured glucose, insulin, insulin resistance index (IR), lipid profile, the concentration of adipokines and ghrelin. Results. IR was detected in 77% of patients and was associated with a history of factors of cardiovascular risk, adverse clinical course of the disease, lipid disorders. The most important marker was the level of free fatty acids. High risk associated with increased in 9 times the concentration of free fatty acids in blood plasma. Patients with IR observed increased concentrations of leptin, resistin, and reduced the protective effect of adiponectin. The high specificity and sensitivity characteristic of the concentration of ghrelin: its reduction by 4 times in the acute phase of myocardial infarction increases the risk of MI by 78%. Conclusions. Significant risk factors for MI myocardial infarction, along with insulinemia and glycemia, is to increase the concentration of free fatty acids and the disbalance in the system adipokines against deficiency of ghrelin in acute and early recovery periods of the disease. Free fatty acids and ghrelin are promising markers to stratify the risk of insulin resistance in patients with myocardial infarction.

 

Annals of the Russian academy of medical sciences. 2013;68(7):13-19
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THE SUCCESS OF HEART RATE VARIABILITY BIOFEEDBACK PARAMETERS IN PERSONS WITH DIFFERENT LEVELS OF BLOOD PRESSURE
Poskotinova L.V., Demin D.B., Krivonogova E.V., Dieva M.N., Khasanova N.M.

Abstract

Objective. The aim was to determine the nature of cardiovascular reactions during a single session of heart rate variability (HRV) biofeedback in order to increase vagal effects on heart rhythm in patients with different initial levels of blood pressure (BP). Participants and methods. 33 people with normal blood pressure (group I), 20 people with uncorrected arterial hypertension (AH) grade 1-2 (group II) and 22 people with AH grade 1-2 taking antihypertensive drugs (group III) were observed. The parameters of heart rate variability (HRV), BP and pulse oximetry in the initial stage, during a single HRV biofeedback session and after this session in order to increase the total power of the HRV spectrum (each stage was 5 min). Results. In patients of group II low success of HRV biofeedback session, a high sympathetic reactivity and reduced oxygen blood saturation were determined. A reactivity of vagal mechanism is more pronounced in persons of group III than in those of group II. It is reflected in a significant increase in their total power of the HRV spectrum compared to the initial values and in uptrend saturation levels during the biofeedback session.
Conclusions. The ability to HRV biofeedback in order to increase the total power of the HRV spectrum for standard short recording (5 min) can be seen as a test to determine the safety reserves of vagal autonomic cardiovascular regulation in persons with increased blood pressure.

 

Annals of the Russian academy of medical sciences. 2013;68(7):20-23
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NEUROLOGY AND NEUROSURGERY: CURRENT ISSUES
LOCAL FIBRINOLYSIS IN SURGICAL TREATMENT OF NON-TRAUMATIC INTRACRANIAL HEMORRHAGES
Krylov V.V., Burov S.A., Dash'yan V.G., Galankina I.E.

Abstract

More than 70% of hypertensive hemorrhages are located in deep brain structures. The removal of such hematomas using encephalotomy is accompanied by additional cerebral trauma and often results in unsatisfactory outcomes. The puncture aspiration with local fibrinolysis is one of the minimal invasive methods for treatment of intracerebral hematomas (ICH). The puncture and aspiration of liquid part of ICH (not more than 20% of ICH volume) is performed via small burr hole. Afterward the catheter is placed into ICH cavity and fibrinolytic is injected via this catheter in postoperative period for lysis of ICH solid part. The lysed blood is aspirated within 1-4 days. The last generations of fibrinolytics are very effective concerning intensity of blood clot lysis and practically have no systematic effect on blood coagulation system during their local usage. Morphological examinations showed that usage of fibrinolysis leads to formation of smaller cysts in the region of former hematoma as well as reparative processes in perihemorrhagical zone are expressed better comparing with treatment methods without usage of fibrinolytics. The morphological pattern is also confirmed by clinical signs of neurological deficit regress corresponding to damage focus. We operated 124 patients with parenchymal hemorrhages and 28 patients with intraventricular hemorrhages using described minimally invasive method at the base of Scientific Research Institute of Emergency Care n.a. N.V. Sklifosovsky. The applied method allowed decreasing lethality from 35% to 21% among patients with parenchymal ICH and from 98% to 48% - among patients with ventricular hemotamponade underwent usage of ventricular drainage combined with local fibrinolysis. 

 

Annals of the Russian academy of medical sciences. 2013;68(7):24-31
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PEDIATRICS: CURRENT ISSUES
BRAIN BIOELECTRIC ACTIVITY FORMING IN ADOLESCENTS LIVING IN DIFFERENT ENDEMIC GOITER AREA OF EUROPEAN NORTH
Demin D.B.

