Age-Related and Individual Anatomical Variation in Testicular Topography in Human Fetuses

At present, male infertility remains an urgent medical concern. From year to year, despite advances in methods of diagnosis and treatment, medicine encounters an increasing number of infertile couples with male infertility playing a leading role. Prerequisites for fertility disorders very frequently appear in childhood. Urologists consider cryptorchidism a leading cause of male infertility. The aim of our study was to establish the relationship between testicular descent to the scrotum and the age of the fetus. Material and methods. The study was conducted using 195 specimens of male fetuses aged 4–10 months with 81.0–375.0 mm parietalcoccygeal length (PCL) using the methods of macromicroscopic, conventional, and microslide preparation under control of binocular loupes and morphometry. Results. At the beginning of the fetal period of human ontogenesis (fetuses 81.0–135.0 mm PCL), the right and left testicles are mainly located above the corresponding deep inguinal ring and they are less often located in a region of the iliac fossae. An analysis of topographic and anatomical features of the male reproductive glands in 5-month-old fetuses (136.0–185.0 mm PCL) revealed that the testicles were located within the large pelvis, with the lower end of both the right and left testicles located above the entrance to the deep inguinal ring at a distance that equals the length of the pelvic part of the gubernaculum testis—3.2 ± 0.3 mm (right) and 2.8 ± 0.2 mm (left). In 11 fetuses aged 7 months (231.0–270.0 mm PCL), the lower ends of the testicles and their gubernaculum testis are immersed in the corresponding deep inguinal ring. In eight fetuses, the testicles were within the deep inguinal ring. A combination of many factors contributes to the final migration of a testicle through the inguinal canal into the scrotum (fetuses: 270.0 cm–290.0 mm PCL), including muscle contraction of the anterolateral abdominal wall, an increase in intra-abdominal pressure, contractile capacity of the gubernaculum testis of the testicle, the vaginal process of the peritoneum, and the neuro-muscular system. We believe that the gubernaculum testis is a particularly significant factor in testicular descent to the scrotum. The gubernaculum testis is maximally developed prior to migration of a testicle through the inguinal canal (eighth month of antenatal development), as evidenced by the prevalence of smooth muscle cells over connective tissue elements. An analysis of testicular topography in fetuses aged 9 months (311.0–345.0 mm PCL) revealed that testicles were located in the scrotum in nine fetuses, near the superficial inguinal ring in six fetuses, within the inguinal canal in four cases, and in the deep inguinal ring in one case. In fetuses aged 10 months (346.0–375.0 mm PCL), testicles were located in the scrotum in 13 cases and within the inguinal canal in seven cases. According to our research, the fusion of layers of the vaginal process of the peritoneum occurs in fetuses aged 9–10 months, resulting in the disappearance of the communication of its cavity with the peritoneum. A delay in the fusion of the peritoneal vaginal process layers at the end of the fetal period is an anatomic prerequisite for the occurrence of congenital inguinal-scrotal hernias. Conclusions. It has been found that the rate of testicular descent to the scrotum does not always coincide with the corresponding stage of fetal development. An accelerated development of the gubernaculum testis in fetuses aged 5–8 months is a major factor of heterochronic development of a testicle and subsequent testicular descent into the scrotum

THE PECULIARITIES OF THE PRENATAL MORPHOGENESIS OF THE EPIDIDYMIS

Epididymis serves a critical function in the process of sperm cells maturation, since it provides with a unique liquid microbiomedium that allows maturation and survival of the spermatozoa. Therefore, the aim of our study is to clarify the patterns of the morphogenesis of the epididymis during the perinatal period of human ontogenesis. 27 series of the serial histological sections of the human embryos and prefetuses (4.0-80.0 mm of parietal-coccygeal length (PСL)) and 56 specimens of human fetuses (81.0-375.0 mm PCL) have been studied, using the methods of microscopy, macroscopy, graphic and plastic reconstruction and morphometry. It has been found that the anlage of the epididymal tubules occurs in the prefetuses 14,0-16,0 mm of PCL, and the formation of the epididymal segments (caput, corpus and cauda), as well as establishment of the correlation between the tubules of the testicle and epididymis is observed in prefetuses 18,0-65,0 mm of PCL. At the early fetal period the asymmetry of the shape and size of the right and left epididymises is observed; it is preserved during the entire fetal period and is accompanied by the process of their accelerated and slowed development. At the end of the fetal period of the ontogenesis the structure and shape of the epididymal tubular system is close to the definite state

