Clinical Significance of Oligohydramnios in Patients with Preterm Premature Rupture of Membranes

Background. Preterm premature rupture of membranes (PPROM) is one of the main causes of perinatal morbidity and mortality. Associated oligohydramnios may further exacerbate the condition leading to intra-amniotic inflammation and adverse obstetric and perinatal outcomes in preterm labor.Aim of the research. To determine an impact of oligohydramnios on patients with preterm premature rupture of membranes.Materials and methods. We performed a retrospective analysis of two groups of patients with PPROM: 56 patients with oligohydramnios were included in the main group, 111 patients without oligohydramnios were included in the control group. The gestational age varied from 24+0 weeks to 33+6 weeks. Amniotic fluid index, endocervical culture, leukogram and neutrophil-to-lymphocyte ratio (NLR), serum procalcitonin and C-reactive protein levels were assessed in all participants.Results. We witnessed a plethora of consequences in the group of women with PPROM and oligohydramnios: shorter latent phase, higher incidence of clinical chorioamnionitis, antenatal fetal distress, higher levels of C-reactive protein, leukocytes, neutrophils and NLR, lower level of lymphocytes, and increased growth of potentially pathogenic cervical flora. Moreover, the patients with oligohydramnios demonstrated a significantly higher rate of cesarean delivery. The combination of PPROM and oligohydramnios also take a toll on the condition of the newborns: they have lower 5-minute Apgar score and higher prevalence of respiratory distress syndrome, congenital pneumonia, and necrotizing enterocolitis. Furthermore, newborns from the main group are more likely to be admitted to the neonatal intensive care unit, compared with newborns from the control group.Conclusion. Oligohydramnios in PPROM is associated with a dramatic rise of numerous complications affecting both the women and the newborns

Influence of Tocolytic Therapy with Hexoprenaline on Heart Rate Variability, Lipid Spectrum and Glycemic Level in Obese Pregnant Women

Background. Obesity is associated with the risk of spontaneous preterm birth. Hexoprenaline is the effective and most widely used tocolytic agent, possessing however a significant number of side effects. The effect of hexoprenaline tocolysis on heart rate variability, lipid spectrum and glycaemia level in obese pregnant women remain unexplored.Aim of the research. To study the effect of tocolytic therapy with hexoprenaline on heart rate variability, lipid spectrum and glycemic level in obese pregnant women.Materials and methods. The study included two groups of pregnant women with threatened preterm labor who received tocolysis with hexoprenaline. One group consisted of 68 obese patients, the other – 72 non-obese pregnant women (control group). Patients underwent Holter monitoring. Fasting serum glucose and lipids spectrum were measured before starting tocolytic therapy and after 24 hours of tocolysis.Results. In obese pregnant women with hexoprenaline infusion, the heart rate, the 24-hours number of supraventricular extrasystoles and ventricular extrasystoles during the day are significantly higher. Frequency domain parameters, very low frequency during the day, low frequency at night and 24-hours high frequency were significantly decreased than in control group. After a day of tocolysis in obese pregnant women, the level of total cholesterol, low density lipoproteins, triglycerides, and glucose significantly increases when compared with the results before therapy. For patients in the control group treated with hexoprenaline, only the concentration of high-density lipoproteins is increased.Conclusion. Obesity in pregnant women receiving hexoprenaline tocolysis is associated with low heart rate variability and an increase in the number of cardiac arrhythmias, as well as lipid disorders and an increase in glucose level

Risk-oriented approach in analyzing epidemiologic situation with incidence with tick-borne encephalitis on endemic territories

Sverdlovsk region is a zone with a strenuous natural-anthropogenic focus of virus tick-borne encephalitis (TBE). Incidence with the disease has decreased by 5 times over the last 20 years due to mass vaccination among population. Since 2015 incidence with TBE has remained steady at fewer than 3 cases per 100,000 people. However, over the last 10 years incidence with TBE has been decreasing at a significantly slower rate due to a considerable growth in number of immune people (from 68 % in 2007 to 84.99 % in 2018). Analysis revealed that probability of the disease after a person had been bitten by a tick was quite different on different territories in the region. Our research goal was to develop a procedure for ranking administrative territories as per risks of clinical TBE occurrence among people bitten by ticks. We took a number of people bitten by ticks per one TBE case as our risk parameter. Our analysis revealed that average regional risk reached its maximum values (1:40–1:50) in years prior to implementation of mass vaccination against TBE. As a number of immune people grew, risk fell by 6 times (just 1 TBE case per 319 bitten people in 2018). Average regional risk was taken as to be equal to 1. We ranked administrative territories as per their risk index values (a ratio of a territorial risk to average regional one). We showed that ranking of TBE-endemic territories as per their risk index allowed implementing a differentiated approach to planning and organizing efficient preventio

The development of a new bread wheat genotype carrying two loci for endosperm softness

The technological purpose of grain and flour wheat is largely determined by the grains endosperm structure. Its variability among wheat varieties depends mainly on the multiple allelism for a single Ha locus on chromosome 5D leading to a continuous variation of the trait. The grain endosperm can vary from hard and vitreous suitable for yeast baking to soft and floury favorable for confectionery and technical purposes. Furthermore, these traits, especially vitreousness, are strongly influenced by the growth conditions. Earlier, the Ha-Sp locus was introgessed into chromosome 5A of the bread wheat line 84/98w from Aegilops speltoides Tausch., which reduces endosperm hardness and vitreousness, like the dominant allele of the Ha locus. This paper is the first to describe the obtaining and testing of the supersoft lines combining in their genotype the homoeoallelic loci Ha-Sp of the line 84/98w and Ha of the soft grain cultivar Chinese Spring. The lines were isolated from 6–8 generations of self-pollinated F2 hybrids. They consistently exhibit a greater grain softness than the parental forms under both greenhouse and field conditions. These lines can be used in the breeding of wheat cultivars, the flour of which will not require chemical baking powder in the confectionery industry. It is also possible to use them for technical purposes for the production of bioethanol. In addition, these lines may serve as a genetic model for the study of the functional activity of homoeoallelic genes in the complex polyploid genomes of plants

