POLYMORPHISM OF THE HAEMOSTASIS GENES IN WOMEN WITH THREATENED PRETERM DELIVERY

Aim: to study polymorphism of the hemostasis-associated genes in women with physiological pregnancy and those  with threatened preterm birth among the population of the Ivanovo region.Materials and methods. The study included 103 women with threatened preterm delivery and 73 women with physiological pregnancy. The women with threatened preterm delivery were divided into 2 subgroups: subgroup I totaled 53 women who had given birth in a timely manner; subgroup II consisted of 50 women who had had spontaneous birth before 37 weeks of gestation. In all patients, pregnancy was spontaneous and mono-fetal. The inclusion criteria for the main group were abdominal pain and structural changes in the cervix. Total genomic DNA was isolated from 100 µl of whole blood using a kit of «Trial-TOS-Genetics» («DNAtechnology», Russia). Single nucleotide polymorphisms (F2 G20210A, F5 G1691А, F7 G10976A, F13A1 G/T, FGB G -455A, PAI-1 -675 5G/4G, ITGA2 C807T, ITGB3 T1565C) were determined by polymerase chain reaction in real time using an iQS iCycler (Bio-Rad) machine and reagent kits of «Kardiogenetika. Thrombophilia» («DNA-technology», Russia).Results. In patients with threatened preterm delivery, the presence of polymorphic variants of the hemostasis-associated genes exceeds that in women with normal pregnancy. The observed accumulation of polymorphic genes may play a role in hemostasis dysfunction, which affects the blood fibrinolytic activity. As a result, the incidence of bleeding increases and the utero-placental circulation deteriorates.Conclusion. The obtained results indicate an adverse genetic background in part of women in this geographical region, which, in turn, might be caused by unfavorable environmental factors

THE SOCIO-MEDICAL CHARACTERISTICS OF WOMEN WITH THREATENED PRETERM LABOR

Objective: to investigate health and social factors leading to the emergence of threatening preterm birth.Material and methods: This study was designed to evaluate the significance of social conditions, professional and material factors, obstetric and somatic history in 191 singleton spontaneous gestations, included 117 women with threatened preterm labor (О47.0 in ICD) and 74 women with physiological pregnancy. Inclusion criteria for the main group were abdominal pain and structural changes in the cervix (maturation and shortening less than 2 cm). Medical records were also a source of information about the complications and the outcome of pregnancy. We calculated odds ratio and produced a ranking number of risk factors threatened preterm labor.Results: average general education, signs of a threatened abortion in the second trimester, smoking during pregnancy, asymptomatic bacteriuria and the presence of immunoglobulin G (IgG) antibody to Cytomegalovirus (CMV) are the most significant risk factors for threatened preterm labor.Conclusion. It is necessary to conduct preconception preparation of women with above mentioned poor factors, as well as measures aimed at elimination of controllable risk factors, to reduce the likelihood of threatened preterm birth

PATHOMORPHOLOGY OF PLACENTA IN WOMEN WITH PRETERM BIRTHS AT DIFFERENT AGE OF GESTATION

The aim: to identify pathological characteristics of placenta in women with preterm labor according to the gestational age.Materials and methods. The study involved 55 women who gave birth prematurely: 21 women with gestational age from |22 to 32 weeks (group 1) and 34 women with gestational age from 32 to 37 weeks (group 2). All the women had spontaneous singleton pregnancies followed by preterm spontaneous births. We conducted a comparative analysis of the social, clinical and amnestic information, as well as a histopathological study of the placentas; the latter included macroscopic description, organometry and microscopic morphology. The analysis aimed to identify the placental factors associated with the premature delivery occurred before and after 32 weeks of gestation.Results. The study revealed a number of anamnestic and clinical factors associated with preterm births. At a gestational age up to 32 weeks, the placentas showed hypoplasia with a mass deficit of more than 30% in combination with proliferative vylusitis, post-inflammatory hypovascularization, abnormal differentiation of the vascular-stromal component of the villi, and insufficient compensatory and adaptive reactions. After 32 weeks of pregnancy the placenta characteristics included chronic disorders of the maternal and fetal blood circulation, compensatory hyperplasia of the terminal villi, capillaries and their syncytia capillary membranes.Conclusion. There is a need for individual rehabilitation programs for women with the history of preterm births that would include their clinical and anamnestic background together with the pathomorphological characteristics of their placentas. Such a program is expected to help these women to be better prepared prior to their subsequent pregnancy

