A retrospective look at the formation of family education in the Republic of Belarus

In the article, the author offers a retrospective look at the complex processes of the formation of family education on the territory of the Republic of Belarus, focusing on the approaches and forms of family education in different historical periods and concepts such as "family education", "family", "family as a social institution", paying special attention to the influence of modern legislation on the processes family education in the Republic of Belarus.В статье авторы предлагают ретроспективный взгляд на сложные процессы становления семейного воспитания на территории Беларуси, акцентируя внимание на подходах и формах семейного воспитания в разные исторические периоды, раскрывая содержание таких понятий, как «семейное воспитание», «семья как социальный институт», а также современных законодательных актов, касающихся семейного воспитания в современной Республике Беларусь

Improving preoperative management of women with high-grade cervical intraepithelial neoplasia

V.G.&nbsp;Volkov1, T.V.&nbsp;Zakharova2 1Tula State University, Tula, Russian Federation 2E.G.&nbsp;Lazarev Tula City Clinical Hospital No. 2, Tula, Russian Federation Background: persistent infection with oncogenic subtypes of human papillomavirus is the major cause of cervical cancer. Correlation between bacterial vaginosis and virus persistence in squamous cervical epithelium was revealed. Aim: to study the efficacy of preoperative Gaynomax for isolated bacterial vaginosis or in combination with genital candidiasis in women with high-grade cervical intraepithelial neoplasia (CIN). Patients and Methods: complex clinical microbiological study and treatment were performed in 25 women aged 24–58 years (36.9±3.6 years). High-grade CIN was diagnosed in a total of 25 women. Gaynomax was prescribed preoperatively, i.e., before large loop excision biopsy (1 vaginal suppository twice a day for 3 days). Results: at the first visit, 12 women (48%) have reported on the complaints, 5 women (20%) reported on the complaints after active questioning only, 8 women did not reported any urogenital complaints. High&nbsp; risk human papillomavirus (subtypes 16, 18, and 33) and bacterial vaginosis (associated with genital candidiasis in 9 women) were identified in a total of 25 women. Gaynomax resulted in clinical laboratory improvement (i.e., itching relief and significant decrease in vaginal discharge amount) in all women. Drug tolerability was good. Adequate wound healing and no postoperative complications were reported after large loop excision biopsy. Conclusion: preoperative Gaynomax for bacterial vaginosis before cervical procedures for high-grade CIN provides great clinical effect confirmed by microbiological study results. Keywords: cervical intraepithelial neoplasia, cervical biopsy, human papillomavirus, bacterial vaginosis, Gaynomax. For citation: Volkov V.G., Zakharova T.V. Improving preoperative management of women with high-grade cervical intraepithelial neoplasia. Russian Journal of Woman and Child Health. 2019;2(3):243–246. <br

L-carnitine in complex treatment of neurocirculatory hypotension in children and adolescents

The article describes main etiological and pathogenetic factors of neurocirculatory dystonia (NCD). The most frequent type of NCD is arterial hypotension. Arterial hypotension is main cause of energetic deficiency and, as a result, hypoxemia of tissues. L-carnitine plays significant role in formation of energetic compounds; consequently administration of L-carnitine to children and adolescents with neurocirculatory hypotension is reasonable. Treatment with L-carnitine results in beneficial effect on subjective symptoms of the disease, functional parameters of vegetative nervous system and vagus-dependent electrocardiologic parameters. The results of a work allow optimization of NCD treatment in children and adolescents.Key words: children, adolescents, neurocirculatory dystonia, L-carnitine, treatment

Comparative analysis of biochemical, immunological status in patients with different stages of diabetic retinopathy.

Objective: comparative analysis of biochemical, immunological status in patients with different stages of diabetic retinopathy. Material and methods. The study group included 137 patients with diabetic retinopathy. A control group consisted of 30 patients with myopia average. Results. The increase of indicators such as glycated hemoglobin, glucose, cholesterol, LDL cholesterol, IL-8, IL-6, TNF-alpha in patients with diabetic retinopathy compared to normal values. The content of IFN -y in both groups significantly below the normal level. Conclusion. The final peroxidation products, reactive oxygen species generate new antigens and trigger an immune response that is expressed in the form of increased concentration of IL-6 (acute phase of immune inflammation), and then TNF-alpha and IL-8; these cytokines activate angiogenic growth factors TGF 131 and VEGF. Increasing the concentration of angiogenic factors triggers neovascularization and proliferation.</p

Prediction of adverse perinatal outcomes and preeclampsia in pregnant women with chronic arterial hypertension

