Etiological Structure of Intrauterine Infections in Pregnant and Newborns with a Complicated Course of the Early Neonatal Period

Aim of research – the study of the etiological structure of intrauterine infection in pregnant and estimation of their influence on the early neonatal period.Materials and methods. The material for the study was venous blood of pregnant, umbilical blood, breast maternal milk, mother's saliva, newborn's saliva of 114 pairs “mother-newborn”, divided in two groups – control one of physiological course of pregnancy, childbirth and early neonatal period and the main one with clinical symptoms of IUI. The diagnosis was proved by laboratory serological examinations for determining concentrations of IgM to Mycoplasma hominis, Chlamydia trahomatis, Ureaplasma urealyticum, to the herpes simplex virus and concentration and avidity index of specific IgG to HSV, to the virus of 6 type herpes, to the cytomegalovirus. The cytoscopic method was used together with serological ones to diagnose the cytomegaloviral infection.Research results. The increased concentration of IgM antibodies to M. hominis was revealed in the biological material (venous and umbilical blood) of pairs “woman-newborn) with the complicated course of the neonatal period in 9,1 % of examined persons, in 45,4 % of pairs – IgM to U. urealyticum, and in 81,8 % -to Ch. Trahomatis. IgM to the virus of herpes simplex virus (HVS) were revealed in 19,35 % of samples of venous blood, in 9,67 % of saliva samples and in 6,45 % of samples of breast milk of women; and IgM concentrations to HVS were (0,342±0,06) IU/ml, (0,117±0,04) IU/ml) and (0,438±0,001) IU/ml, respectively. Most samples of the biomaterial included low-avid IgG antibodies to the herpes simplex virus, 76 % of samples of women's venous blood, 64 % of samples of breast milk and 38,7 % contained low-avid IgG to 6 type herpes virus. The cytomegaloviral infection in this group was diagnosed in 24 % of women and 32 % of newborns. The associated bacterial and viral infection were revealed in 65 % of examined pairs “mother-newborn” with the complicated course of the neonatal period, the triple infection with chlamydias, herpes simplex virus and cytomegalovirus was noted in 14 %; the association of herpes simplex virus, cytomegalovirus and ureaplasma was detected in 5 %. The double chamydia and herpes viral infection of 6 type were observed in 15 % of examined persons, at that these infections were added with ureoplasma in 7 %, with mycoplasma – in 5 %. The mix-infection of urogenital agents – chlamydias and ureaplasma was associated with the cytomegalovirus in 4 % of cases.Conclusions1. As a result of the realized study, the diagnosis was confirmed in all newborns with a suspected intrauterine infection.2. Mix-infections – Chlamydia, associated with viruses of the herpetic group occupy the leading place in the etiological structure of IUI agents, and the neonatal period is most complicated in children with double or triple infection.3. The leading clinical symptoms in children with IUI are the intrauterine development delay, intrauterine pneumonia, conjugated icterus, conjunctiviti

Development of remote sequelae such as castrointestinal tract pathology in patients specially treated for differentiated thyroid cancer

