Analysis Of Anamnestic Data Research Articles

Фактори ризику аденоміозу в жінок репродуктивного віку

The problem of adenomyosis is of particular relevance to patients of reproductive age since these diseases are accompanied by significant violations of the menstrual and generative functions. Aim - determine the risk factors for the development of adenomyosis in women of reproductive age in order to improve a complex pathogenetically based approach in the selection of treatment. Materials and methods. Analysis of anamnestic data and examination of 90 women of reproductive age with adenomyosis, which made up the main group, was carried out. The control group - 30 gynecologically healthy non-pregnant women of reproductive age. Results. The article provides data on the results of clinical-statistical analysis among reproductive-age women with the adenomyosis. The risk factors of development of adenomyosis in investigated group are determined. Those are: complicated heredity, high frequency of the clinical abortions, spontaneous miscarriages, pathological deliveries in the past. The low index of health is observed in such category of women: high sick rate of gynecological or extragenital pathology, 3 times higher frequency of child's and respiratory illnesses, the surgical intervention on uterus and ovarium promotes the progress of the endometriosis. That the most frequent clinical manifestations of adenomyosis are pain and hemorrhagic syndrome. Conclusions. The clinical and statistical analysis of the examined patients made it possible to identify risk factors for the development of adenomyosis in women of reproductive age: burdened heredity (60%), unmarried and single women (58.5%); employees with intellectual and mental and neuropsychological stress (63.3%), high infection index, accompanying extragenital pathology (37.4%), menstrual cycle disorders (93.3%) and reduced reproductive and sexual function; aggravated gynecological history: chronic inflammatory processes of the uterus and appendages (44.2%), pathology of the cervix (36.5%), artificial (66.6%) and involuntary (14.4%) abortions; intrauterine surgical interventions (76.3%). The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of the participating institution. The informed consent of the patient was obtained for conducting the studies. No conflict of interests was declared by the authors.

Может ли компонентная аллергодиагностика помочь в установлении траектории формирования «атопического марша»?

Recently, the atopic march (AM) is no longer considered a clear and sequential development of successive allergic diseases, such as atopic dermatitis (AD), asthma, and allergic rhinitis (AR). Recent studies have shown that associations between allergic disorders in children are much more complex, and there may be different variants of AM trajectories. Previously, eight classes of AM were described: (1) no allergic disorders, (2) AM, (3) AD and transient wheeze, (4) AD with later-onset rhinitis, (5) transient wheeze and later-onset rhinitis, (6) transient wheeze only, (7) eczema only, and (8) rhinitis only. 48.3% of children exhibit specific types of sequential development of allergic disorders, but only 7% exhibit profiles resembling ‘classic' AM. The aim of this article was to analyze AM trajectories in real clinical practice in children and to discuss the role of component resolved diagnosis (CRD) in the analysis of AM. The article presents anamnestic patient data and CRD results using a multiplex panel. The literature shows that AM classes do not always match the actual clinical presentation of a patient, indicating the presence of previously unreported AM trajectories. Molecular allergy diagnostics can identify true and cross-sensitization in complex clinical cases, allowing for consideration of the causes of established sensitization and conceptualization of clinical symptoms and individual AM trajectory. It is important to ensure that sensitization to true allergens is established and clinically verified. The analysis of anamnestic data can make it difficult to understand the sequence of allergic disease development. However, CRD significantly facilitates diagnostic search by allowing consideration of the order of sensitization and clinical manifestations. This can help predict the possible severity of allergic reactions to established allergens. KEYWORDS: atopic march, atopic dermatitis, allergic rhinitis, asthma, children, component resolved diagnosis, respiratory allergens. FOR CITATION: Lepeshkova T.S., Andronova E.V. Can component resolved diagnosis help establish "atopic march" trajectory? Russian Medical Inquiry. 2024;8(3):163–170 (in Russ.). DOI: 10.32364/2587-6821-2024-8-3-7.

