The role of obesity in the development of labor and postpartum abnormalities

Aim. Comparative assessment of the features of the course of labor and postpartum period in women with obesity of various classes. Methods. During 2014-2016, a cohort retrospective and prospective study included 318 birth records. The main group consisted of 198 case records of women with different severity of obesity (122 with obesity class I, 57 with class II and 19 with class III), and the control group included 120 case records of women without obesity. Results. In women with obesity class II and III (p=0.003 and p <0.001) had preterm birth more often than in the control group. Patients with obesity class III had the cesarean section significantly more often than in the control group (p=0.043), in the same group hypertensive disorders in labor and intrauterine hypoxia of the fetus developed more frequently (p=0.009 and p=0.039). In the postpartum period with class III obesity, postpartum haemorrhage was significantly more frequent than in the control group (p=0.045). Among complications of postpartum period in patients with obesity class II, a loychiometer (by 1.7 times), endometritis (by 1.6 times), complications after cesarean section (by 2.1 times) were registered more often than in the control group, and in obesity class III - subinvolution of the uterus (by 2.1 times), endometritis (by 2.4 times), complications after cesarean section (by 3.2 times), divergence of the seams on the perineum (by 2.4 times), but these parameters were not statistically significantly different. Conclusion. The negative impact of excess body weight on the labor course was shown, moreover, labor in obesity class I is more favorable than in class II and III

Spectrum of mutations and their phenotypic manifestations in children and adults with long QT syndrome

Aim. To determine the spectrum of mutations in the genes responsible for the long QT syndrome (LQTS) and study their phenotypic manifestations in patients with LQTS in different age groups.Materials and methods. The study included 35 unrelated probands with a clinical diagnosis of LQTS: 23 adults (8 men) and 12 children (9 boys). There were following clinical features: syncope — 54%, positive family history for SCD — 29%, implanted cardioverter defibrillator (ICD) — 46%. All participants underwent 12-lead electrocardiography (ECG), 24-hour Holter monitoring, genealogical analysis, echocardiography and cardiac MRI. The genetic study was performed by nextgeneration sequencing (NGS) using the MiSeq system (Illumina). The quantitative comparison of two unrelated groups was carried out using the nonparametric MannWhitney U-test. The differences were considered significant at p&lt;0,05.Results. In the examined group of 35 probands, 23 genetic variants of pathogenicity class IV and V (hereinafter referred to as) were identified. The molecular genetic variant of the disease was verified in 66% of probands. At the same time, the detection of mutations in the group with early manifestation (children) was significantly higher: 83% (10 out of 12 children) vs 57% in adults (13 out of 23). Rare genetic variants of uncertain significance (VUS, class III pathogenicity) were detected in 4 probands (11%). In the groups of children and adults with LQT1, LQT2 and LQT3, the sex distribution deviated from the 1:1 ratio. Among children, two-thirds were boys, among adults — the same proportion was represented by women. Disease manifestation time, QTc duration and adverse events risk depended on the genetic type of LQTS, intragenic localization of mutations and sex. In children, all 4 missense mutations in the KCNQ1 gene were located in transmembrane domain, and in adults, 4 mutations were in the transmembrane domain and three — in the C-terminal domain of the protein. LQT1 in boys was characterized by early manifestation, while QTc did not exceed 500 ms and there were no adverse outcomes. Two women out of 7 adults with LQT1 with mutations in the transmembrane domain had na ICD (QTc &gt;520 ms). All patients with LQT2 (4 children, 4 adults) had QTc &gt;500 ms. At the same time, 2 children and 3 women had an ICD. LQT3 was diagnosed only in the children subgroup (2 boys, with QTc of 510 ms and QTc of 610 ms); one of them died suddenly despite beta-blocker therapy. Four adult patients, carriers of class III pathogenicity variants, had QTc &lt;500 ms and delayed disease manifestation (after 30 years). Three of them had episodes of clinical death with subsequent resuscitation and implantation of cardioverter defibrillator.Conclusion. The average diagnostic efficiency of mutation identification using NGS in patients with clinically manifest LQTS was 66%. At the same time, mutations were more common in the children’s group. In genotype-positive probands, the risk of adverse outcomes correlated with sex, age and the genetic variant of disease. The greatest number of adverse outcomes was observed in carriers of mutations in both KCNH2 (LQT2) and SCN5A (LQT3) genes. Variants with unknown clinical significance were identified in 4 probands (11%), which potentially allowed to confirm the diagnosis after functional tests

Дифференциальный подход к лечению пациентов с первичной открытоугольной глаукомой