Abstract

Northern European regions are goiter endemic and iodine-deficient areas, and also differ in the degree of extreme weather conditions in the Polar and Subpolar latitudes. The age formation of the nervous system in adolescents depends on these discomfort climatic factors. Aim. The study of functional brain activity depending on the thyroid profile in adolescents living in the European North. Patients and methods. 211 adolescents (male and female) aged 1516 years living in the Subpolar (64°30' N) and Polar (67°40' N) Russian regions were observed. An electroencephalogram in a state of quiet wakefulness with eyes closed monopolar 16 standard leads was recorded. Electroencephalogram characteristic were performed by the values: of the wave amplitudes, index and absolute spectral power in each frequency band: 47 Hz, 812 Hz and 1324 Hz. In serum samples by immune-enzyme assay thyrotropin, triiodothyronine and thyroxine levels were determined. All the described changes were statistically significant at p <0,050,001. Results. A higher activity of diencephalic subcortical brain structures, expressed in the form of increased θ-activity and photic driver reactions were determined in adolescents living in Polar region. Background thyroid status determines the age formation of brain activity. In adolescents living in the Polar region a high concentration of thyrotropin in the blood and the availability of significant relations with thyroid hormones levels with a brain θ-activity were detected. In adolescents living in Subpolar region is more intense age optimization of neural processes, as well as the greatest number of neuro-endocrine relationships.

 

Annals of the Russian academy of medical sciences. 2013;68(7):32-35
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INDICES OF MATRIX METALLOPROTEINASES (MMP-2, MMP-9, TIMP-1) WITH JUVENILE ARTHRITIS IN CHILDREN
Kailina A.N., Ogorodova L.M., Chasovskikh Y.P., Kremer E.E.

Abstract

One of the perspectives of modern rheumatology is the study of  matrix metalloproteinases (MMP) in juvenile arthritis - enzymes that play a key role in the process of joint destruction. Aim. To analyse the content of matrix MMP-2 and MMP-9 and their tissue inhibitor (TIMP-1) in blood serum and synovial fluid in various embodiments of juvenile arthritis in children. Patients and Methods.The study involved 82 children with juvenile arthritis, and 20 healthy children. The level of MMP-2, MMP-9 and TIMP-1 were determined in serum and synovial fluid by ELISA. Results. It was found out that with any form of arthritis serum concentrations of MMP-2, MMP-9 and TIMP-1 was significantly higher than control values, but the level of MMP-2 in a subset of enthesitis-related arthritis, didn’t differ from the control. Studied parameters in the synovial fluid were much higher than the serum level. With the development of uveitis TIMP-1 in blood serum was lower than in the absence of eye damage. On treatment of patients significant changes in the studied enzymes weren’t established. On a good response to therapy the level of MMP-9 in serum decreased, on the lack of effectiveness – increased. Conclusions. The analysis results  confirm the involvement of MMP-2, MMP-9 and TIMP-1 in the processes of inflammatory changes of the joints in juvenile idiopathic arthritis (JIA) and reactive arthritis, regardless the patients’sex or age.

 

Annals of the Russian academy of medical sciences. 2013;68(7):36-40
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IMMUNOLOGIC INDEXES, ENZYME STATUS OF LYMPHOCYTES AND FUNCTIONAL ACTIVITY OF BLOOD NEUTROPHILS IN CHILDREN WITH INFECTIOUS MONONUCLEOSIS CAUSED BY EPSTEIN–BARR VIRUS
Kurtasova L.M., Tolstikova A.E., Savchenko A.A.

Abstract

Aim. Explore the immunological parameters, levels of activity of NAD(P)-dependent dehydrogenases lymphocytes, interferon status parameters, phagocytic activity and chemiluminescence response of neutrophils in the blood of children in the acute phase of infectious mononucleosis caused by the Epstein-Barr virus. Patients and methods. 65 children at the age of 46 years old with infectious mononucleosis caused by EBV in acute phase were observed. Such indexes as cell-mediated, humoral and interferon immunity, NAD(P)-depended dehydrogenases activity in blood lymphocyte, phagocytes activity, levels of spontaneous and induced chemiluminescence of peripheral blood neutrophils were studied. Results. Children with EVB-infection have immunophenotype spectrum changes and changes of enzymes status of blood lymphocytes against the increasing in leucocytes and the useful increasing in lymphocytes. The useful increasing in IgA, IgM, IgG contenting in serum blood were found. The decreasing of spontaneous production of IFN α and the decreasing of induced production of IFN α, IFN γ were determined. The breach of phagocytes activity and chemiluminescent response of blood neutrophils were found. Conclusions. The children in the acute phase of infectious mononucleosis caused by the Epstein-Barr virus, there are changes in the immune status, changes the activity of NAD(P)-dependent dehydrogenases in blood lymphocytes, marked changes in functional and metabolic state of peripheral blood neutrophils.

 

Annals of the Russian academy of medical sciences. 2013;68(7):42-46
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CHANGES IN AUDITORY FUNCTION DURING FIRST 6 MONTHS IN PREMATURE CHILDREN WITH INTRAUTERINE GROWTH RETARDATION
Rakhmanova I.V., Sichinava L.G., D'yakonova I.N., Ledovskikh Y.A., Zinker G.M.