Analysis of anamnestic data and their significance in predicting the course of glaucoma in dogs

Glaucoma is a dangerous disease for all animal species, as it is accompanied by intractable pain and progressive loss of vision. It is widely known that the classification of the disease is based on the state of the angle of the anterior chamber of the eye (open-angle and closed-angle), as well as on concomitant factors, such as the condition of the iris, lens. Due to the high incidence of glaucoma in animals, especially in dogs, the scientific article discusses the risk factors for the occurrence and development of glaucoma, as well as the analysis of anamnestic data was also performed. The objects of the study were dogs in the amount of 23 animals of different breeds and sex and age groups. The study was conducted at the Department of Veterinary Surgery of the Federal State Budgetary Educational Academy of Higher Education MSAVM&B - MVA named after K.I. Scriabin, as well as the VC «CUVO&M». All animals underwent an ophthalmological examination using a head magnifying glass and a slit lamp, measurement of intraocular pressure and gonioscopy. A diagnosis of glaucoma was made. Particular attention was paid to the iridocorneal angle, the state of the trabecular meshwork, the position of the iris, the presence of fibrinous or hemorrhagic exudate in the anterior chamber, and the localization of the lens were assessed. To achieve the goal of the study, the severity of the manifestation of the disease and its course were established. When analyzing the data of the anamnesis, it was revealed that dogs of the French bulldog and mestizo breeds were most often ill with glaucoma. The age of the animals most susceptible to this disease was 5-10 years. Based on the data of a comprehensive examination, the type of glaucoma that most often occurred in dogs was established: angle-closure secondary. The risk factors for glaucoma were goniodysgenesis, lens luxation, trauma, arterial hypertension, swelling cataract, fibrinous iridocyclitis, postoperative complication. Patterns were revealed between the form of the disease and the risk factors noted in each clinical case, which makes it possible to predict the course of the disease and the preservation of vision. The analysis of the history data made it possible to establish the most important prognostic factors for the onset of glaucoma in dogs and to determine a number of criteria for identifying the primary goals of the therapeutic approach to glaucoma.

Clinical and laboratory characteristics of patients with type 2 diabetes and diabetic foot syndrome

Background: Diabetes mellitus (DM) is one of the most common chronic diseases, leading to the development of many complications includingdiabetic foot syndrome (DFS). The problem of a progressive increase in the number of patients with DFS and the high risk of amputation in the population of patients with DM requires research to identify risk factors and specify ways to correct them.Aim: To study the clinical and laboratory characteristics of patients of the limb rescue center suffering from type 2 diabetes (DM2).Materials and Methods: A retrospective analysis of 729 medical histories of patients with T2D hospitalized in the foot rescue department of the limb rescue center of the State Clinical Hospital named after V.P. Demikhov in the period between 2019 and 2020 was carried out. An analysis of anamnestic data, clinical and laboratory parameters, drug therapy, the nature of surgical intervention and the outcome of hospitalization was performed. The statistical analysis was carried out using STATISTICA 8.0.Results: The study included 729 patients with T2D. Men dominated among patients (58%). The median of age was 66 [59.0; 73.0] years. 50.89% had experience of diabetes for more than 10 years. 53% of these patients had DFS, 79.2% had diabetic polyneuropathy, 45% had previously undergone amputation of the lower extremity, 24.8% had revascularization. A significant proportion of patients at admission had uncontrolled high level of glycemia. The median of glucose level was 9.9 mmol/l [7.2; 13.8]. Median meaning of HbA1c was 7.8% [6.7; 9.1]. BMI and lipid profile were not evaluated in all patients. In the department 224 patients were diagnosed with DFS for the first time. Gangrene prevailed among the ulcerative-necrotic complications of DFS. Arterial hypertension (AH) prevailed among the concomitant pathologies. GFR ˂ 60 ml/min/1.73m2 was observed in 45.36% of patients. According to X-ray data, 27.16% of patients (107 out of 394) showed signs of impaired bone density. In the department, 113 patients underwent revascularization, 372 — amputation of the lower limb, while 37 patients (9.95%) underwent amputation at the level above the knee, and 335 (90.05%) — at the level below the knee. Only 244 patients received local treatment among patients with DFS. A total of 718 patients were discharged; 11 patients died. The median duration of hospitalization of discharged patients was 13.0 [9.0; 18.0] bed days, the average duration of hospitalization of deceased patients was 11.31±2.21 (95% CI 6.49–16.13) bed days.Conclusion: Most of the patients with DM2 and DFS had prolonged decompensation of carbohydrate metabolism, dyslipidemia, increased BMI, hypertension. The study concluded that it is important to monitor and correct risk factors to improve the prognosis of the disease.