Hereditary tubulopathies including the associated bone disease

Tubulopathy is a heterogeneous group of diseases combined by the nephron functions disorders of one or more enzyme proteins in the tubular epithelium that cease to function as a reabsorption of one or several substances filtered from the blood through the glomeruli into tubules, which determines the development of the disease. This review addresses the tubulopathies accompanying bone disease, namely: de Tony-Debre-Fanconi syndrome (autosomal dominant, autosomal recessive, X-linked), renal distal metabolic acidosis type I (classic, autosomal dominant, autosomal recessive inheritance), renal distal tubular metabolic acidosis I (autosomal dominant, autosomal recessive inheritance) and type II (autosomal recessive inheritance accompanying delayed mental development and eye disorders), combined distal and proximal renal tubular metabolic acidosis type III (autosomal recessive inheritance characterized by osteoporosis), hypophosphatemia rickets (X-linked dominant, autosomal dominant, primary hypercalciuria, autosomal recessive inheritance). However, the diagnosis of tubulopathy remains complex and requires expensive laboratory equipment and specialist expertise; it can be diagnosed in children showing the following symptoms: impaired growth, vitamin D resistant rickets (lower limb deformities between 2 and 3 years of age). In the evaluation of such patients urine analysis is commonly used (levels of calcium, phosphorus, pH, bicarbonate, sodium, potassium, glucose, creatinine, protein, amino acids), blood count (levels of creatinine, uric acid, alkaline phosphatase, glucose, pH and sodium, bicarbonate, potassium, chloride, calcium, phosphorus ions), ultrasound of the kidneys to detect nephrocalcinosis. Determination of serum parathyroid hormone concentration, vitamin D metabolites, aldosterone and plasma renin activity, cysteine lymphocyte concentration (suspicion to diagnose cystinosis) and ophthalmologist examination may also be used as additional diagnostic methods. Despite the fact that most tubulopathies can be diagnosed clinically, molecular genetic studies are needed to clarify the type of inheritance and prognosis. The use of calcitriol will help in the management of phosphorous levels in the blood. Correction of vitamin D deficiency state is not required. Calcitriol supplementation may prevent secondary hyperparathyroidism resulting from increased phosphate intake

PECULIARITIES OF SEMINAL VESICLES AND SEMINAL DUCTS FORMATION

Introduction. Recently, decrease in male reproductive function has become particularly relevant. Nowadays, 8 to 29% of married couples are infertile throughout the world. The purpose of our study was the ascertainment of the peculiarities of development of seminal vesicles, seminal and ejaculatory ducts. Material and methods. The study was carried out on 16 series of histological sections of pre-fetuses of 10-12 weeks and 4-month fetuses. Nine waxed reconstructions of pelvic organs of pre-fetuses of 65.0 mm parietococcygeal length (PCL) and fetuses of 82.0, 85.0, 95.0 and 130.0 mm PCL were made and studied. Results. In pre-fetuses of 46.0-52.0 mm PCL, the mesonephric duct (wolffian duct) is reduced in the cranial and middle sections. The diameter of the unreduced portion of the wolffian duct at the gonad level varies from 58 to 68 μm. At the beginning of the fetal period of ontogenesis, the length of the right seminal vesicle is 1.56 ± 0.12 mm, its width is 0.54 ± 0.05 mm, its thickness is 0.46 ± 0.06 mm. The dimensions of the left seminal vesicle are accordingly: 1.39 ± 0.11, 0.61 ± 0.05 and 0.57 ± 0.06 mm. In fetus of 130.0 mm PCL, the seminal vesicles are represented by the main tubule and its branches. The length of the right seminal vesicle is 2.3 mm, and the left is 2.2 mm. The length of the cavity of the main duct of the right seminal vesicle is 4.6 mm, and 6.4 mm including the branches. The length of the cavity of the main duct of the left seminal vesicle is 4.8 mm, and 5.6 mm including the branches. Conclusions. At the end of the 10 th – the beginning of the 11 th week of prenatal development, intensive upgrowth of the caudal parts of the mesonephric ducts was noted, resulting in the seminal ducts, seminal vesicles and prostate excretory ducts appearance. In the fetuses of 95.0-120.0 mm of PCL, formation of an ampulla of the seminal duct was observed. At the end of the 4 th month of prenatal development, the external and internal structure of the seminal vesicles and ampullae of the seminal duct becomes more complicated

