Doppler assessment of throphoblastic blood flow to predict adverse pregnancy outcome

Objective. To evaluate the diagnostic utility of trophoblastic blood flow Doppler parameters in predicting an adverse pregnancy outcome.Material and Methods. This was a retrospective study of 218 pregnancies of women between 8 and 11 weeks’ gestation. Depending on the pregnancy outcome, patients were divided into 4 clinical groups. All women underwent an ultrasound examination using Voluson S8, Voluson E8 with high-quality grey scale, color flow mapping and pulsed-wave Doppler modes. We used a program for obstetric research with the following instrument settings: 100 MHz Doppler frequency, thermal index (TI) was <1, mechanical index (MI) was 1. The examination time did not exceed 20 minutes. There was no radiation exposure. Transvaginal and transabdominal sonographies were performed.Results. To form a risk group for an adverse fetal outcome due to fetoplacental insufficiency, it is necessary to identify ultrasound markers of inadequate placental perfusion by means of a Doppler study of fetoplacental blood flow. For this purpose, we examined 218 pregnancies of women between 8 and 11 weeks’ gestation to determine the diagnostic utility of various parameters: resistivity index, pulsatility index, systolic/diastolic ratio and chorionic vascularization index (k, %). We received results proving high sensitivity (76.9%) and specificity (89.7%) of the chorionic vascularization index (k, %), as well as low specificity (54.7%) and high sensitivity (81.5%) of trophoblastic blood flow resistivity index.Conclusion. Thus, the chorionic vascularization index (k, %) is of high diagnostic utility for predicting an adverse fetal outcome

Multiparametric ultrasound in the diagnosis of ovarian focal lesions

Objective Development of an ultrasound diagnostic matrix for predicting the severity of proliferative changes in the ovarian focal lesion.Material and Methods The research was conducted on the basis of the Clinical Oncology Center, Regional Clinical Hospital no. 2. Echography (B-mode), color Doppler mapping, energy Doppler mapping (pulsation index, resistance index) on GE Voluson E8 and Aloka SSD 3500 devices were used as research methods. Retrospectively, 81 patients of reproductive age from 18 to 45 years were examined. Depending on the histological structure of ovarian lesion, the results of surgical treatment, dynamic observation and the outcome of the disease, were divided into 4 clinical groups: I (n = 12; 14,8%) – controls with no changes in the structure of the ovaries; II (n = 20; 24,7%) – patients with retention ovarian lesions; III (n = 20; 24,7%) – with benign tumors; IV (n = 29; 35,8%) – with malignant tumors.Results A large number of diagnostic parameters does not always allow to formulate an instrumental diagnosis correctly because they have different diagnostic significance. That is why we made an attempt to create a diagnostic matrix. For each of the 18 parameters, three answers were offered. When analyzing the results of the study, there was an increase in the number of pathological parameters from II to IV clinical groups. Thus, in group III, the combination of 2 pathological signs was found in 65% of cases, and 3 signs – in 25% of the examined women. In group IV, the combination of 2 signs was determined in 82% of the subjects, and 3 signs in 65%.Conclusion Thus, we found out that in-depth ultrasound examination (color Doppler imaging, pulsed Doppler) allowed to identify the severity of the proliferative changes and to give the prognosis of the disease

Echohysterosalpingography: pros and cons. A systematic review

Background. Infertility is becoming ever more pressing a problem by year in Russia and worldwide. Tubal-peritoneal infertility is most frequent, with the prevalence of 42.5-80.5% in various estimates. Echohysterosalpingography is considered the today’s “gold standard” in tubal-peritoneal infertility diagnosis in women. This method is known to possess a series of limitations and adverse consequences due to painful sensations during and after check-ups that psychologically afflict women.Objectives. An overview of current methods for inspecting fallopian tubes in reproductively impaired patients to inform promising diagnostic research.Methods. Publications were mined and analysed in the PubMed, eLibrary, Web of Science, Cochrane Library and Cyberleninka electronic databases. The query terms were: echohysterosalpingography [эхогистеросальпингография], echohysterography [эхогистерография], infertility [бесплодие], pregnancy planning [планирование беременности], fallopian patency [проходимость маточных труб], ultrasonic diagnosis [ультразвуковая диагностика], submucous myomatous node [субмукозный миоматозный узел], incompetent uterine scar [несостоятельный рубец на матке], niche [ниша]. The topic selected was female infertility, particularly, the use of echohysterosalpingography in fallopian diagnosis in reproductively impaired women.Results. The review covers 52 sources of the total 118 analysed. Current published evidence and its review identify a notable success of imaging techniques in the fallopian tube diagnosis in women with reproductive problems. The continually developing echohysterosalpingography technique is considered more promising for routine use. Techniques gain more value in analyses of implantation failures. The main challenges in current radiodiagnosis and monitoring of fallopian lesions at a background therapy are the inspection standardisation, disease classification, imaging diagnostic accuracy and prognostic value evaluation in patients with reproductive loss and infertility.Conclusion. The prospective routes of research comprise the definition of optimal check-up terms, echohysterography and echohysterosalpingography diagnostic criteria descriptiveness, improving prognosis in the carrying of pregnancy and treatment efficacy control. A timely and accurate diagnosis of uterus and fallopian tubes is of paramount importance to sustain the women’s reproductive health