Indicator of thyroid hormones in newborns from mothers with diffuse-endemic goiter

Introduction. Pathologies of thyroid dysfunction associated with iodine deficiency remain one of the urgent problems throughout the world and are mainly associated with natural iodine deficiency in places where about 30% of the world’s population lives.Objective. Study of the dynamics of thyroid hormones in infants born from mothers with diffuse endemic goiter.Materials and methods. A retrospective study of 68 infants from mothers with diffuse endemic goiter (DEG) was carried out. Research methods included: analysis of anamnestic data, palpation, and ultrasound in mothers, with a study of the level of thyroid hormone in newborns and parturient women.Results. Infants from mothers with DEG have characteristic changes in the level of thyroid hormones in the blood, in particular, in the cord blood, the level of thyroid-stimulating hormone (TSH) is 22.4% higher than in the control group (p < 0.05). The difference between free triiodothyronine (T3) and thyroxine (T4) is on average lower by 8.6% and 4.3%, respectively, (p < 0.05 and p < 0.1). On the 3rd day of life, these fluctuations persist, and the level of TSH in the peripheral blood exceeded up to 20.9%, but there were no pronounced clinical signs of congenital pathology associated with the thyroid gland. At the same time, in the first months of life in infants, there is a lag in weight gain by an average of 9.6% about practically healthy newborns.Conclusion. In infants born to mothers with DEG, there is an increase in the umbilical blood level of TSH up to 22.4% about practically healthy newborns, with a simultaneous decrease in T4 to 4.3%, T3 to 8.6%, without pronounced clinical signs of congenital pathology. In these children, in the first months of life, there is a lag in physiological weight gain of up to 9.6%, which should be taken into account when managing children in an outpatient setting.

Compensation Possibilities of Mental Disorders — Individual Case of a Child with Severe Neurological Disorder

IntroductionNeurological diseases often lead to mental disorders in children. After the structure of disorder is identified, an important task is to examine the abilities to compensate developmental delay (Lev S. Vygotsky).ObjectivesThe goal of the study was to explore potential of children with opsoclonus-myoclonus syndrome (OMS), which is important for psychocorrection.MethodsCase study of a boy with idiopathic OMS (aged 3 years 5 months) who was patient at the Psychoneurological Department no. 2 of the Russian Children Clinical Hospital. The following methods were used: analysis of anamnestic data, analysis of patient’s medical record, pathopsychological assessment.ResultsAnamnestic data and medical records indicate the absence of pregnancy pathologies and normal early development. OMS was first detected when the child was aged 2 y. 7 m. Pathopsychological assessment gave the following results: 1) movement disorder (primary disorder) leads to secondary mental disorders; 2) locomotor activity disorders inhibit the child’s use of space and orientation of body in it; 3) secondary defects are detected in constructive activity, speech and drawing. Intact components of the mental processes: 1) the child demonstrates motivation for independent activity despite operational difficulties; 2) in certain activities, the general plan of actions remains intact, i.e., the goal set is actualized in movements and actions; 3) notions about objects, actions with them, planning and performance of movements are intact.ConclusionsThe research demonstrates disbalance between operational difficulties and integrity of semantic orientation, internal planning of actions. The data prove the importance of discussion on abilities of children with OMS to compensate mental disorders.DisclosureNo significant relationships.

Approaches to treatment of recurrent eczema in practice of general practitioner (clinical example)

The article presents a clinical case of recurrent eczema. Despite treatment lasting more than 5 years, the patient observed only a short-term effect of the therapy. The cause of the continuous course of severe eczema was malnutrition and hypovitaminosis of vitamins A and E, due to a lack of fish and seafood in the diet. Despite the relatively rare occurrence of eczema in the outpatient practice of a general practitioner, on average from 2 to 5 % of the adult population in the world suffers from this disease. Among the main methods of treating eczema is long – term antihistamine and anti-inflammatory therapy. However, these methods of treatment are not always enough. The reason for the continuous course of eczema was irrational nutrition with a lack of fat-soluble vitamins A and E. Correction of the diet using a sorbent based on the herb Zostera marina allowed to achieve significant improvement and remission of the disease.Conclusions. 1) A thorough analysis of anamnestic data is required to determine the treatment regimen in cases of prolonged persistence of eczema symptoms, with resistance to standard therapy algorithms. 2) Patient’s refusal of certain types of food can lead to hypovitaminosis, which is accompanied by skin symptoms. 3) The appointment of retinol, tocopherol acetate and vitamin D 1 will contribute to a rapid and effective improvement of the condition of the skin in cases with insufficient consumption of products containing fat-soluble vitamins. Preparations made from the sea grass Zostera marina help to improve digestion, sorb and remove unwanted biologically active substances, reducing the severity and relieving skin manifestations.

