THE PECULIARITIES OF THE CENTRAL HEMODYNAMICSFORMATION AMONG THE CHILDREN IN LONG-TERM REMISSION OF ACUTE LYMPHOBLASTIC LEUKEMIA

Purpose: To identify the peculiarities of the central hemodynamics formation among the children in long-term remission of acute lymphoblastic leukemia.Materials and Methods: The monitored group consisted of 22 children having been in long-term remission of acute lymphoblastic leukemia for more than 5 years. All the children had previously been treated according to the standard and intermediate risk groups of the ALL-MB-2002protocol. The control group included 81 children belonging to the first and second health groups. All the children had gone through a complex medical examination including electrocardiography, cardiointervalography, Doppler echocardiography.Results: Cardiac syndrome is significantly more frequently registered among the children in long-term remission of acutelymphoblastic leukemia. At the same time authentic differences in the incidence of repolarization violations were detected among the patients in long-term remission of acute lymphoblasticleukemia. Early signs of diastolic myocardial dysfunction were also revealed among the patients with acute lymphoblastic leukemia despite the absence of systolic function changes and hyperkinetic type of blood circulation was significantly more often formed. In assessing the vegetative function the prevalence of the original sympathicotony and asympathicotonic vegetative reactivity was established

SOME PARTICULARITIES OF THE HORMONAL STATUS OF THE VULVOVAGINITIES IN FREQUENTLY SICK CHILDREN

Purpose: To make a careful study particularities of the hormonal system by the vulvovaginities of often being ill girls in the period of senior preschool ages.Materials and methods. For the reason studies clinical and functional particularities of the reproductal system, authors examined 90 frequently sick girls with the vulvovaginities aged 3-6 years old. The control group had 30 practycaly healsy girls the same age with normal physical and sexual development.Results. It was determined that the frequently sick girls with the vulvovaginities had different exchange of hormonal status. Summary: In was determined that the frequently sick girls with the vulvovaginities had different breaches of hormonal statusand reproductal exchange

ROLE OF ANGIOGENIC FACTORS FOR TRANSPLACENTAL TRANSFER OF THE MEASLES ANTIBODIES

Angiogenesis factors (VEGF, Ang-1, TGF-β) influence production, development and functioning of vascular endothelium that are part of the placental barrier structure and are involved into transplacental transfer of different substances. The aim of this study was to study the relationship between VEGF, Ang-1, and TGF-β concentrations, and the levels of transplacental IgG-antibodies to the measles virus in cord blood of children born to mothers with placental insufficiency. Patients and methods: venous blood was taken from 32 women with uncomplicated pregnancies, and 34 samples from pregnant women with placental insufficiency, as well as umbilical blood of their newborns, the level of IgG-antibodies to measles and the concentration of some angiogenic factors (VEGF, Ang-1, TGF-β) examined by ELISA techniques. The following results were obtained: in a cord blood of infants seronegative for the measles virus, born to women with placental insufficiency, showed uniformly low VEGF levels, decreased Ang-1 concentration (1.6) and increased TGF-β concentration (2.7) as compared to seropositive newborns. In a similar group of children from mothers with physiological pregnancy, the level of these factors did not differ from those in newborns with protective antibodies to measles. Conclusion: in physiological pregnancy, transplacental transmission of IgG-antibodies to the measles virus is directly dependent on the presence of specific antibodies in a woman; in case of placental insufficiency, an imbalance in the system of angiogenic factors may promote disturbances of transmission mechanisms for IgG measles-specific antibodies from mother to the fetus

Development Diastolic Dysfunction Myocardium in Children with Acute Lymphoblastic Leukemia at the Stages of fhe Polychemotherapy

The development of progressive myocardial dysfunction is one of the side effects of polychemotherapy. Changes in diastolic filling of the left ventricular is the earliest marker that precedes the full-scaled clinical picture of heart failure. Purpose: Assessment of left ventricle’s diastolic function and the study of the state of lipid peroxidation processes in children with acute leukemia at the stages of polychemotherapy. Materials and Methods: We have examined 54 patients with acute lymphoblastic leukemia at the age ranging from 3 to 17 years old. Results: Complex transthoracic Doppler echocardiography shows the occurrence of diastolic dysfunction at the time when the disease is diagnosed and its progression after the end of polychemotherapy. The development of cardiac complications is accompanied by an increase in the generation of reactive oxygen species, accumulation of oxydated lipoproteins, which suggests the free-radical genesis of myocardial damage. Summary: Early detection of disorder of diastolic function of the left ventricle may allow to appoint cardiotropic therapy on the initial stage and decrease the rate of complications of polychemotherapy