Event shape in momentum space of proton-proton interactions at 360 GeV/c and comparison to e+e−e^{+}e^{-} data

none35J.L. Bailly;S. Banerjee;F. Bruyant;B. Buschbeck;C. Caso;H. Dibon;A. Ferrando;F. Fontanelli;Yu.A. Golubkov;R. Hamatsu;J. Hrubec;Y. Iga;Yu. Ivanyushenkov;N.S. Khalatyan;E.P. Kistenev;S. Kitamura;J.M. Kohli;V.M. Kubik;B.B. Levchenko;J. Macnaughton;L. Montanet;G. Neuhofer;G. Pinter;P. Porth;R. Raghavan;T. Rodrigo;J.M. Salicio;J.B. Singh;S. Squarcia;K. Takahashi;L.A. Tikhonova;U. Trevisan;T. Tsurugai;T. Yamagata;G.V. ZholobovJ. L., Bailly; S., Banerjee; F., Bruyant; B., Buschbeck; C., Caso; H., Dibon; A., Ferrando; Fontanelli, Flavio; Golubkov, Y. u. A.; R., Hamatsu; J., Hrubec; Y., Iga; Ivanyushenkov, Y. u.; N. S., Khalatyan; E. P., Kistenev; S., Kitamura; J. M., Kohli; V. M., Kubik; B. B., Levchenko; J., Macnaughton; L., Montanet; G., Neuhofer; G., Pinter; P., Porth; R., Raghavan; T., Rodrigo; J. M., Salicio; J. B., Singh; Squarcia, Sandro; K., Takahashi; L. A., Tikhonova; U., Trevisan; T., Tsurugai; T., Yamagata; G. V., Zholobo

ЭПИДЕМИОЛОГИЧЕСКАЯ, КЛИНИЧЕСКАЯ И ФИНАНСОВАЯ СОСТАВЛЯЮЩИЕ РЕЗУЛЬТАТОВ МНОГОЛЕТНЕЙ АНТИРЕТРОВИРУСНОЙ ТЕРАПИИ ПАЦИЕНТОВ С ВИЧИНФЕКЦИЕЙ

The aim of the study was to analyze the results of long-term antiretroviral therapy (ARV) in patients with HIV-infection basing on epidemiological, clinical and economical parameters in the Northwestern Federal District (NFD) of Russia. Materials and methods. Epidemiogical analysis was conducted using the data of reports from 10 NFD regions in the period from 2005 to 2018: morbidity rate, prevalence of HIV-infection, number of people living with HIV-infection (PLWH) and being under regular medical  check-up. For clinical analysis were used some key indices of ARV effectiveness such as patients’ therapy coverage, clinical stages of HIV-infection, mortality rate and lethality rate in patients. Health costs were calculated basing on ARV procurement in the District from federal and regional programs as well as from funds allocated on diagnostic products and prevention programs. Study results. On the top of  administered ARV, rates of mortality and prevalence of HIV-infection in the RF and NFD had increasing tendency. The rate of mortality in PLWH increased in several times while the lethality rate changed insignificantly. Number of PLWH on the stage of clinical signs grew sixfold reaching 63,1%. Questionnaire survey was held in 74 infectious disease physicians with the following estimation of values of some reasons of low effectiveness of ARV and  transformation of epidemic into severe and comorbid forms. By reason rating, low ARV coverage in patients was the most common, late detection of HIV-infection and treatment onset, poor adherence and therapy discontinuation, qualified staff shortage, low accessibility of medical organizations, insufficient choice and quality of ARV. In considering financial costs on ARV, insufficient appropriation of funds and insufficient support of other activities including organizational and preventive measures were revealed. Цель исследования: анализ результатов многолетней антиретровирусной терапии (АРВТ) пациентов с ВИЧ-инфекцией на основании эпидемиологических, клинических и клинико-экономических показателей в Северо-Западном федеральном округе (СЗФО)Российской Федерации (РФ). Материалы и методы. Эпидемиологический анализ проводили, используя сведения из отчетов десяти регионов СЗФО с 2005 по 2018 г.: заболеваемость, пораженность и распространенность ВИЧ-инфекции, число людей, живущих с ВИЧ (ЛЖВ) и состоящих на диспансерном учете. Для клинического анализа были использованы несколько ключевых показателей эффективности АРВТ: охват пациентов терапией, клинические стадии ВИЧ-инфекции, смертность и летальность больных. Медицинские затраты рассчитывали, исходя из закупок АРВТ по округу из федеральных и региональных программ, а также финансовых средств, выделяемых на закупку  диагностических препаратов и на профилактические программы. Результаты исследования. На фоне проводимой АРВТ показатели заболеваемости и пораженности ВИЧ-инфекцией в РФ и СЗФО имели одну направленность — в сторону возрастания. Показатель смертности ЛЖВ вырос в несколько раз, в то время как летальность менялась менее значимо. Количество ЛЖВ в стадии клинических проявлений возросло в шесть раз, достигнув 63,1%. Проведено анкетирование 74 врачей-инфекционистов с оценкой значения отдельных причин невысокой эффективности АРВТ и трансформации эпидемии в форму тяжелых и коморбидных форм. По рейтингу причин наиболее часто отмечали низкий охват пациентов АРВТ, позднее выявление ВИЧ-инфекции и начало АРВТ, низкую приверженность и прекращение терапии, кадровый дефицит в службе, низкую доступность медицинских организаций, недостаточный выбор и качество АРВТ. При рассмотрении финансовых затрат на обеспечение АРВТ отмечены недостаточные выделение средств, поддержка других направлений деятельности, включая организационные и профилактические мероприятия. <br /