The role of transcription factor FoxP3 as a predictor of acute and chronic urticaria in children

Objective: To study the transcription factor FoxP3 in children with acute and chronic spontaneous urticaria as a possible predictor of the severity and chronicity of urticaria.Materials and Methods: A total of 264 children of both sexes aged from 6 to 16 years old with diff erent variants of urticaria course were examined. Clinical methods of the study included the analysis of anamnestic data and an objective examination of the child with the determination of the severity of urticaria. Immunological methods of the study included the identifi cation of T-regulatory lymphocytes with the CD4+CD25+ Foxp3+CD45+immunophenotype.Results: A signifi cant decrease in the level of transcription factor FoxP3 was found in children with severe acute urticaria and chronic urticaria compared to the control group.Conclusion: Th e degree of reduction in the level of FoxP3 signifi cantly aff ected the likelihood of the development of a severe course of acute urticaria and possible chronization of the disease.

Ефективність алергенспецифічної імунотерапії пилковими алергенами в дітей із позиції молекулярної алергології

Мета роботи — встановити можливі причини неефективності алергенспецифічної імунотерапії (АСІТ) пилковими алергенами (бур’янів) у дітей із сезонним алергічним ринітом і/або бронхіальною астмою на підставі вивчення гіперчутливості до алергенів, аналізу анамнестичних даних. Матеріали та методи. Проведено алерготестування 192 дітей. 52 пацієнтам проведене анамнестичне опитування з акцентом на перехресну алергію та супутню патологію верхніх дихальних шляхів, а також на ефективність АСІТ. Статистична обробка результатів проведена в програмі Statistica for Windows 6.0. Результати. Серед хворих на поліноз переважала гіперчутливість до амброзії (56 %), циклахени (46 %) та соняшника (58 %). До злакових рослин (райграс, грястиця, вівсяниця) чутливі 10—20 % пацієнтів. 23 % дітей мають сенсибілізацію до 5 та більше алергенів (в середньому до 3,3 ± 0,4). 52 % дітей мають супутню харчову алергію, 15 % — синдром оральної алергії, третина дітей — аденоїдні вегетації, гіпертрофію глоткових мигдалин, у 13 % алергічний риніт ускладнювався синуситом. Незадовільний клінічний ефект АСІТ пилковими алергенами асоціювався з наявністю поєднаної пилково-грибкової сенсибілізації, перехресної харчової та пилкової алергії, із сенсибілізацією до 4 та більше пилкових алергенів, з полівалентною алергією, а також спостерігався при поєднанні алергічного риніту із синуситом (р < 0,05). Висновки. Перед початком АСІТ дітям із полінозами необхідно визначити групу ризику стосовно можливої неефективності цього методу терапії та рекомендувати їм визначення специфічних імуноглобулінів класу Е до мажорних та мінорних алергенів для прогнозування ефективності АСІТ.

The teeth whitening in an age aspect: prevalance of the method use, substantiation of its carrying out and possible complications (clinical research)