Effect of vitamin D and interferon α-2b on cytokine profile in pregnant women with vaginal infections

A study was conducted to evaluate effectiveness of vitamin D and interferon α-2b preparations on cytokine profile in pregnant women with vaginal infections. It was shown that pregnant women with vs. without bacterial vaginosis were featured with low vitamin D level in 53.8–60.5% cases. Administration of vitamin D and interferon α-2b preparations in combination with antibacterial therapy in pregnant women with bacterial vaginosis conferred anti-inflammatory effect resulting in normalized IL-8 level corresponding to that one in healthy subjects. Use of vitamin D altered interferon status and augmented antimicrobial activity in pregnant women confirmed by reduced rate of ARI episodes

INDICATORS OF ADAPTIVE IMMUNITY TO OPPORTUNISTIC BACTERIA IN NEWBORNS

Purpose: to evaluate the performance of transplacental adaptive immunity to opportunistic bacteria in newborns.Materials and Мethods: the study involved 682 newborn baby born to women 18-44 years old with various infectious anamnesis: weighed down (I group) and favorable infectious anamnesis (II group). Material for research is umbilical cord blood in that by linked immunosorbent analysis were determined IgG-antibody to opportunistic bacteria: S.aureus, S.epidermidis, S.pneumoniae, P.aerugonosa, E.coli, P.vulgaris, H.influenzae and K.pneumoniae.Results: it is set that a range of mean values of antibodies to оpportunistic bacteria was 36,5-60,6 conventional units at all 682 inspected. Thus, for the children of I of group their range hesitated within the limits of 41,3-57,2 conventional units, in II to the group - 50,3-64,7 conventional units. Lower values detected antibodies only to two оpportunisticbacteria -S. pneumoniae and H. influenzae in children in I group as compared to group II infants. And their level was lower in the umbilical cord blood of newborns born to women over the age of 25-30 years.Summary: the presence of infectious and inflammatory diseases in women during pregnancy, especially older than 25 years can be considered as a risk factor. This fact substantiates the need for the complex medical-diagnostic and preventive measures for the prevention of controlled infectious diseases caused by оpportunistic bacteria in the future in children

ROLE OF IMPAIRED IRON METABOLISM IN THE DEVELOPMENT OF DISORDERS OF RHYTHM AND CONDUCTION IN CHILDREN WITH ACUTE LYMPHOBLASTIC LEUKEMIA

Purpose: to analyze the relationship between iron metabolism and rhythm and conduction disorders in the children with acute lymphoblastic leukemia (ALL).Materials and Мethods: the children were studied over time: at admission to the clinic before the start of chemotherapy (Group 1a), after remission induction (Group 1b), and after discontinuation of intensive polychemotherapy (Group 1c).Results: examination of iron metabolism in the children with ALL revealed significantly elevated serum iron level with increased iron transferring saturation index, ferritin and hepcidin levels and lower total iron binding capacity (TIBC) at all stages of polychemotherapy (PCT). Summary: the children with ALL demonstrated significant association between serum iron level and nomotopic automatism disorders (sinus tachy-, brady, arrhythmias) at all PCT stages; between serum iron level and extrasystoles appearance during and after discontinuation of the treatment; and also between serum ferritin level and myocardial depolarization disorders at all PCT stages and conduction disorders during and after discontinuation of the treatment

ACTIVATION OF TOLL-LIKE RECEPTORS AND SYNTHESIS OF PROINFLAMMATORY CYTOKINES, CAUSED BY THEVACCINE AGAINST HAEMOPHILUS TYPE B INFECTIONS IN UMBILICAL CORD BLOOD OF NEWBORNS