ЩИТОВИДНОЙ ЖЕЛЕЗЫ НОВООБРАЗОВАНИЯ /ОСЛРАК ЩИТОВИДНОЙ ЖЕЛЕЗЫ /ОСЛЖЕЛУДОЧНО-КИШЕЧНЫЙ ТРАКТ /ПАТОЛОГГИПОТЕРИОЗТИРОКСИН /ПРИЕМL-3,5,3 /ПРИЕМL-ТИРОКСИН /ПРИЕМЛЕВОТИРОКСИН /ПРИЕМЖЕНЩИН ЗДОРОВЬЕЭНДОКРИНОЛОГИЯМЕТАБОЛИЗМ И ЭНДОКРИНОЛОГИЯЛАКТАЦИЯЦель. Оценить возможные отдаленные эффекты лечения дифференцированного рака щитовидной железы (ДРЩЖ) в виде патологий желудочно-кишечного тракта (ЖКТ) на основании катамнестических данных историй болезни пациентов с ДРЩЖ. Материалы и методы. Изучались вопросы развития отдаленных последствий в виде патологий ЖКТ на катамнестических данных 157 пациентов с ДРЩЖ, которые проходили лечение по стандартной схеме, включающей радикальное хирургическое лечение, радиойодтерапию и гормонотерапию. База данных для проведения исследования содержала в максимально доступном объеме оцифрованные данные бумажных историй болезни с периодом наблюдения более 1 года после лечения. Количество логических записей об отдаленных последствиях составляло 463 единицы – одна запись на одно последствие каждого из 157 пациентов. Исследование проводилось по двум направлениям: сравнение частот встречаемости патологий ЖКТ до начала лечения и на отдаленных сроках после проведенного специального лечения и выявления факторов статистически значимого влияния на появление патологий ЖКТ среди характеристик лечения. Результаты. Выявлено, что общее количество патологий ЖКТ увеличилось в 1,6 раза при статистически значимых изменениях в частоте встречаемости со стороны желчного пузыря, печени и поджелудочной железы. Показано, что у пациентов с патологией желчного пузыря по сравнению с пациентами без патологии была ниже продолжительность супрессивной гормонотерапии (4 месяца против 13 месяцев) и были ниже дозы L-тироксина на фоне некомпенсированного гипотериоза (2,3 мкг/кг против 3,5 мкг/кг). Выявлена статистически значимая связь между суммарной длительностью лактации при нарушениях метаболического здоровья у женщин и развившейся в будущем патологией печени (преимущественно неалкогольного стеатогепатита). Заключение. Обоснованным элементом пожизненного постлечебного мониторинга пациентов, проходивших специальное лечение ДРЩЖ, должно быть обязательное всестороннее исследование состояния органов ЖКТ.Objective. Evaluate the potential long-term effects of differentiated thyroid cancer (DTC) treatment, on the gastro-intestinal tract (GIT) based on a retrospective study of DTC patients. Methods. Occurrence of long-term GIT pathologies was retrospectively studied in 157 DTC patients. All patients were treated according to the standard of care, which includes radical surgery, radiation therapy and hormone therapy. The database contained digitalised medical histories of patients followed for at least 1 year after treatment. A total of 463 entries were available, representing one entry per noted consequence for each of the 157 patients. The study focused on two aspects. The frequencies of complications before and after treatment were compared, and factors impacting DTC pathology in a statistically significant manner were isolated. Results: The total onset frequency of gallbladder, liver and pancreas disorders was increased by a factor of 1.6 in a statistically significant manner in DTC patients. Patients initially presenting gallbladder disorders received shorter cures of hormone therapy (4 versus 13 months), and lower levels of L-thyroxine in a context of uncompensated hypothyroidism (2.3 versus 3.5 mg/kg). A statistically significant relation was established between the total duration of breastfeeding in women presenting metabolic health disorders, and onset of liver pathology (essentially non-alcoholic steatohepatitis). Conclusion. Life-long GIT pathology monitoring should be standard of care for patients after special DTC treatment

Assessment of Correction Effectivenes of Psychoemitional State in Pregnant Women After Application of Assisted Reproductive Technologies

To determine the role and effectiveness of the proposed the­rapeutic and preventive complex in the correction of psychoemotional state in the dynamics of pregnancy in pregnant women after assisted reproductive technologies (ART) application in order to improve the tactics of antenatal obser­vation and prevention of obstetric and perinatal complications. 299 pregnant women were comprehensively examined and a set of therapeutic and preventive measures was carried out: the main group included 249 women whose pregnancy occurred as a result of ART application. The control group consisted of 50 pregnant women with spon­taneous pregnancy. The complex of measures for pregnant women after ART application included: micronized pro­gesterone, magnesium oxide, folic acid, L-arginine aspartate, Omega-3 polyunsaturated fatty acids and long-term psychological correction – before ART program, at 8-10 weeks of pregnancy, at 16-18 weeks of pregnancy and at 28-30 weeks of pregnancy. Introduction of the proposed complex of psychoemotional correction contributed to the formation of reactive anxiety and personal anxiety levels at a moderate level in women of subgroups IA-44 (89.8%) and 43 (87.6%), IIA – 43 (89.6%) and 44 (91.7%) and IIIA – 30 (83.3%) and 26 (72.2%), which is considered to be an adaptive, physiological type during pregnancy. The positive effect of the proposed complex of psychoemotional correction demonstrates the improvement of processes of formation of type of component gestational dominant, its return to the optimal type in women of subgroup IA – 41 (83.6%), IIA – 39 (81.3%) and IIIA – 26 (72.2%) that is close to the physiological course of pregnancy and contributes to the reduction of perinatal and obstetric complications among pregnant women of these subgroups