The objective of this study was to determine predictors and develop a prognostic model for preeclampsia (PE) and adverse perinatal outcomes in pregnant women with chronic arterial hypertension (CAH). Methods and Results: The study cohort included pregnant women (n=376) with hypertensive disorders: Group 1 –pregnant women with CAH (n=134), Group 2 – with PE on the background of CAH (n=242). Healthy pregnant women made up the control group (n=34). The diagnosis of pregnant women with CAH was made on the basis of existing national and foreign recommendations that an increase in SBP ≥140 mmHg and/or DBP ≥ 90 mmHg indicates CAH. All patients underwent the following examinations: a survey on a special questionnaire; an anthropometric examination; physical examination; an assessment of the content of uric acid (UA) in the blood serum and microalbuminuria (MAU) in the urine at 6-8 and 16-17 weeks of pregnancy; 12-lead ECG, echocardiography, 24-hour ambulatory blood pressure monitoring, sonography of the uterus, fetus, and placenta at 6-8 and 16-18 weeks. It was found that an inappropriate left ventricular mass (LVM) in pregnant women with CAH, a certain “phenotype” of 24-hour ABPM and indicators of metabolic disorders demonstrate the systemic nature of organ damage and appear to be a predictor of adverse perinatal outcomes and the development of PE. The revealed changes in the LV structure, which are more significant in PE on the background of CAH, suggest the association of concentric left ventricular hypertrophy and disorders of uteroplacental blood flow. Detecting abnormal blood flow from early pregnancy will reduce not only perinatal morbidity and premature birth, but also the probability of organ (LV myocardium, kidney) damage in women with CAH. To predict the risks of adverse perinatal outcomes in pregnant women with CAH and PE, a number of factors were identified that have a statistically significant relationship with the studied complications. The developed model makes it possible to predict the probability of PE and unfavorable perinatal outcomes in pregnant women suffering from CAH with high efficiency (91.1%).(International Journal of Biomedicine. 2021;11(4):422-427.). © 2021, International Medical Research and Development Corporation. All rights reserved

Timely diagnosis of lysosomal acid lipase deficiency in children and young adults with lipid profile abnormalities. Expert opinion

M.V. Ezhov1, E.Yu. Zakharova2, A.A. Avramenko3,4, A.S. Alieva5, I.N. Zakharova6, I.V. Leont'eva7, S.I. Malyavskaya8, I.M. Osmanov9, D.I. Sadykova10, M.L. Stolina11, T.V. Strokova7,12 1National Medical Research Center of Cardiology, Moscow, Russian Federation 2Research Center for Medical Genetics, Moscow, Russian Federation 3V.P. Polyakov Samara Regional Clinical Cardiological Dispensary, Samara, Russian Federation 4Samara State Medical University, Samara, Russian Federation 5V.A. Almazov National Medical Research Center, St. Petersburg, Russian Federation 6Russian Medical Academy of Continuous Professional Education, Moscow, Russian Federation 7Pirogov Russian National Research Medical University, Moscow, Russian Federation 8North State Medical University, Arkhangelsk, Russian Federation 9Z.A. Bashlyaeva Children’s City Clinical Hospital, Moscow, Russian Federation 10Kazan State Medical University, Kazan, Russian Federation 11Pacific State Medical University, Vladivostok, Russian Federation 12Federal Research Center for Nutrition and Biotechnology, Moscow, Russian Federation Lysosomal acid lipase deficiency (LAL-D) is a monogenic progressive life-threatening condition characterized by abnormal lipid profiles in most patients of all ages. Timely diagnosis and early pathogenetically-oriented treatment (available in Russia) are crucial for children and young adults since abnormal serum levels of lipids are associated with the onset and severity of atherosclerosis in adolescence, young and middle age. The prognosis of LAL-D without pathogenetically oriented treatment is poor. Data on cholesteryl ester storage disease (a variant of LAL-D in children and adults), early atherosclerosis, coronary heart disease, aortic calcification, etc., are available. However, early diagnosis of LAL-D is difficult due to long-term latent course and nonspecific clinical signs. In December 2020, a panel of leading Russian experts in the diagnosis and treatment of orphan diseases and lipidologists was held in Moscow. This panel developed an algorithm to optimize the early diagnosis of dyslipidemias in children and young adults and identify patients with LAL-D in a total population of patients with lipid profile abnormalities. Keywords: lysosomal acid lipase deficiency, lipid profile, atherosclerosis, lipid center. For citation: Ezhov M.V., Zakharova E.Yu., Avramenko A.A. et al. Timely diagnosis of lysosomal acid lipase deficiency in children and young adults with lipid profile abnormalities. Expert opinion. Russian Journal of Woman and Child Health. 2021;4(3):268–276 (in Russ.). DOI: 10.32364/2618-8430-2021-4-3-268-276. </p