Abstract

Aim: To define an influence of  intrauterine growth restriction to forming of hearing function of preterm infants. Patients and methods. The audiological test by the method of distortion product otoacoustic emission (DPOAE) was performed 3 times (during supposed dates of birth; 3 months old; 6 months old) in 136 premature children born while different gestation periods. Children were divided into 2 groups: premature children with intrauterine growth restriction (IUGR) and premature children with normal weight for their gestation age (normotrophy). Results. During checkup in supposed date of birth of children with IUGR, DPOAE was detected less than children with normotrophy and with the same gestation period. Test results in all 3 months old premature children of gestation period less than 32 weeks were significantly lower in comparison with children of another date of gestation. Results in 6 months old children with IUGR and with normotrophy were almost identical. In 17% of children with IUGR born at term gestation less than 32 weeks of auditory function is not available. Children with normotrophy from the same subgroup lack of auditory function were noted in 12% of cases. Conclusions. Premature children with IUGR maturing of auditory function is likely not to end in 6 months and can continue after 6 months.

 

Annals of the Russian academy of medical sciences. 2013;68(7):47-52
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PULMONOLOGY: CURRENT ISSUES
ASSOCIATION OF POLYMORPHISM RS6737848 IN THE SOCS5 GENE WITH BRONCHIAL ASTHMA
Saltykova I.V., Freidin M.B., Bragina E.Y., Ogorodova L.M., Puzyrev V.P.

Abstract

Aim: to investigate the role of polymorphic variants of immune-response modifying genes in predisposition to asthma. Patients and methods. The analysis of restriction fragments length polymorphism was used to investigate 10 single-nucleotide polymorphisms: IFNG rs2069705, IFNGR2 rs17880053, IL4 rs 2070874, IL4RA rs 1805010, GATA3 rs10905277, TBX21 rs11652969, PIASY rs3760903, PIAS3 rs12756687, STAT5β rs16967593, and SOCS5 rs6737848 in 106 asthma patients and 115 healthy people. Results. The rs6737848 SOCS5 polymorphism was significantly associated with asthma in additive model (р =0,05, OR =0,338, 95%CI 0,1580,723) and in dominant model (р =0,02, OR =0,284, CI 0,1260,638). None of the polymorphisms of the studied genes was associated with total IgE levels. Conclusions. This is the first report on the association of rs6737848 SOCS5 with asthma.

 

Annals of the Russian academy of medical sciences. 2013;68(7):53-56
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MYCOPLASMA AND CHLAMYDIA AS ETHIOLOGICAL FACTORS OF BRONCHIAL ASTHMA IN TERMS OF ETHNOGENESIS
Sharavii O.A., Smirnova S.V.

Abstract

 Aim. The study of the prevalence and clinical peculiarities of Mycoplasmosis and Chlamydiosis in patients with different pathogenic forms of bronchial asthma (BA) taking into account ethnicity of a patient. Subjects and Methods. The research covered 239 subjects – both the Europeoids and the Mongoloids in the city of Krasnoyarsk and the town of Kyzyl, all of them being BA patients of different stages, including acute stage and practically healthy. We had determined antigens Mycoplasma pneumoniae, Mycoplasma hominis, Chlamydophila pneumoniae, Chlamydophila psittaci and Chlamydia trachomatis in smears of mucosa of pharynx and antibodies to these antigens in peripheral blood serum. Results.  We found high frequency of Mycoplasmosis and Chlamydiosis in the inhabitants of Eastern Siberia, BA patients with different pathogenic forms as compared to control group. We had determined ethnic peculiarities of specific immune response: IgM to М. pneumoniae was revealed in the Europoids more frequently than in the Mongoloids, but IgM to С. pneumoniae and to C. trachomatis, C. trachomatis antigens had been revealed more often in the Mongoloids than in the Europoids. We accepted as clinical equivalents of Mycoplasmosis and Chlamydiosis diagnostics the following signs: temperature around 37C (subfebrile temperature), non-intensive but stable coughing with scanty mucous and muco-purulent sputum, dyspnea of mixed character. Conclusions. Mycoplasma and Chlamydia are meaningful etiologic factors of bronchial asthma. We have found the peculiarities of immune response depending on ethnicity of a patient (ethnic belonging). Clinical markers of Mycoplasmosis and Chlamydiosis should be taken into account in bronchial asthma in order to provide diagnostics timely as well as eradication of infection agents. Because of insufficient knowledge of problem of bronchial asthma related to contamination with Мycoplasma and Chlamydia we put the goal to study the frequency of Mycoplasmosis and Chlamydiosis occurrence in bronchial asthma patients and determine the characteristics clinical course of diseases. We defined antigens Мycoplasma pneumoniae, Мycoplasma hominis, Chlamydophila pneumoniaе, Chlamydophila psittaci, Chlamydia trachomatis in smears of oropharynx mucosa and antibodies to them in blood serum.

 

Annals of the Russian academy of medical sciences. 2013;68(7):57-60
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