The following article presents results of the clinical research on prevalence of use, justification of leading and development of possible complications due to the teeth’ whitening. The main aim of the research is to study prevalence of apply of the teeth’ whitening procedure among patients of different age groups in the Dental Department of the Odessa University Clinic, with a study on indications for leading the aforementioned procedure, as well as complications, that had been developed as a result of it. The research materials are: anamnestic data of patients from the University Clinic, who underwent the teeth’ whitening procedure. Moreover, we had taken into account the following indexes: patient’s age, presence of concominant pathology, the data on leading the teeth’ whitening procedure in the past. The main group was presented by 32 patients, who underwent the aforementioned procedure for the first time in their lives. The group of comparison is represented by 33 patients, who underwent the same procedure couple of times before (once, twice, three times or four times). The research methods: anamnestic, statistical. The methods of whitening, that had been chosen: hardware whitening, laser beam, thermocatalytic whitening and use of chemical catalysts. The analysis of anamnestic data, which was held, make us possible to postulate, that 5% of patients from both groups did not have any complications after the teeth’ whitening procedure. The other patients of the study groups though had a stable pain syndrome, the intensity of which is increasing in 24-48 hours after the procedure and last in average 5-7 days. The folowing article presents a data on a fact, what concominant conditions and diseases of the oral cavity do stimulate a pain syndrome development more often and during what period of time. The current article also describes a character of inner-connections between pain syndrome and gender feature as well as presence of such procedures in the past. The authors had postulated, that the less traumatic and quite efficient method is oxidative cleavage of enzymes, by using which a stable long-lasting effect is reached, as well as there is a lack of pain after the procedure.

The risk of forming neurological disease in extremely premature infants: a review of literature and clinical cases

Introduction. Premature infants are at risk of developing central nervous system malformations; therefore, increased survival rates among infants with very low birth weight and extremely low birth weight have contributed to the rise in prevalence of neurologic deficit in extremely premature infants.Purpose. To summarize the literature data and demonstrate rare family clinical observations of preterm infants associated with adverse neurological outcomes as a result of exposure to various perinatal factors.Materials and methods. For the literature review, we used data from full-text scientific research from international scientific databases. The influence of ante-, intra-, and postnatal risk factors on the neurological outcome of the disease was studied in two male sibs born at 27 weeks of gestation with a weight of 980 and 970 grams, a body length of 34 and 33 cm, and an Apgar score of 5/7 and 6/7, respectively. The analysis of anamnestic data and results of clinical and laboratory-instrumental examination was performed; the catamnestic observation was 24 adjusted months of life.Results.The presented observations revealed a combination of various ante-, intra-and postnatal risk factors that lead to CNS damage in preterm infants. The obtained results indicate that prematurity and extremely low birth weight are not the only risk factors for neurological disorders, but the burdened neonatal period (congenital sepsis, bronchopulmonary dysplasia, lung atelectasis, neonatal convulsions, and 2-degree intraventricular hemorrhage verified by USC/MRI of the brain on both sides) contributed to the formation of neurogolic pathology in the second examined sibs. The results obtained can be considered preliminary, and a larger study is needed.Conclusion.Thus, the obtained results indicate that prematurity, extremely low birth weight and low Apgar score are not the only risk factors for the formation of neurological disorders. A combination of several significant ante-, intra-, and postnatal risk factors is necessary for the development of severe perinatal CNS damage, the formation of adverse neurological outcomes, and severe delay in motor and psycho - speech development in preterm infants. The prognosis of neurological outcome in a preterm baby requires long-term dynamic monitoring and a comprehensive approach using clinical and instrumental diagnostic methods. The results obtained can be considered preliminary, requiring additional more extensive research.

УЛЬТРАСОНОГРАФИЧЕСКИЕ ИЗМЕНЕНИЯ У КОШЕК ПРИ ОСТРОМ БАКТЕРИАЛЬНОМ ХОЛАНГИОГЕПАТИТЕ

The development of an inflammatory process in the liver tissue and bile ducts in cats is a frequent and severe pathology that requires early diagnostic and therapeutic approaches. It is shown that the diagnostic approach for feline cholangiohepatitis should be comprehensive and based on a thorough analysis of anamnestic data, the results of physical examination and additional methods of instrumental and laboratory diagnostics. It is important in the diagnosis of cholangiohepatitis in cats to conduct visual diagnostic methods, in particular ultrasonography. It is established that the method of ultrasonographic diagnostics is of high value in the verification of acute cholangiohepatitis in domestic cats. Hepatomegaly was detected in 23.5% of sick cats, the severity of this sign positively correlated with the severity of the course of cholangiohepatitis. Microhepathy in patients with feline cholangiohepatitis was observed with a frequency of 5.9%, hyperechogenicity of the liver – 17.6%, hypoechogenicity of the liver – 7.8%, dilatation of the bile ducts – 23.5%, thickening of the gallbladder wall – 9.8%, pathological echogenicity of the gallbladder wall – 3.9%, echogenic debris in the gallbladder cavity – 32.4%, change in the echogenicity of the pancreas - 31.4%, increase in the size of the pancreas – 15.7%, thickening of the duodenal wall – 11.8%, pathological layering of the duodenal wall – 7.8%, hyperechogenicity of parapancreatic fat – 5.9%, peritoneal effusion – 5.9%.