SPINAL MUSCULAR ATROPHY (WERDNIG-HOFFMANN ATROPHY/DISEASE): TWO CASE PRESENTATIONS AND LITERATURE REVIEW

Introduction. Spinal muscular atrophy type 1 is an autosomal recessive neuromuscular disorder characterized by degeneration of the anterior horn cells in the spinal cord, leading to symmetric muscle weakness and atrophy. 95% of affected children die before 2 years of age. The annual incidence in the world has been estimated at around 1/11 000. The errors (mutations) in the SMN1 gene prevalence vary from 1: 38 to 1: 70 in the population. The disorder is primarily caused by the homozygous deletions of the gene (5q12.2-q13.3). The SMN gene mutation is primarily caused by a homozygous deletion in exons 7 or 8. Case presentations. 2 clinical cases of children with the Werdnig-Hoffmann disorder will be presented, and a literature review of this pathology. Two cases of spinal muscular atrophy diagnosed in Chernivtsi region, Ukraine, are presented. In both children, a molecular genetic analysis found the homozygous deletions of SMN1 gene in exons 7 and 8. Most affected children die within 2.3- 1.3 years of age. These two cases ended lethally due to subinfection. Material was collected in accordance with ethical standards of work person under Helsinki Declaration (World Medical Association Declaration of Helsinki, Ethical Principlesfor Medical Research Involving Human Subjects). Genealogical analysis of families, biochemical analysis of blood, ENMG were carried out. The molecular genetic method was used: DNA was extracted and the deletions of 7 and 8 exons of the telomeric SMN gene were tested by PCR method. The disorder usually manifests in young children, if mother has a history indicating a weak fetal movement during pregnancy. Hypotension and hypotrophy of muscles, absence of tendon reflexes on lower extremities, fibrillation of the muscles of the tongue and fingers are observed in the neonatal period. Children with this pathology can poise their heads, but never turn over and do not sit. They are characterized by a „frog“ position: the limbs are laid in the shoulder and femoral joints and bent in elbow and knee joints. Chest distortions are pathognomonic. The main cause of death is respiratory distress associated with intercurrent respiratory disorders. Conclusion. Based on the literature data and our experience of monitoring children with SMA type I, the disorder has a malignant rapidly progressing course

Psychosomatic disorders in people with Shereshevsky-Turner syndrome

The article deals with topical issues related to the etiology, peculiarities of the phenotypic manifestations of the Shereshevsky-Turner syndrome in different age groups.The incidence of Shereshevsky-Turner syndrome among newborn girls is 1: 2000-1:5000, although some studies mention much more frequent occurrence.An analysis of the features of mental development in patients with partial or complete monosomy was carried out.Patients with Shereshevsky-Turner syndrome should be under a constant supervision of clinical psychologists who are aware of the peculiarities of the disease, and it is also necessary to carefully develop social skills and attitudes in social medium, which will be useful in their further social adaptation.</p

Hereditary tubulopathies including the associated bone disease

Tubulopathy is a heterogeneous group of diseases combined by the nephron functions disorders of one or more enzyme proteins in the tubular epithelium that cease to function as a reabsorption of one or several substances filtered from the blood through the glomeruli into tubules, which determines the development of the disease. This review addresses the tubulopathies accompanying bone disease, namely: de Tony-Debre-Fanconi syndrome (autosomal dominant, autosomal recessive, X-linked), renal distal metabolic acidosis type I (classic, autosomal dominant, autosomal recessive inheritance), renal distal tubular metabolic acidosis I (autosomal dominant, autosomal recessive inheritance) and type II (autosomal recessive inheritance accompanying delayed mental development and eye disorders), combined distal and proximal renal tubular metabolic acidosis type III (autosomal recessive inheritance characterized by osteoporosis), hypophosphatemia rickets (X-linked dominant, autosomal dominant, primary hypercalciuria, autosomal recessive inheritance). However, the diagnosis of tubulopathy remains complex and requires expensive laboratory equipment and specialist expertise; it can be diagnosed in children showing the following symptoms: impaired growth, vitamin D resistant rickets (lower limb deformities between 2 and 3 years of age). In the evaluation of such patients urine analysis is commonly used (levels of calcium, phosphorus, pH, bicarbonate, sodium, potassium, glucose, creatinine, protein, amino acids), blood count (levels of creatinine, uric acid, alkaline phosphatase, glucose, pH and sodium, bicarbonate, potassium, chloride, calcium, phosphorus ions), ultrasound of the kidneys to detect nephrocalcinosis. Determination of serum parathyroid hormone concentration, vitamin D metabolites, aldosterone and plasma renin activity, cysteine lymphocyte concentration (suspicion to diagnose cystinosis) and ophthalmologist examination may also be used as additional diagnostic methods. Despite the fact that most tubulopathies can be diagnosed clinically, molecular genetic studies are needed to clarify the type of inheritance and prognosis. The use of calcitriol will help in the management of phosphorous levels in the blood. Correction of vitamin D deficiency state is not required. Calcitriol supplementation may prevent secondary hyperparathyroidism resulting from increased phosphate intake