ASSESSMENT OF MECHANICAL STRESSES IN STEEL PLATE DURING BENDING BY MAGNETIC PARAMETERS

The object of the study was a plate of steel 20 under the influence of mechanical stresses. The field dependences of the eddy current transducer at different frequencies of the alternating magnetic field were obtained. The mathematical processing of the obtained curves was performed.Работа выполнена в рамках государственного задания МИНОБРНАУКИ России (тема «Диагностика», №122021000030-1)

Application of chitosan-based wound dressings in local treatment of parenchymal organ wounds: a preclinical experimental study

Background. Injuries of various origins with damage to parenchymal organs remain one of the urgent issues of emergency surgery, despite all the achievements of medical science of the first quarter of the XXI century. One way to improve the quality of treatment for patients with this pathology consists in developing new wound dressings or modifying the properties of existing ones. Hemostatic efficacy is claimed to be one of the main requirements for such dressings.Objective. To perform a comparative analysis of the efficacy of the developed biodegradable wound dressings based on chitosan in the treatment of experimental wounds of parenchymal organs.Methods. The study involved laboratory animals (male rabbits weighing 2900 ± 150 g) to form experimental wounds of parenchymatous organs. The methodology involved wounding the liver via internal method, with the creation of a tissue defect of a given volume, or forming a linear incised wound with fixed parameters followed by application of a developed wound dressing. In the control group of animals, a collagen hemostatic sponge was used as a wound dressing. The animals used in the experiment were kept in accordance with GOST 33044-2014 “Principles of good laboratory practice”. The experiment involved studying the properties of two samples of wound dressings developed on the basis of modified Chitosan Soft (Ch-S) and Chitosan Hard (Ch-H) chitosan, having different properties due to their different structural parameters. The applied ultrasound control of the experimental wound area, with visualization of the samples of the investigated material in the process of biodegradation, enabled the features of the wound process to be studied in more detail. Statistical processing of the study results was carried out by methods of variational statistics, including the calculation of mean values (M), standard errors of mean values (± m). The criterion of the level of statistical significance considered a value of p <0.05. Histomorphological examination of samples was carried out using classical methods.Results. An experimental study conducted on laboratory animals in the treatment of liver wounds, followed by a comprehensive assessment of the results obtained, revealed high efficacy in the developed wound dressings in comparison with the control. The following parameters predicted in the development of wound dressing samples were confirmed: stable hemostatic and scaffold functions, biodegradability, adhesiveness and stimulating effect on bioreparative processes in the wound area. In addition, the ultrasound control algorithm in vivo was adapted in animals to assess the dynamics of the wound process and biodegradation of the studied wound dressings in wounds of parenchymal organs in the experiment, previously used in studying the dynamics of the wound process in soft tissues.Conclusion. The developed samples of chitosan-based wound dressings proved their efficacy in an experimental model of the wound process in parenchymal organs. The applied ultrasonic method for monitoring the biodegradation of the studied wound dressing, as well as the dynamics of the wound process in the liver tissue, revealed the correspondence between the visualized image and the histomorphological picture of the studied tissues, the structure and properties of the wound dressing

BIOCHEMICAL MARKERS OF OBESITY IN THE 18-25-YEAR-OLD PATIENTS

Aim. To study the dynamics of metabolic syndrome markers: insulin, glucose, uric acid, triglycerides, low and high density lipoproteides; of food addiction (ghrelin-leptin) in both genders, of 18-25-year-old patients with normal and extensive body fat tissue amount.Material and methods. Totally, 76 persons participated. At first stage, participants underwent survey on their food related behavior and physical activity. For the evaluation of fat tissue amount OMRON BF 506 devices were used, and the analizator of the balance of water-containing body sectors ABC-01 “Medass”. At the concluding stage of the study all participants underwent biochemical and hormonal blood tests.Results. Excessive amount of body fat by bioimpedance is common in normal body mass index. Nevertheless, the correlation data on leptin, insulin, lipids and uric acid with gender and amount of fat tissue makes it to suspect subclinical metabolism disorder in the presence of minimal excess of fat tissue.Conclusion. For the on time more effective prevention of obesity and its consequences as type 2 diabetes, arterial hypertension, etc., it is aimful to use the results of body fat tissue amount measurements, but not empirical calculations