УЛЬТРАСОНОГРАФИЧЕСКИЕ ИЗМЕНЕНИЯ У КОШЕК ПРИ ОСТРОМ БАКТЕРИАЛЬНОМ ХОЛАНГИОГЕПАТИТЕ

The development of an inflammatory process in the liver tissue and bile ducts in cats is a frequent and severe pathology that requires early diagnostic and therapeutic approaches. It is shown that the diagnostic approach for feline cholangiohepatitis should be comprehensive and based on a thorough analysis of anamnestic data, the results of physical examination and additional methods of instrumental and laboratory diagnostics. It is important in the diagnosis of cholangiohepatitis in cats to conduct visual diagnostic methods, in particular ultrasonography. It is established that the method of ultrasonographic diagnostics is of high value in the verification of acute cholangiohepatitis in domestic cats. Hepatomegaly was detected in 23.5% of sick cats, the severity of this sign positively correlated with the severity of the course of cholangiohepatitis. Microhepathy in patients with feline cholangiohepatitis was observed with a frequency of 5.9%, hyperechogenicity of the liver – 17.6%, hypoechogenicity of the liver – 7.8%, dilatation of the bile ducts – 23.5%, thickening of the gallbladder wall – 9.8%, pathological echogenicity of the gallbladder wall – 3.9%, echogenic debris in the gallbladder cavity – 32.4%, change in the echogenicity of the pancreas - 31.4%, increase in the size of the pancreas – 15.7%, thickening of the duodenal wall – 11.8%, pathological layering of the duodenal wall – 7.8%, hyperechogenicity of parapancreatic fat – 5.9%, peritoneal effusion – 5.9%.

Study of the features of fears in preschool children with impaired speech development in comparison with normally developing peers in Moscow City

Currently, the number of children with impaired speech development is constantly increasing, but the emotional difficulties that exist in this category of children remain insufficiently studied. Regional studies are particularly important in this area, and they provide the best insight into which emotional disturbances are related to the structure of the disability and the family situation, and which are related to general social tensions in a particular region and especially in a metropolitan setting. This article presents the research data on the psychological study of fears in children with various speech development disorders and their normally developing peers. The aim of the research is to identify and study the characteristics of fears in preschoolers with speech development impairments in Moscow City. The research methods. The study and analysis of medical, psychological and pedagogical literature, observation, conversation, the study of medical and pedagogical documentation, collection and analysis of anamnestic data, analysis of the products of children’s activities, modified questionnaire by A.I. Zakharov “fears in the houses”, Peter Muris’s modified test “fear levels”, a questionnaire for parents to identify the fears of children and parents, test questionnaire of child-parent relationship (QPR) by A.Y. Vargi and V.V. Stolin. methods of mathematical statistics, quantitative and qualitative analysis of the experimental data. The results of the study. Experimental data were obtained and systematized. It characterizes the features of fears of older preschoolers with different impaired speech development in comparison with normally developing peers. The description of the dominant fears of preschool children and their specific features inherent in children with speech disorders is given. Data were obtained on predisposition to an increased number of fears in the male part of the examined group of children. There were identified the average fears indicators that were higher than the existing standards for all the studied groups.

Редкий случай сложности ультразвуковой диагностики эктопической беременности после вспомогательных репродуктивных технологий. Клинический случай

Ectopic pregnancy is one of the most frequent and serious complications when using assisted reproductive technologies (ART). Difficulties in diagnosing ectopic pregnancy after ART are explained by atypical localization and ambiguous clinical picture. To analyze the clinical case of management and delivery of a pregnant woman words with twins when one of the fetuses is located in rudimentary horn. The retrospective analysis of anamnestic data, results of clinical and instrumental studies pregnant based on the exchange card of the pregnant woman and new mothers, birth history of the perinatal center of Tyumen. The clinical case of atypical placement of the fetus in the rudimentary horn in multiple pregnancies after ART is a fairly rare complication of the gestational period. Difficulties with timely diagnosis were associated with the lack of clear imaging during ultrasound examination. A timely diagnosis, in the current emergency situation, allowed the pregnancy to end favorably, both for the mother and for the fetus.