Experience of antiangiogenic and corticosteroid therapy of a diabetic macular edema

Diabetic macular edema (DME) is a leading cause of blindness in patients with diabetes. The purpose of the research is to evaluate the effectiveness of treatment of patients with DMOs resistant to the administration of ranibi-zumab, using the intrauritreal implant "Ozurdex". Material and Methods. 66 patients (98 eyes) are examined. All of the patients were divided, into three groups, depending on a stage of a diabetic retinopathy. The patients underwent a complex of examinations: along with traditional methods, optical coherence tomography, fluorescence angiography of the fundus, multifocal electroretinography, determination of the content of VEGF-Aand cytokines in serum were used. Results. According to ОСТ of a retina and a visometry there are differences in efficiency of treatment depending on a condition balance of cytokine. Conclusion. The use of the intrauretic implant "Ozurdex" was more effective in patients with DMO in the stage of p re-pro I iterative diabetic retinopathy and in patients resistant to anti-VEGF therapy.</p

Cardiac Phenotypes of Pregnant Women with Hypertensive Disorders in Different Ethnic Groups

The objective of this study was to conduct a comparative analysis of the features of LV myocardial remodeling in pregnant women with chronic arterial hypertension (CAH) and preeclampsia (PE) on the background of CAH. Methods and Results: The study cohort included pregnant women (n=547) with hypertensive disorders. All women were divided into two groups: Group 1 included 376 Caucasian patients living in the Republic of Dagestan; Group 2 included 171 patients living in the Republic of Sakha (Yakutia) (indigenous residents [Yakuts and Evenks). Later on, all patients were divided into the following subgroups: Sub1A (n=134), and Sub2A (n=69) – pregnant women with CAH; Sub1B (n=242) and Sub2B (n=102) – pregnant women with PE on the background of CAH. The diagnosis of pregnant women with CAH was made on the basis of existing national and foreign recommendations that an increase in SBP ≥140 mmHg and/or DBP ≥90 mmHg indicates CAH. Different patterns of left ventricular (LV) geometry were defined based on left ventricular mass index (LVMI) and relative wall thickness (RWT), as recommended by the American Society of Echocardiography. The observed/predicted LVM ratio was calculated as 100×(oLVM/pLVM). Participants with an oLVM/pLVM ratio of >128% were categorized as having “inappropriate” LVM (iLVM). iLVM was found in Subgroups 1B and 2B in the third trimester. The frequency of LV remodeling in pregnant women of Subgroups 1 A and 2A in the second and third trimesters did not differ significantly. In Subgroup 1B, the frequency of concentric left ventricular hypertrophy (cLVH) was higher in the third trimester (42.6%) than in the second trimester (26.9%) (P=0.000). Moreover, in the third trimester, the frequency of cLVH was significantly higher in Subgroup 1B than in Subgroup 2B (42.6% and 29.4%, respectively, P=0.022). At the same time, in the third trimester, the frequency of left ventricular concentric remodeling (LVCR) was significantly higher in Subgroup 2B than in Subgroup 1B (56.9% and 44.2%, respectively, P=0.032). In the second trimester in Subgroup 1B, the frequency of LVCR was higher than in Subgroup 1A (50% and 38.1%, respectively, P=0.026). By the third trimester, the severity of LV remodeling has increased significantly in Subgroup 1B. Thus, in Subgroup 1B, the frequency of c LVH reached 42.6% compared to 31.3% in Subgroup 1A (P=0.03). In Subgroup 2B, in the third trimester, the frequency of LVCR was slightly higher than in Subgroup 2A (56.9% and 43.5%. respectively, P=0.08). Conclusion: Living conditions predetermine the prevalence of iLVM and LVCR in pregnant northerners with CAH. A more common type of LV remodeling in pregnant women with CAH in conditions of high-altitude hypoxia is also LVCR, which transforms into cLVH by the third trimester in pregnant women with PE on the background of CAH. The study of the type of LV geometry and the appropriateness of LVM allows us to clarify the degree of LV damage in hypertension-related pregnancy. iLVM in pregnant women with CAH appears to be a predictor of the development of PE. The revealed changes in the LV structure—LVCR and cLVH—are more significant in PE on the background of CAH. © 2022, International Medical Research and Development Corporation. All rights reserved