Morphometric study of the skeleton of the thorax in human fetuses aged 7-10 months

Introduction. It is necessary to clearly understand the norms of morphometric parameters of thorax during the fetal period of human ontogenesis, which is one of the main directions to solve the problem of modern normology. Objective. To trace the dynamics of changes of morphometric parameters of the bony thorax in human fetuses aged 7-10 months. Materials and methods. The anatomical study involved 39 human fetuses specimens of 231.0-375.0 mm of crown-rump length (CRL). The study was conducted by means of macro-microscopic preparation, morphometry and variation statistics method. Results. It was found that the length of the costal cartilage increases from rib I to VII and is the longest in the rib VII. The ribs are the highest along the midclavicular line. At the same time, the height of the ribs decreases along the posterior axillary line and becomes the shortest along the scapular line. It was revealed the greatest width of the II and III intercostal spaces along the parasternal and midclavicular lines. The width of the four superior intercostal spaces along the midclavicular line on the right and on the left is larger than the height of the corresponding ribs. The width of the II-X intercostal spaces on the right and on the left along the scapular lines exceeds the height of the corresponding ribs in 1.33-1.65 times. The greatest width of the II, IV and VII intercostal spaces was along the posterior axillary line both sided. The greatest width of the II, IV and X of the intercostal spaces was noted along the scapular lines. Conclusions. The length of the costal cartilage increases from rib I to VII and is the largest in VII ones. The smallest value of the length of the costal cartilage was found in the rib XII. During the 7th-10th months of the intrauterine development, an intensive increase in the length of costal cartilages of the ribs I-III occurs, on average, by 1.5 times, and there is a slow increase in the length of the costal cartilage of the rib VII. The ribs along the midclavicular line are the highest. At the same time, the height of the ribs decreases along the posterior axillary line and along the scapular line it is the lowest

ЕПІДЕМІОЛОГІЯ УРОДЖЕНИХ ВАД У ЧЕРНІВЕЦЬКІЙ ОБЛАСТІ ЗА РЕЗУЛЬТАТАМИ ПРЕНАТАЛЬНОГО СКРИНІНГУ

We have studied the epidemiology of congenital malformations in the Chernivtsi region by means of the method of prenatal screening during the period from 2004 through 2008. The greatest number of defects (62.53%) was diagnosed during the period of 16-28 weeks of gestation, the lowest (12.16%) – up to week 16. In 2005 and 2006 here were more fetuses of the feminine gender with congenital defects, whereas in 2008 – of the male gender.Изучено эпидемиологию врожденных пороков в Черновицкой области методом пренатального скрининга за период 2004-2008 гг. Наибольшее количество пороков (62,53%) диагностировано в период 16-28 недель гестации, наименьшее (12,16%) – до 16-й недели. В 2005 и 2006 годах с врожденными пороками больше было плодов женского пола, в 2008 году – мужского.Вивчено епідеміологію уроджених вад у Чернівецькій області методом пренатального скринінгу за період 2004-2008 рр. Найбільшу кількість вад (62,53%) діагностовано в період 16-28 тижнів гестації, найменшу (12,16%) – до 16-го тижня. У 2005-му та 2006-му роках з уродженимивадами більше було плодів жіночної статі, у 2008-му – чоловічої

