MADE ULTRASONIC DIAGNOSIS OF FETAL MALFORMATION. REALITY AND PERSPECTIVE

Purpose: Analysis of the identified congenital malformations of the fetus, as well as identifying opportunities for their prenatal diagnosis.Materials and methods: In a medical and social audit, analysis of data, examine the anamnesis approaches for pregnancy, birth, and fetal outcomes among 204 women who gave birth with defects of development. Given the dynamics of growth of malformations for the years 2010-2012 based on the maternity hospital No. 1 of Rostov-on-Don.Results: There were different types of stains. The work is given the structure of the identified defects. Noted that out of 204 women, only 9 (4.41%) during pregnancy, fetal abnormalities have been identified, the remaining 195 (95.59%) patients vices have not been diagnosed. Such defects have been diagnosed as lumbar hernia, abnormalities of the cardiovascular system and intestines. Other malformations, including chromosomal disease, were not identified. UntimelySummary: All this requires on the one hand to improve prenatal diagnosis of fetal malformation, and improving the training of professionals who know fully the methods of ultrasoun

THE ROLE OF PERSONNEL ASSESSMENT IN THE PROCESS OF HUMAN RESOURCE MANAGEMENT

The article considers the methods of personnel assessment in modern Russian and foreign companies, such as the method of management by objectives, performance management, method of personnel assessment «360 degrees», «assessment center». «As-sessment сenter» has studied in more detail. This method is a set of procedures that de-termines the success of a person in the professional sphere, the parameters of which have been laid down by the competence model. This method has proved itself as a powerful stimulating factor in the training of workers. Its peculiarity consists in the individual ap-proach, which determines the interest of respondents in training. At the same time, the evaluator can show the employee his hidden potential and possible growth zones. At pres-ent time, it is necessary to search new innovative approaches to personnel assessment

Episiotomy as one of the problems of modern periniology

Objective: to analyze the course of pregnancy, childbirth and indications for mediolateral episiotomy in 439 women.Materials and methods: the comparative analysis of outcomes of Rostov-on-Don in two clinical groups on materials of maternity Department of the state hospital of emergency medical care No. 1 of the city of Rostov-on-Don was carried out. The  first group consisted of 439 women who are in childbirth according to the testimony was made episiotomy. Th e second clinical group consisted of 128 women who had no episiotomy if indicated.Results: the main indications for episiotomy in the fi rst clinical group was: threatened rupture of the perineum in 376 (85,65 %) cases, 41 (9,34 %) v distress of the fetus, at 22 (5,01 %) cases — the weakness of the attempts. In 128 women of the second clinical group, in the absence of an episiotomy, although indications for this operation were, there was a rupture of the perineum of the first and second degree.Conclusions: at the signs of a threatening rupture of the perineum or at the clinic of fetal hypoxia in the second period of labor, the mediolateral episiotomy is justified in modern obstetrics

Effect of the qualitative composition of a high-fat diet in rats with systemic inflammatory response syndrome upon myocardial resistance to ischemic-reperfusion injury and cytokine levels

