Case of Hemorrhagic Vasculitis with Difficult Stream of 9 Years Old Boy

We are presenting a case of hemorrhagic vasculitis with difficult stream of 9 years old boy. Feature of this case is manifestation of the disease after quinsy with pronounced lymphoproliferative syndrome (enlargement of anterior and posterior cervical and submandibular lymph nodes up to 12-15 mm in diameter), which made it necessary to conduct a differential diagnosis with lymphoproliferative disorders. Thereby the biopsy of lymph node was made. Another feature was that with hemorrhagic rash on lower extremities extensive necrosis were developed, accompanied by severe pain and no analgesic effect. Later joined abdominal and renal syndromes, with development of cruel nephritis. The therapy allowed to achieve clinical remission, however the urinary syndrome retained for long. After correction of the therapy (sandimmun) there were marked rapid positive changes

Analysis of global trends in caesarean section rates using the Robson classification

The rate of Cesarean section (CS) continues to rise and researchers have no clear understanding of the underlying drivers and consequences. Robson’s 10-group classification is based on simple obstetric parameters (parity, prior CS, gestational age, onset of labor, fetal presentation, and a number of fetuses), which allowed the authors to make an effective evaluation of indicators that lead to an increase in the frequency of abdominal delivery. In the context of the global increase in the frequency of abdominal delivery, further modification of the scale will allow the specialists not only to assess the frequency of CS but also to assess the levels of perinatal morbidity and mortality in the groups that make the most significant contribution to the level of CS. Global trends in the commercialization of childbirth require global approaches to reduce the level of abdominal delivery in the population

Morphological verification of the first missed abortion

Objective. The study aimed to compare the level of INF a2 immunoexpression in tissues obtained during medical abortion with the corresponding level of IFNa2 expression in a retained fetal egg tissues after the first missed abortion. The authors compared the anamnestic data on previous inflammatory diseases of the genital tract with the results of an extended morphological study of the material obtained during the evacuation of the contents of the uterine cavity during the first non-developing pregnancy in the first trimester.Materials and methods. The study included 15 patients with first-time missed abortions caused by a viral infection (6-8 weeks of pregnancy). All patients demonstrated either recurrent herpes simplex labialis/genitalis or PCR confirmed HSV, HPV, CMV. Exclusion criteria were recurrent miscarriage, blighted ovum, endocrinopathies, male factor infertility, and other causes of miscarriage. The comparison group included 20 women of the same age that chose to undergo a medical abortion.Results. In patients from the comparison group, the main producer of IFN a2 was syncytiotrophoblast as well as maternal decidual cells in the parietal endometrium and uteroplacental area. In the main group, manifested hematogenous infection (microabscesses, vasculitis, lymphocytic and macrophage infiltration) with dystrophy and necrosis of decidual maternal cells and secondary pathological changes in the placental villi were diagnosed, which led to a significant decrease in the IFN a2 immunoexpression in all the studied cells.Conclusion. The lack of anamnestic data on previous urogenital infections does not exclude the etiological role of the inflammatory component in the genesis of non-developing pregnancy. First-time occurred pregnancy loss requires adequate postoperative interferon therapy and a thorough examination of a couple

Single electron emission in two-phase xenon with application to the detection of coherent neutrino-nucleus scattering

We present an experimental study of single electron emission in ZEPLIN-III, a two-phase xenon experiment built to search for dark matter WIMPs, and discuss applications enabled by the excellent signal-to-noise ratio achieved in detecting this signature. Firstly, we demonstrate a practical method for precise measurement of the free electron lifetime in liquid xenon during normal operation of these detectors. Then, using a realistic detector response model and backgrounds, we assess the feasibility of deploying such an instrument for measuring coherent neutrino-nucleus elastic scattering using the ionisation channel in the few-electron regime. We conclude that it should be possible to measure this elusive neutrino signature above an ionisation threshold of $\sim$3 electrons both at a stopped pion source and at a nuclear reactor. Detectable signal rates are larger in the reactor case, but the triggered measurement and harder recoil energy spectrum afforded by the accelerator source enable lower overall background and fiducialisation of the active volume

The Case of Dilated Cardiomiopathy, the Girl of Three Years from the Silver-Rassel Syndrom

Dilated cardiomyopathy is a serious disabling disease with unclear etiology. In some cases, its occurrence is associated with genetic mutations. In this context the case of dilated cardiomyopathy of the three years old girl from the Silver-Russell syndrome is of considerable interest. This is a genetic disorder characterized by numerous anomalies in the symmetry of the body, malnutrition and premature puberty

Daily periodicity of labor in pregnant women in physiological and complicated pregnancy depending on the sex of the fetus