ХРОНОНЕОНАТОЛОГІЯ: БІОРИТМІЧНА ОРГАНІЗАЦІЯ НОВОНАРОДЖЕНОГО

Human biorhythms display the adaptation of living organisms to the external environment. These are mechanisms that are so well-regulated by nature that they are often called ‘biological clock’.There are definite functions in the body of the newborn that have a daily rhythm (with a period of 2 to 25 hours). Such a rhythmic setup depends on the maturity of the newborn: the circadian rhythm of melatonin synthesis in humans arises from the first days after birth, and its formation ends up 9-12 weeks and in premature babies for 2-3 weeks later. The development of the ‘biological clock’ of the newborn is significantly influenced by the conditions of the environment. Melatonin provides recovery, stabilization and synchronization of chronorhythms of different frequencies, including daily periodism.At this rate, the pleiotropic effects of melatonin on the control of biological rhythms during this period are a matter of particular attention. Our reference is devoted to it.During early postnatal adaptation, it is reasonable to determine the biorhythmologic features of the main physiological indicators of life: hourly blood pressure, heart rate and respiratory movements, body temperature, cortisol, adrenaline, norepinephrine, 6-sulfatoxymelatonin (melatonin metabolite) in fractional urine in the dynamics of the early neonatal period.The tasks of chrononeonatology are the study of the peculiarities of the formation of the circadian setup of physiological functions and the level of the main adaptive hormones in the dynamics of the early neonatal period.In the prenatal period, melatonin penetrates the fetus from the pregnant woman through the placenta, and after birth it enters the baby's body with the mother's milk. It is believed that periodic signals emanating from the mother's pineal gland (PG) cells synchronize the fetal chronorhythms. In the early stages of embryogenesis, these signals have a nervous and humoral genesis, and after birth, only humoral influences.The concentration of melatonin in the blood of a pregnant woman reaches a maximum level to the 32nd week of pregnancy and is restored by the 2nd day after childbirth.Fetal growth restriction is due to a significant decrease in the secretion of melatonin during the first 3 months of life of newborns. It is important that in the preterm infants, the relative deficit of melatonin lasts from 2-4 to 7-8 months.Maternal influence on development does not end with delivery, but continues in the neonatal period. Breast milk contains more than 60 biologically active substances (STH, lactogenic hormone, IGF-1, insulin, etc., in particular melatonin), whose level significantly exceeds their concentration in the peripheral blood of the mother.Early breastfeeding, the rooming-in in the postpartum period, an arbitrary feeding regime contribute to the earlier formation of biorhythms of physiological indicators of life and the favorable course of adaptive processes in newborns.So, summing up, we note that the child's condition is associated with an adequate biorhythmic daily activity. Metabolism lability in the newborn requires keeping in mind the structure of biorhythms in the postnatal period to prevent the development of morbid conditions.Биоритмы человека являются проявлением адаптации живых организмов к внешней среде. Это настолько отлаженные природой механизмы, что их часто называют "биологическими часами".В организме новорождённого зарегистрированы функции, имеющие суточную ритмичность (с периодом от 2 до 25 часов). Данная ритмичность напрямую зависит от зрелости организма новорождённого: циркадианный ритм синтеза мелатонина у человека возникает с первых дней после рождения и его формирование завершается до 9-12 нед., а у недоношенных на 2-3 нед. позже. На развитие «биологических часов» новорождённого значительно влияют условия внешней среды. Мелатонин обеспечивает восстановление, стабилизацию и синхронизацию хроноритмов различной частоты, в частности суточного периодизма.При таких условиях, главного внимания заслуживают плейотропные эффекты мелатонина по обеспечению биологических ритмов в этот период. Этому и посвящен обзор.В течение ранней постнатальной адаптации целесообразно определить биоритмологические особенности основных физиологических показателей жизнедеятельности: почасовой уровень артериального давления, частоты сердечных сокращений и дыхательных движений, температуры тела, экскреции кортизола, адреналина, норадреналина, 6-сульфатоксимелатонина (метаболит мелатонина) в порционной моче в динамике раннего неонатального периода.Задачами хрононеонатологии является изучение особенностей формирования циркадианной организации физиологических функций и уровня основных адаптивных гормонов в динамике раннего неонатального периода.