Ожирение и дефицит массы тела как предикторы гестационной гипертензии и сердечно-сосудистых заболеваний

Purpose of work. To reveal possible predictors of cardiovascular diseases on the basis of studying mechanisms of gestational adaptation, parameters of homeostasis in women with obesity and body weight deficiency. Material and methods. During pregnancy in 297 patients with changed body weight and 107 women of the comparison group carried out dynamic study of homeostasis parameters and adaptation mechanisms. The clinical state was assessed using morphological, electrophysiological, hormonal, biochemical and microbiological methods. Results. Analysis of anamnestic data revealed that parents of 87% of patients with obesity and weight deficit had arterial hypertension combined with atherosclerosis, obesity, diabetes mellitus, and depression. The upper distribution of subcutaneous tissue and gestational hypertension were found to be prevalent in women of the main clinical group: during the whole period, the average blood pressure was exceeded in obese women and in women with a deficit of body weight in the second trimester. General cholesterol level in the second trimester was increased due to atherogenic fractions in pregnant women of the first group up to 6.21 ± 0.13 mmol/l, in the second group – 5.95 ± 0.20 mmol/l, against the control group 4.96 ± 0.31 mmol/l. Transitor glucosuria (in case of excluded diabetes mellitus) occurred only in pregnant women with changed body weight in the 2nd trimester. Stress reactions prevailed in women with obesity and deficit of body weight on the eve of labor: 77% (1) and 88% (2), exceeding the parameters of the control group; there was also an increase in the level of norepinephrine and dioxyphenylalanine in daily excretion of urine by 4-6 times. Decrease in species landscape of intestinal and vaginal flora with increasing share of pathogenic microorganisms was registered in 91% of pregnant main groups and only in 33% of control group patients. Conclusion. In women with changed body weight, pregnancy is accompanied by excessive activation and disintegration of adaptation systems, the clinical equivalent of which is gestational hypertension, metabolic and microecology disorders. Gestational stress-test allows to estimate phylogenetic features of response systems of young women and probable ontogenetic risks of cardiovascular diseases.

Assessment of risk factors for the development of simple and complex non-atypical endometrial hyperplasia

Annotation. Goal – to identify and assess the most significant risk factors for the development of simple non-atypical endometrial hyperplasia (SNAEH) and complex non-atypical endometrial hyperplasia (CNAEH) in women. Retrospective analysis of anamnestic data of 58 case histories of patients with SNAEH, 35 case histories of patients with CNAEH and data of 30 women of the control group, which allowed to identify risk factors for hyperproliferative processes of the endometrium (HPE) for research, the statistical significance of which was further assessed by calculating odds ratio (OR). The main feature associated with the risk of SNAEH is heredity – OR = 49.73 (95% CI 2.90–852.32). Significantly increases the risk of developing SNAEH in the presence of thyroid gland lesion (TGL) – OR = 34.97 (95% CI 2.03–601.20). The third in the hierarchical sequence is the polycystic ovary syndrome factor; OR = 25.72 (95% CI 1.488–444.59). Heredity occupies the top of the hierarchical structure in the group of patients with CNAEH. OR is 80.67 (95% CI 4.56–1424.76). A high probability of developing CNAEH is also observed for women over the age of 50 (OR = 32.44 (95% CI 1.82–576.56). In third place – the presence of TGL, which significantly increases the risk of developing CNAEH; OR = 28.63 (95% CI 1.60–510.56) Identification of statistically significant risk factors for the development of HPE will help to identify risk groups among the population, to carry out preventive measures among them (lifestyle adjustments, treatment of concomitant diseases) and decrease the incidence of the HPE.