Radioprotection by Cu(II) Chelates of Nicotinyl-L-Aminoacidates

Essential metalloelement chelates presents a promising class of compounds for search and development of novel anti-radiation agents, study of which offers a new approach to overcome the pathological effects of ionizing radiation. In this study Cu(II) chelates of Nicotinyl-L-Tyrosinate and Nicotinyl-L-Tryptophanate Schiff Bases were synthesized and investigated as radioprotectors in animal experiments against injuries caused by ionizing irradiation. Based on the assessment of average life-span indices and 30-day animal survival after radiation exposure at LD50/30 (4.8 Gy) or LD100/30 (8.7 Gy) the radioprotective effects of 0 mg/kg (Vehicle), 10 mg/kg, 20 mg/kg, or 40 mg/kg Cu(II)(Nicotinyl-L-Tyrosinate)2 or Cu(II)(Nicotinyl-L-Tryptophanate)2 as well as their parents Schiff Bases were studied in case of single subcutaneous and oral administration to rats 1, 3, 6 and 24 hours prior to X-ray irradiation. The mixture of 4% propylene glycol and 1.4% polyvinyl alcohol in saline was used as a Vehicle for the administration of compounds to animal organism. According to the results obtained, administration of the metallochelates to the rat organism prior to X-ray irradiation provided strong radioprotective effects expressed upon application of all considered dose, mode and time treatment schedules: in groups of animals treated with Cu(II) chelates there was an remarkable increase in the indices of survival and average life-span in a 30-day period post exposure compared to the control Vehicle treated - irradiated rats. The appropriate parents Schiff Bases Nicotinyl-L-Tyrosinate and Nicotinyl-L-Tryptophanate also exerted the radioprotective action. However, these compounds were active as effective radioprotectors only in case X-ray irradiation at a dose level equal to or less than LD50/30. Data of analyses indicated that Cu(II) chelates as well as their initial amino acid Schiff Bases did not avert the development of disturbances of hematological indices of animals exposed at LD50/30. However, the findings of immunological studies have demonstrated the inhibiting effects of these compounds on circulating immune complexes (CICs) in blood plasma, which are the major mediators of immune response and are considered as indicators of the autoimmune and inflammatory components of radiation-induced up-regulated immune response. Unlike to Nicotinyl-L-Aminoacidate Schiff Bases their corresponding Cu(II) chelates diminished the harmful effects of radiation-induced CICs formation not only in case of irradiation at LD50/30, but also at much higher radiation dose levels. Thus, the single administration of Cu(II)(Nicotinyl-L-Tyrosinate)2 and Cu(II)(Nicotinyl-L-Tryptophanate)2 at non-toxic doses provides effective radiation protection and high level of survival of exposed animals. Research is performed in the frames of ISTC A-1321 Project

RADIOLOGICAL DIAGNOSTIC OF PLACENTA ACCRETE IN PREGNANT WOMEN WITH CESAREAN SCAR

Aim. To define significant ultrasound and magnetic resonance imaging markers in diagnostics of the depth of chorion invasion in myometrium in pregnant women after Cesarean section was carried out.Materials and methods. 68 pregnant women from 28 to 32 gestation weeks with Caesarian scar and placenta on the front wall of uterus were retrospectively studied. Pregnant women were divided into 4 groups depending on histologic verification of placenta invasion depth. MRI and ultrasound assessment of the lower uterine segment was carried out and the most significant US and MRI markers of placenta accreta were distinguished. Subsequently, the received results of the research were processed by algorithms of factor analysis with calculation of informativeness of each marker and with determination of the forecast of placenta accreta.Results. As a result, group I of pregnant women scored within 0-0.9 conventional units, in group II – 1-3 conventional units, in group III – the score was 3.1-5.0 conventional units, in group IV – 5.1-7.0 conventional units. In groups III and IV are characterized by the fact of signs combination. In group III the combination of 2 signs was detected in 65% of cases, of 3 signs – in 25% of pregnant women.Conclusion. The most informative marker of ultrasound diagnostic of placenta accreta was determination of venous lacunas in its suprabasal part (0.42), in case of MRI it was the assessment of the bladder wall (0.45). The sensitivity and specificity of ultrasonography were 86.2% and 84.8%, in MRI they were 96% and 94.4% respectively