В пренатальном периоде мелатонин беременной проникает к плоду через плаценту, а после рождения – поступает в организм ребёнка с молоком матери. Считают, что периодические сигналы, исходящие из клеток шишковидной железы матери, синхронизируют хроноритмы плода. На ранних этапах эмбриогенеза такие сигналы имеют нервный и гуморальный генез, а после рождения – только гуморальное влияния.Концентрация мелатонина в крови беременной достигает максимального уровня на 32 нед. беременности и восстанавливается на второй день после родов.Внутриутробная задержка роста плода обусловлена существенным уменьшением секреции мелатонина в течение первых 3 месяцев жизни новорождённых. Важно, что у недоношенных новорождённых период относительного дефицита мелатонина длится от 2-4 до 7-8 мес.Материнское влияние на развитие не завершается с родами, а продолжается и в неонатальном периоде. Грудное молоко содержит более 60 биологически активных веществ (СТГ, пролактин, ИФР-1, инсулин и др., в том числе мелатонин), уровень которых существенно превосходит их концентрацию в периферической крови матери.Раннее прикладывание к груди, совместное пребывание матери и ребенка в послеродовом периоде, произвольный режим вскармливания способствуют более раннему формированию биоритмов физиологических показателей жизнедеятельности и благоприятному течению адаптационных процессов у новорождённых.Итак, подводя итоги, отметим, что состояние ребенка ассоциируется с адекватной околосуточной биоритмической деятельностью. Лабильность обмена веществ у новорождённого требует учёта структуры биоритмов в постнатальном периоде для предотвращения развития патологических состояний.Біоритми людини є проявом адаптації живих організмів до зовнішнього середовища. Це настільки відлагоджені природою механізми, що їх часто називають "біологічним годинником".В організмі новонародженого зареєстровані функції, що мають добову ритмічність (з періодом від 2 до 25 годин). Дана ритмічність напряму залежить від зрілості організму новонародженого: циркадіанний ритм синтезу мелатоніну у людини виникає з перших днів після народження і завершується його формування до 9-12 тиж., а в недоношених на 2-3 тиж. пізніше. На розвиток «біологічного годинника» новонародженого значно впливають умови зовнішнього середовища. Мелатонін забезпечує відновлення, стабілізацію та синхронізацію хроноритмів різної частоти, зокрема добового періодизму.За таких умов, чільної уваги заслуговують плейотропні ефекти мелатоніну щодо забезпечення біологічних ритмів у цей період. Цьому і присвячено наш огляд.Упродовж ранньої постнатальної адаптації доцільно визначити біоритмологічні особливості основних фізіологічних показників життєдіяльності: погодинний рівень артеріального тиску, частоти серцевих скорочень та дихальних рухів, температури тіла, екскреції кортизолу, адреналіну, норадреналіну, 6-сульфатоксимелатоніну (метаболіт мелатоніну) в порційній сечі в динаміці раннього неонатального періоду.Завданнями хрононеонатології є вивчення особливостей формування циркадіанної організації фізіологічних функцій і рівня основних адаптивних гормонів у динаміці раннього неонатального періоду.У пренатальному періоді мелатонін вагітної проникає до плоду, через плаценту, а після народження – надходить в організм дитини з молоком матері. Вважають, що періодичні сигнали, що виходять із клітин шишкоподібної залози матері, синхронізують хроноритми плода. На ранніх етапах ембріогенезу такі сигнали мають нервовий і гуморальний ґенез, а після народження – тільки гуморальні впливи.Концентрація мелатоніну в крові вагітної досягає максимального рівня на 32 тиж. вагітності і відновлюється на 2-у добу після пологів.Внутрішньоутробна затримка росту плода зумовлена істотним зменшенням секреції мелатоніну впродовж перших 3 місяців життя новонароджених. Важливо, що у недоношених новонароджених період відносного дефіциту мелатоніну триває від 2-4 до 7-8 міс.Материнський вплив на розвиток не завершується з пологами, а триває і в неонатальному періоді. Грудне молоко містить понад 60 біологічно активних речовин (СТГ, пролактин, ІФР-1, інсулін та ін., зокрема мелатонін), рівень яких суттєво переважає їх концентрацію в периферичній крові матері.Раннє прикладання до грудей, сумісне перебування матері і дитини в післяпологовому періоді, довільний режим вигодовування сприяють більш ранньому формуванню біоритмів фізіологічних показників життєдіяльності і сприятливому перебігу адаптаційних процесів у новонароджених.Отже, підбиваючи підсумки, зазначимо, що стан дитини асоціюється з адекватною навколодобовою біоритмічною діяльністю. Лабільність обміну речовин у новонародженого вимагає врахування структури біоритмів у постнатальному періоді для запобігання розвитку патологічних станів