Cytokine status disorders in children with urticaria

Objective: to study the state of cytokine status in children with acute and chronic urticaria.Materials and methods: 264 children of both sexes aged from 6 to 16 years with different variants of urticaria were examined. Clinical research methods included analysis of anamnestic data, objective examination of the child to determine the severity of urticaria. Immunological research methods included determination of IL-4, IL-6, IL-17, and IFN-γ levels by the method of enzyme immunoassay of blood serum.Results: cytokine profile analysis revealed hyperproduction of IL-17, γ-IFN with reduced IL-4 synthesis in children with acute urticaria. In children with chronic urticaria, IL-6 hyperproduction is noted against the background of a significant decrease in IL-4 synthesis.Conclusion: there was a significant relationship between the development of severe acute urticaria and the levels of proinflammatory cytokines IL-6, IL-17, and between the formation of chronic urticaria and the level of IL-6.

Comprehensive program of therapy and rehabilitation of patients with cognitive impairments in depressive disorders

The relevance of the study is due to the high prevalence of depressive disorders and significant negative medical and social consequences of the disease, which affect the decrease in the quality of life and social functioning of patients. A comprehensive program of therapy and rehabilitation (CPTR) for patients with cognitive impairment in depressive disorders was developed and its effectiveness was evaluated. The proposed CPTR for patients with cognitive impairment with depressive disorders implemented in four stages: diagnostic, therapeutic, rehabilitation and prophylactic. The diagnostic stage included a clinical and psychopathological assessment of the patients’ cognitive disorders, an analysis of anamnestic data, clinical symptoms, dynamics and prognosis of the disease, the relationship of clinical and socio-psychological factors. The therapeutic stage included a set of pharmacotherapy and psychotherapy measures aimed at correcting cognitive impairment, stopping depressive disorders, normalizing the psycho-emotional state, social adaptation and réadaptation of the patient. The rehabilitation stage included a set of pharmacotherapy and psychotherapy measures aimed at restoring cognitive functions, strengthening the effect of antidepressant therapy, and restoring the patient’s social functioning. The preventive stage designed to maintain a normal psycho-emotional state, effectively resist stress, and prevent the recurrence of depressive disorders. In approbation of the developed CPTR, 97 patients with cognitive impairment with depressive disorders make up the main group. The control group consisted of 93 patients with cognitive impairment with depressive disorders who underwent a course of therapy according to traditional schemes. The effectiveness of the proposed CPTR in patients with cognitive impairment with depressive disorders were proved, which consists in a more pronounced reduction of clinical manifestations of depressive disorders, improvement of cognitive functions, reduction of maladaptive and increase in adaptive strategies for cognitive regulation of emotions, improvement of social functioning in the main spheres of life. Keywords: cognitive impairment, depressive disorders, therapy and rehabilitation, social functioning.

BARDET — BIEDL SYNDROME WITH CONGENITAL KIDNEY MALFORMATION IN A 14-YEAR-OLD GIRL

Aim. To show the variety and severity of the clinical symptoms of a rare hereditary disease — Вardet — Biedle syndrome — in a14-year-old girl. Materials and methods. We carried out a retrospective analysis of anamnestic data, the course of the disease, laboratory and instrumental data, as well as the therapy of a 14-year-old patient with Вardet-Вiedlе syndrome. Results. A 14-year-old patient with hereditary Вardet — Вiedlе syndrome (polydactyly, mental retardation, progressive obesity, pigment retinopathy) was found to have a congenital abnormality of kidney development — hypoplasia and dysplasia of the only right kidney complicated by chronic secondary pyelonephritis with the development of chronic kidney disease. Urine tests revealed leukocyturia, bacteriuria and proteinuria. The echo-signs of diffuse changes in the parenchyma of the right kidney were found during the ultrasound kidney examination. The left kidney was not determined. The conclusion of dynamic renal scintigraphy: the image of the left kidney is not reliably visualized (a sharp decrease in the function or absence of the kidney), the preserved filtration function and a moderate decrease in the excretory function of the right kidney. Intoxication syndrome, leukocyturia, bacteriuria and proteinuria were relieved against the background of antibacterial (Ceftriaxone) and symptomatic therapy. Conclusion. We have described a clinical case of the Вardet — Вiedlе syndrome with congenital kidney malformation (impaired function), but with the normal structure of the internal reproductive organs and sexual development. In the future, due to the development of chronic kidney disease, the patient should receive specialized nephrological care, as well as be observed by endocrinologist due to a high risk of developing type 2 diabetes mellitus.