Objective: the study aimed to reveal the daily periodicity of labor, the nature of melatonin metabolism, and the outcome of childbirth in women with a physiological and complicated pregnancy, depending on the sex of the fetus.Materials and methods: to study the chronophysiological characteristics of birth outcomes depending on fetal sex, 1 980 birth histories and stories of newborns were analyzed. The neonates were born between January 1 and December 31, 2016, in a maternity ward of the Federal State Budgetary Educational Institution of Higher Education “RostGMU” of the Ministry of Health of Russia. Melatonin production was identified by the level of urinary excretion of 6-sulfatoxymelatonin (6-SM) (its main metabolite) examining the morning portion of the urine of women by the ELISA method (at 8 am 3 ml of urine were collected in Eppendorf tube).Results: it was revealed that fetal sex modulated the activity of the central regulatory mechanisms responsible for the daily period functional processes in the female body and the initiation of labor. The largest number of spontaneous births by male fetuses occurred in the early evening before midnight when daily illumination was decreased, while the birth of girls was observed more often in the period from midnight to early morning. At the same time, mothers of boys had lower production of melatonin compared to that of girls’ mothers.Conclusions. The peculiarities of labor and birth complications associated with the sex of the fetus were identified

ASSOCIATION OF MATRIX METALLOPROTEINASES GENE POLYMORPHISM WITH CLINICAL MANIFESTATIONS OF BRONCHIAL ASTHMA IN CHILDREN

In the present study, we have examined association between different polymorphic variants of metalloproteinases genes and clinical manifestations of bronchial asthma in children. We observed 103 patients including 42 children with an established diagnosis of asthma. Moreover, 61 persons were examined in the control group. All patients underwent genetic testing by allele-specific polymerase chain reaction. In particular, 320A>C polymorphic locus of ММР20 gene; Val275Ala ММР20, and -8202A>G gene ММР9 were analyzed.We have found that 30 patients (71.4% of total) had bronchial asthma of mild severity, 9 children (21.4%) exhibited moderate degree, and 3 patients (7%) had severe-grade disease. Homozygous C/C variant of the polymorphic ММР20 gene, 320A>C heterozygous variant of the ММР20 Val275Ala polymorphism, and heterozygous locus of -8202A>G ММР9 gene were found to be most frequent among the children with asthma. Generally, we have observed that the frequencies of the studied alleles and genotypes did not significantly differ berween the asthma patients and children from the control group (p < 0.05). However, in patients with GGgenotype of -8202A>G ММР9 polymorphism combined with homozygosity for the C allele of ММР20 320A>C, a more severe disease was observed, being combined with polyvalent sensitization and high total IgE levels in blood serum.In conclusion, frequencies of alleles and genotypes among patients with asthma did not show any statistically significant differences from the group of healthy children. The patients homozygous for G allele of ММР9 -8202A>G polymorphism gene and for the C allele ММР20 gene (320A>C) seem to be predisposed for a more severe clinical course of the disease

CLINICOMORPHOLOGICAL SUBSTANITIATION OF REHABILITATION THERAPY AFTER ECTOPIC PREGNANCY

Purpose: To demonstrate the need of rehabilitation actions for patients, nearly died from aborted tubal pregnancy.Material and Methods: Comparative clinical analysis of two groups of patients (1st and 2nd) after tubectomy due to abortedtubal pregnancy and different blood loss. The blood loss in 1st group did not exceed 500 ml, and in 2nd group (nearly diedpatients - «near miss») - more than 1500 ml. The 3 group was contained of died patients.Results: It was identified a significant causal dependence of pathomorphological changes of anterior pituitary and adrenal glandfrom the blood loss volume, characterizing compensatory mechanism in acute adrenocortical insufficiency, attributable to anyshock, including posthemorrhagic. The data, obtained in the group of maternal deaths, allow to extrapolate the identified changesand suppose the development of these changes for patients, nearly died from major bleeding due to aborted tubal pregnancy.Summary:The presented data of autopsy of characteristic morphological changes of anterior pituitary and adrenal gland,depending on the blood loss volume, determine the direction of rehabilitation for «near of miss» patients

THE EFFECT OF LIGHT DEPRIVATION ON FUNCTIONAL PROCESSES IN THE SYSTEM “MOTHER – PLACENTA – FETUS” IN CASE OF THREATENING PRETERM BIRTH AND ITS CLINICAL SIGNIFICANCE

Objective: to study the nature of uterine contractile activity, hormonal status, melatonin metabolism, blood flow in the uterine and fetal vessels, and the state of the fetus wellbeing before and after standard drug treatment and combination therapy involving the additional use of light deprivation. Materials and methods: a total of 547 women with threatening preterm birth were examined at 28 – 35 weeks of pregnancy. Among these, 198 pregnant women received standard therapy and 196 women received combined treatment, medical along with light deprivation. The control group consisted of 153 women with physiological pregnancy. We used cardiotocography to study the contractile activity of the uterus and the fetal cardiac rhythm, enzyme-linked immunosorbent assay methods to study the expression of hormones (ACTH, cortisol, progesterone, estriol, placental lactogen) in the blood and 6-sulfatoxymelatonin in the urine of pregnant women. Results: threatening preterm labor is accompanied by an increase in the level of generalized (bilateral) uterine activity, a decrease in the level of melatonin and an increase in the level of stress hormones. After using standard drug therapy, there is a suppression of any form of uterine activity, which leads to a deterioration of the fetus state in 30,2% of women, while combined therapy increases the level of melatonin, decreases the activity of stress-liberating subsystems of the mother’s body, and increases the level of right-sided uterine contractions that contribute to maintaining functional activity of the uteroplacental “pump”, contributing to the prevention of fetal distress. Conclusions: the studies indicate an improvement in the therapeutic effect with using light deprivation, as an additional method for tocolysis in women with the threat of premature birth