Overweight and obesity are among the main factors of cardiovascular risk, but the prospective studies on the dependence between high-fat diets and weight gain yielded contradictory results. Different types of fats exert varying metabolic effects, and this fact leads to a difference in the risk associated with increasing body weight. The effects of fat quality in the daily diet on immunological status and resistance of myocardium to ischemic-reperfusion damage should be studied experimentally in biomedical models. The purpose of this work was to assess the effect of the qualitative composition of a high-fat diet used for induction of primary visceral obesity (PVO) in rats with systemic inflammatory response syndrome (SIRS) upon myocardial resistance to ischemic-reperfusion injury, and levels of pro- and anti-inflammatory cytokines.The experiments were performed on adult male Wistar rats with PVO caused by 28-day consumption of any fat types: hydrogenated fats (HF), vegetable oils (VO), animal fats (AF) or milk fat (MF). The SIRS model included a combination of chemically induced colitis (CIC) and intragastric injection of a broad-spectrum antimicrobial agent (AMA) for three days. Five days later, immunological and biochemical studies were conducted, as well as composition of intestinal microbiota in faecal samples, morphological changes in the structure of the large intestine, hemodynamic parameters and myocardial resistance to ischemic-reperfusion injury were studied in the model of isolated heart perfusion, by Langendorff technique.There was a significant increase in the concentration of anti-inflammatory cytokines in animals with SIRS, i.e., TNFα, IL-1α, IL-2, IL-8, as well as a decrease in TGF-1β, an anti-inflammatory cytokine. SIRS was accompanied by severe dietary disorders and evacuatory function of the gastrointestinal tract. Minimal changes in the intestinal microbiota composition, as well as the most pronounced regeneration signs of intestinal epithelium was observed in rats in the group with MF injection. There was a trend for increasing size of infarction in all the groups as compared with control, directly correlating with increase in BDNF and IL-2 production. However, a significant increase in the infarction size was found only in the group receiving milkfat, thus suggesting a decrease in myocardial resistance to ischemic reperfusion injury (IRI).Thus, the presence of SIRS in the primary obesity model is characterized by controllable change of inflammation markers and depends on the quality of dietary fats. The degree of morphofunctional deterioration of isolated heart, including a decrease in resistance to ischemia-reperfusion injury, correlates with the concentration of BDNF and IL-2 during the studied observation terms

Modeling of systemic inflammatory response syndrome by chemical induction of colon injury in rats

Our objective was to develop a model of systemic inflammatory response syndrome (SIRS) by chemical induction of colon injury and antibiotic-associated intestinal dysbiosis in rats with primary visceral obesity (PVO) for studies of myocardial resistance to ischemia-reperfusion injury. The experiments were performed with adult Wistar male rats with PVO under improved conditions of a conventional animal clinic. The chemically induced inflammatory colon disease (CIICD) was accomplished by intragastric administration of a mixture of broad-spectrum antimicrobial agents (AMA) for 3 days. Five days later, immunological and biochemical studies were carried out, as follows: composition of the intestinal microbiota in feces and shortchain fatty acids in blood, morphological changes in the structure of the colon, hemodynamic parameters and myocardial stability with modified Langendorff system. In PVO rats, the mass of visceral fat deposits and the content of lipopolysaccharides (LPS) in the blood were significantly increased when giving them fatcarbohydrate diet (FCD). In animals with CIICD, in addition to LPS, there was a significant increase in proinflammatory cytokine concentration (TNF, IL-8, MCP-1), and after oral administration of the AMA mixture, pronounced disturbances of food behavior and evacuatory function of gastrointestinal tract, deep destructive changes in colon, as well as qualitative and quantitative composition of intestinal microbiota with characteristics typical to the first-grade dysbiosis. High levels were shown for IL-8 cytokine only. An increase in acetic and propionic acid concentrations were shown in blood in animals with CIICD, and, to a greater extent, in rats with antibiotic-induced dysbiosis (AID). FCD was followed by significantly reduced levels of lactobacilli and bifidobacteria in colonic contents. CIICD leads to detection of Escherichia coli, and intestinal dysbiosis leads to the manifestation of Proteus. A comorbid combination of pathological changes in the immune and digestive systems caused a significant increase in the area of myocardial necrosis (by 35 percent) in isolated heart by, thus presuming decreased myocardial resistance to ischemia-reperfusion injury (IRI). The SIRS model induced by chemical trauma to large intestine is aggravated by the introduction of AMAs mixture, and it is characterized by a controlled change in inflammatory markers. Deterioration of morphofunctional characteristics in isolated heart included decrease in resistance to IRI seems to correspond to acute inflammatory bowel disease with induced intestinal dysbiosis. This model can be used in experimental medicine in the field of cardiology, endomicroecology, gastroenterology, and immunology