The possibility of endometriosis development among adolescent girls suffering from dismenorhea

Aim of the research has been the working out of the methodological approach towards the prophylaxis and treatment of endometriosis during the period of reproductive function development in adolescent girls. Material and methods: complex prospective clinical and laboratory examination of 140 adolescent girls with the problems of reproductive function development (dismenorhea and puberty uterine bleeding) and women of reproductive age with different types of endometriosis. Control group consisted of adolescent girls with normal development of reproductive function. Study results: the informative parameters of immune homeostasis have been revealed after mathematical processing: class M immunoglobulins, circulating immune complexes and T-lymphocytes level. The decisive rule has been worked out. Conclusion: estimation of the immune system allowed to choose the complex of informative parameters and to propose the method of early (preclinical) endometriosis diagnosis.Цель работы разработка методического подхода к профилактике и лечению эндометриоза в периоде становления репродуктивной функции у девочек-подростков. Материалы и методы: проведено комплексное проспективное клинико-лабораторное обследование 140 подростков с нарушениями становления репродуктивной функции по типу дисменореи и МКПП (маточных кровотечений периода пубертата), женщин репродуктивного возраста с различными формами эндометриоза. Контрольную группу составили девочки подростки без нарушения становления репродуктивной функции. Математическая обработка полученного материала проводилась методами моделирования (метод распознавания образов на основе искусственных слоистых нейронных сетей). Результаты исследований: после математической обработки были выявлены информативные показатели иммунного гомеостаза: иммуноглобулины класса М, цирклирующие иммунные комплексы, уровень Т-лимфоцитов. С применением математического аппарата выведено решающее правило. Выводы: обследование иммунной системы позволило выделить комплекс информативных показателей и предложить метод ранней (доклинической) диагностики эндометриоза

FEATURES OF IMMUNE RESPONSE IN PRETERM BABIES WITH BRONCHOPULMONARY DISPLASIA OF VARIOUS SEVERITY

To evaluate the immunity indexes in the children who were born with bronchopulmonary dysplasia (BPD) of varying severity at very early delivery terms (22-27 weeks), dynamic examinations were performed in 35 infants: 17 children were with severe BPD; 18, with mild-severity and moderately severe BPD. The comparison group consisted of seven children born at 22-27 weeks of gestational age without signs of BPD. Relative numbers of lymphocyte subpopulations (CD3+, CD4+, CD8+, CD19+, CD16+CD56+, CD4+CD25+), and monocytes (CD14+CD64+, CD14+HLA-DR+) were determined by flow cytometry. The level of cytokines (IL-6, IL-8, IL-4) was measured by enzyme immunoassay technique. The features of immune status in children with BPD of severe, mild and moderate severity were discerned. It was found that the predictors of severe BPD development in the children born at very early terms, are: increased content of IL-8 at birth and at the age of 1 month, reduced level of expression on monocytes (CD64, HLA-DR) on the 1 month of life, and CD14+CD64+ cells at 38-40 weeks post conception. The revealed features of immune status in newborns with BPD can be used to assess the effectiveness of the therapy, which requires further research in this direction

Experience of the successful treatment with canakinumab of a patient with NLPC4-associated autoinflammatory syndrome with enterocolitis

The article shows the observation of rare NLPC4-associated autoinflammatory syndrome with enterocolitis and familial cold urticaria. Diagnosis is confirmed molecularly-genetically: previously not described mutation c.928C>T in the heterozygous state in NLRC4 gene is discovered by a method of the new generation sequencing. The use of a monoclonal antibody to the interleukin 1 canakinumab provided complete relief of fever and skin and intestinal symptoms in just 1 week of treatment. Later the signs of inflammation have disappeared completely; the patient’s quality of life improved and life-threatening complications were prevented. The above example demonstrates the high clinical efficacy of canakinumab in the patient with NLRC4-associated autoinflammatory syndrome and suggests promising therapeutic use of interleukin 1 blockers in such patients. There were no adverse events during canakinumab therapy

High Efficiency of Kanakinumabum for a Patient with a Late Diagnosed Chronic Infantile Neurological Cutaneous Articular Syndrome (CINCA)

The article presents the monitoring of a severe course of CINCA/NOMID syndrome diagnosed at late stages. The use of monoclonal antibodies to IL 1 — kanakinumabum — in a patient with chronic neurological cutaneous and articular syndrome was successful: fever, cutaneous and pain syndromes were completely stopped, joint contractures decreased after one week of therapy. Laboratory parameters of the child’s disease activity (ESR and CRP) became normal after 8 weeks of treatment. Movements in the affected joints recovered completely after 24 weeks; the audiologist noted an improvement in hearing. The above clinical example demonstrates the high efficiency of kanakinumabum for a patient with chronic neurological cutaneous and articular syndrome, and shows the perspective of therapeutic application of IL 1 blocker for patients with CINCA syndrome including advanced stages of the disease. No adverse effects were noted during kanakinumabum therapy