Purpose: to assess the parameters of natural and adaptive immunity to H.influenzae type b in infants to predict the risk of Hib-infection.Materials and methods: examined two groups of infants: I group- born to women with infections during pregnancy (140 pers.), IIgroup- born to mothers withoutinfections during pregnancy (40 pers.). On monocytes (MNCs) cord blood to determine the level of expression of TLR2, TLR4 and cytokine production (IL-1β, IL-6, TNF) under the influence of polysaccharide conjugate vaccine to prevent infection by H.influenzae type b (≪Act-HIB≫). In umbilical blood serum were determined with ELISA of IgG to H. influenzae type b.Results: under the impact of the vaccine on cord blood MNCs differences in the level of expression of TLR2 and TLR4 have been identified. Functional activity of MNCs, estimated by the synthesis of IL-1 and IL-6 in the supernatants of cell cultures was higher in I group of children. It was established that the level of IgG antibodies to H.influenzae type b in children I group was lower (p <0.05) than children of II group.Summary: the low level of antiHaemophilusantisubstance in combination with high activity of prion flammatory cytokines may have important diagnostic and prognostic value and may be considered as a factor predisposing to the development of diseases in neonates and infants caused by H.influenzae

INDUCTION OF EFFECTORS OF INNATE AND ADAPTIVE IMMUNITY IN THE PROCESS OF THERAPY OF TOPIC FORM OF RECOMBINANT INTERFERON-a2b DURING RESPIRATORY INFECTIONS IN PREGNANT

Aim. Study immunologic phenotype of lymphocytes in the process of therapy of topic form of recombinant interferon-a2b during respiratory infections in pregnant. Materials aih. methods. 74 pregnant women from 14 weeks of gestation took part in the study, among their 55 - within 24 hours with symptoms of acute respiratory infection (ARI) of light and medium, severe course of infection, who do not need hospitalization. Group I - 34 pregnan omen with ARI receiving basic therapy with human recombinant interferon-a2b in gel form. Group 11 - 21 pregnant with ARI receiving only basic therapy. Control group had 19 pregnant omen without signs of ARI. Relative content of principle lymphocyte subpopulations was -:udied by flow cytofluorimetry: CD3+, CD3+CD4+, CD3+CD8+, CD3-CD19+, CD3-CD16+56+, CD3-CD8+; immune regulatory index was calculated in blood within 24 hours 'om the onset of the disease and 8 - 10 days later. Results. A disbalance of lymphocyte subpopulations was noted in pregnant women with light or medium severity course of acute 'espiratory infections, that was characterized by an increased content of CD3-CD16+56+ .nd CD3+CD8+, as well as a reduced content of CD3+ and CD3+CD8+. Inclusion of a :opical form of recombinant interferon-oc2b during the first days of development of the disease .as a systemic effect on cell immunity and results in normalization of subpopulation compoition of blood lymphocytes that is characteristic for physiological course of pregnancy. Conclusion. Administration of topic form of recombinant interferon in pregnant with light or medium severity of ARI can be accompanied by activation of factors of innate and adaptive immunity

Preventing Complications in Pregnant Women with Mild and Moderate Severity of Acute Respiratory Infections

Relevance. Pregnant women are often exposed to respiratory viruses. Occasionally, the fetus may be harmed by the virus.Goal to present materials revealing the safety and effectiveness of local interferon therapy used in the initial stage of acute respiratory infection in pregnant women from 14 weeks of gestation.Materials and methods. An in-depth analysis of the results of a study of the safety and efficacy of local interferon-therapy of respiratory infections presented in more than 60 literature sources, and own research.Results. It is shown that the inclusion of interferon-α2b (Viferon®) preparation in the complex of basic ARI therapy in pregnant women leads to a decrease in the content in the nasal washout of IL-8, the growth of T-lymphocytes and T-helpers, a more pronounced tendency to decrease natural killers; positively affects the microbiocenosis of the mucous membranes of the upper respiratory tract; leads to a reduction in symptoms of acute pharyngitis, bacterial complications from the upper respiratory tract and, as a consequence, minimizes the need for systemic antibacterial therapy.Conclusions. The conclusion is made about the expediency of including the recombinant interferon-α2b (Viferon®) preparation in intranasal gel form in the complex of basic ARI therapy in pregnant women