PREGNANCY AND CHILDBIRTH OUTCOME AFTER A CLOSED COMPLICATED VERTEBRAL COMPRESSION FRACTURE

The aim was to analyze the course of pregnancy and childbirth in a woman after a severe spinal injury.Materials and methods. A patient, who became pregnant after a severe spinal injury, was examined and provided with obstretric aid. Her medical documents (medical history) and an individual card of the pregnancy course were examined.Results. The outcome of pregnancy and childbirth was determined for the patient and the fetus after a severe spinal injury.Conclusion. This case demonstrated the course of pregnancy and childbirth in a patient with serious complications arising from a spinal injury. However, despite the severe extragenital pathology, and thanks to the efforts of relevant specialists, the patient endured the pregnancy and was delivered by cesarean section at 37 weeks of gestation, with the birth of a live fullterm newborn. Patients with post-traumatic changes of the musculoskeletal system should be allocated to a separate risk group. Such pregnant women should be subject to a thorough examination in the early stages of pregnancy by a traumatologist and a neurologist, as well as, if indicated, by other specialists. The management tactics of this category of women during pregnancy and childbirth should be strictly individualized.Conflict of interest: the author declares no conflict of interest

EFFECTIVENESS OF OZONE THERAPY IN REHABILITATION OF NEWBORNS AFTER INTRAUTERINE HYPOXIA

Aim. To estimate efficiency of inhalation ozone therapy at rehabilitation of newborns who had suffered from intrauterine hypoxia.Materials and methods. The complex clinical laboratory research of the antioxidant status of 150 newborns was conducted. The control group included 30 almost healthy newborns whose mothers had no somatic diseases and were characterized by physiological gestation course. The group of comparison was presented by 45 newborns whose mothers had secondary chronic placental insufficiency and received drug treatment without the course of ozone therapy. 75 newborns whose mothers received ozone-air mixture inhalations along with traditional therapy entered into clinical group. The erythrocytes of newborns’ dark blood taken right after the birth were chosen as a material for the research. The activity of superoxide dismutases (SOD), catalases, glutathione peroxidases (GPO), glutathione reductase (GSR), glucose-6-phosphate dehydrogenase (G6PD), as well as concentration of the restored glutathione (GSH) were assayed. Results. It was established that the compensatory and adaptive reactions providing elimination of the reasons of oxidizing stress development due to the stimulating influence of ozone on activity of antioxidant protection enzymes were formed in newborns of clinical group.Conclusion. In this regard, the offered scheme of the ozone therapy can be recommended for a complex rehabilitation of pregnant women with the chronic secondary placental insufficiency against the background of cardiovascular diseases

MYASTHENIA GRAVIS AS A RISK FACTOR DURING PREGNANCY

Aim. To present a clinical case of pregnancy and delivery in infants with a favorable outcome for mother and fetus. Materials and methods. Individual medical cards of pregnancy have been studied, examination and delivery of a patient with a rare severe extragenital pathology – miastenia have been carried out.Results. Favorable outcome of pregnancy and delivery, both for the patient and her newborn baby.Conclusion. Despite the fact that myasthenia gravis is a severe disease with an unpredictable disease course, delivery in such cases can be favorable. For positive outcome, dynamic monitoring of the obstetrician and neurologist is required throughout pregnancy and postpartum periods, including patients in compensation stage. Cooperative management of such women and timely correction of deviations in the course of the disease can lead to the birth of healthy generation as a result of which such patients won’t be deprived of joys of motherhood

MANAGEMENT OF PREGNANCY AND LABOR IN MYOPIC PATIENTS

Aim. To study the course of pregnancy and labor in women suffering from myopia.Materials and methods. A comparative analysis of pregnancy outcomes among 100 women with myopia was held. There were 48 women in the study group who had a retinal laser correction within the period of pregnancy. The control group was represented by 52 women who did not undergo the correction.Results. We noted that the peripheral laser retinopexy made possible labor through natural birth canals for women of the study group. While the control group of women underwent abdominal delivery.Conclusion. The problem of myopia during pregnancy remains the focus of attention of obstetricians and ophthalmologists, since it is very important to choose the optimal method of delivery. In this case it is necessary to take into account not only the degree of myopia, but also the state of the retina. Peripheral vitreochorioretinal dystrophic changes (PVCDC) are indication for cesarean section. It was found that the timely use of LRP for retina makes possible reducing the percentage of surgical delivery, and thereby reduces the risk of post-surgery complications