PURPOSE: To evaluate Prolatan effectiveness in groups of patients with risk of glaucoma progression. METHODS: We used Moriscos-Green/Blank clinical and psychological tests-scales of compliance to assess 190 patients with primary open-angle glaucoma (POAG). We revealed 57 out of 190 POAG patients (30%) to be insufficiently committed to their treatment. Among them were 22 (38%) women and 35 (62%) men with mean age 64.4±2.5 years. 18 (32%) patients were diagnosed with glaucoma within the last month before admission, while 39 (68%) patients had progressive glaucoma. All patients underwent standard ophthalmic examination and additional Humphrey standard automated perimetry (threshold 30-2 strategy) at baseline and after 3 months. RESULTS: Statistically significant non-compliance factors were the following: age over 60, male gender, POAG duration from 3 to 10 years, comorbid pathology, regimens comprising a large number of drugs, mild glaucoma, cognitive impairment and financial difficulties, hindering the purchase of medicinal products. On the average, Prolatan decreased IOP level by 33%. By the end of the 3rd month our study revealed retinal light sensitivity increase in all sectors of the visual field from 0 to 30 degrees due to IOP stabilization. CONCLUSION: Prolatan increases adherence to treatment by the end of the 3rd month of follow-up, which is associated with a reduction in the number of instillations, no side effects after instillation, patients’ good health during the treatment course, reduction of treatment material costs. ЦЕЛЬ. Оценить эффективность препарата Пролатан в группах риска прогрессирования глаукомы. МЕТОДЫ. С помощью клинико-психологической тестовой методики — шкалы комплаентности Мориски – Грин проведена оценка комплаентности 190 пациентов с первичной открытоугольной глаукомой (ПОУГ). Из 190 обследованных пациентов с ПОУГ недостаточно приверженными лечению были 57 (30%) пациентов. Среди них было 22 (38%) женщины и 35 (62%) мужчин, средний возраст составил 64,4±2,5 года. Впервые выявленная глаукома в течение 1 месяца была у 18 (32%) пациентов, некомпенсированная глаукома — у 39 (68%) больных. Проводили стандартное офтальмологическое исследование, дополнительно — статическую компьютерную периметрию на компьютерном периметре Humphrey по пороговой стратегии 30-2 исходно и через 3 месяца. РЕЗУЛЬТАТЫ. Достоверными факторами нон-комплаенса у обследованных больных были: возраст старше 60 лет, мужской пол, длительность ПОУГ от 3 до 10 лет, наличие коморбидной патологии и большое количество лекарственных средств, которые вынужден применять пациент, начальная стадия глаукомы, наличие когнитивных нарушений, финансовые затруднения пациентов при приобретении лекарственных средств. Снижение внутриглазного давления (ВГД) в результате применения препарата Пролатан составило 33%. На фоне стабилизации ВГД к концу 3-го месяца выявлено увеличение показателей светочувствительности сетчатки по всем секторам поля зрения от 0 до 30°. ЗАКЛЮЧЕНИЕ. На фоне лечения препаратом Пролатан увеличивается приверженность лечению к концу 3-го месяца наблюдения, что связано со снижением количества инстилляций, отсутствием побочных эффектов после закапывания, хорошим самочувствием пациентов во время лечения, снижением материальных затрат на лечение.

Профузные кровотечения из прямой кишки и мочевого пузыря как осложнения лучевой терапии рака предстательной железы

Among more than 300 patients with end-stage radiation-induced bladder and rectal lesions treated at different institutions of Russia, the authors observed 38 patients with severe profuse hemorrhage after megavoltage radiotherapy for localized forms of prostate cancer. The pathogenetic mechanisms of a radiation lesion and profuse bleeding from the bladder and rectum are substantiated. Effective treatments in such patients are given.

Hypertension, lipid abnormalities and cardiovascular changes in autosomal dominant polycystic kidney disease

WOS: 000072398500033PubMed ID: 9546713

Isolated glycogen storage disease of the heart

Isolated glycogen storage disease of the heart (PRKAG2 syndrome) is a form of glycogenosis, which is characterized by left ventricular hypertrophy, similar to the phenotype of hypertrophic cardiomyopathy, associated with pre-excitation of the ventricles and conduction disorders. The disease is caused by mutations in the gene PRKAG2 encoding for the 5’Adenosine Monophosphate-Activated Protein Kinase (AMPK), specifically for its y2 regulatory subunit, inheritance — autosomal dominant. A review of the literature data and clinical observation of two patients from the same family with the mutation c905C&gt;A (p.Arg302Gln) in the PRKAG2 gene associated with WPW syndrome and early development of conduction disorders requiring implantation of a pacemaker are presented. The issues of diagnosis and treatment strategy of the disease were discussed

Hypertension, lipid abnormalities and cardiovascular changes in autosomal dominant polycystic kidney disease [18]

PubMedID: 9546713[No abstract available

Investigation of Mechanical Engineering Academicians’ Use of Distance Education Technologies

The aim of this study is to determine the use of distance education technologies, conditions of use and how often they use various computer applications, and also to investigate the use of these applications by academicians who teach in the Department of Mechanical Engineering. In the research carried out with the scanning model, there were 370 volunteers from various universities in Russia, consisting of academicians who teach in the field of mechanical engineering. The research was carried out in the spring term of 2020–2021; before the research, a 6-week online training was given to mechanical engineer academicians. In the study, the ‘distance education technologies’ measurement tool developed by the researchers and compiled by experts in the field was used. The measurement tool was delivered to the academicians via the online method and collected. The analysis of the data was carried out by using the SPSS programme, frequency analysis, t-test and ANOVA test, and the results were added to the research with tables. Accord-ing to the results obtained from the research, although the distance education technologies of the academicians who teach in the field of mechanical engineering are satisfactory, the rate of academicians never using new technologies in the teaching process is quite low and the rate of using them very often is quite high. © 2022 Kassel University Press GmbH. All rights reserved

Cardiac functions, autonomic nervous system and lipoprotein values in white coat hypertension patients [5]

PubMedID: 12119497[No abstract available