Anamnestic Risk Factors Research Articles

Systematic review and meta-analysis on prevalence and anamnestic risk factors for erosive tooth wear in the primary dentition.

Erosive tooth wear is a multifactorial and common condition in children. This systematic review and meta-analysis aimed to determine the prevalence and key risk factors for erosive tooth wear in the primary dentition of children up to 7 years of age. Electronic databases (PubMed, Embase, Scopus, and Web of Science) were searched in February 2023 for observational studies reporting prevalence and anamnestic risk factors. Additionally, a manual hand search was performed. Meta-analyses were conducted for the prevalence and odds ratios of identified risk factors. Risk of bias was assessed using the Newcastle-Ottawa scale modified for cross-sectional studies. A total of 26 sources, reporting on 23 studies, were included in the systematic review. The overall estimated prevalence of children with erosive tooth wear in the primary dentition amounted to 35.6% (95% CI: 24.8-48.1). Anamnestic factors were structured into domains. Meta-analyses revealed gastroesophageal reflux disease (GERD; padj. = .008; OR = 1.98, 95% CI: 1.37-2.87), consumption of acidic food (padj. < .001; OR = 5.14, 95% CI: 3.56-7.42) and acidic drinks (padj. < .001; OR = 6.90, 95% CI: 4.64-10.25), holding beverages in the mouth while drinking (padj. = .035; OR = 1.82, 95% CI: 1.26-2.63), and snacking regularly (padj. = .041; OR = 1.58, 95% CI: 1.18-2.10) to be significantly associated with erosive tooth wear. Future research should use standardized questionnaires to assess erosive tooth wear and its underlying risk factors (PROSPERO: CRD4202339776).

Prediction of bleeding in labor in women with uterine scar as a tool to prevent massive blood loss: an observational cohort study

Background. Postpartum hemorrhage is recognized as a leading cause of maternal mortality and morbidity in the world. Predicting postpartum hemorrhage in high-risk patients with uterine scar enables preventive measures to be scheduled and costs of treatment and rehabilitation to be reduced.Objective. To determine antenatal predictors of high postpartum hemorrhage risk in pregnant women with uterine scar in order to improve the prevention of massive blood loss.Methods. An observational cohort study involves the medical records of 4494 maternity women with uterine scar (pregnancy and delivery histories) of the Perinatal Center of Regional Clinical Hospital No. 2, Krasnodar Krai. The study sample included data of maternity women coded O34.2 according to International Classification of Diseases, 10th Edition, for the period from 2017 to 2020. The sample participants were distributed into two groups depending on the blood loss during delivery, determined in compliance with clinical recommendations: a group of patients without massive blood loss during delivery and a group of patients with massive blood loss in labor/early postpartum period. The study was mainly focused on parameters of the prediction performance of bleeding in labor and early postpartum period in pregnant women with uterine scar using a multiparametric, logistic regression models. The study considered demographic data, comorbidity, obstetric history, pregnancy course, ultrasound data, and volume of blood loss at delivery. The performance of prediction for postpartum hemorrhage was calculated using multivariate binary logistic regression. Descriptive statistical analysis was carried out by means of statistical software package SPSS Version 26 (IBM, USA). Two-sided p-value &lt; 0.05 was taken as a statistically significant difference. A prognostic significance of predictors was determined by binary logistic regression. The Wald statistic was used to determine an observed significance. In order to define the performance of the model, the study involved calculating sensitivity, specificity, positive and negative predictive value, Nagelkerke coefficient of determination, as well as performing ROC analysis. The DeLong test was used for paired comparisons of ROC curves.Results. In the retrospective follow-up group (2017–2020) (n = 502), postpartum hemorrhage with massive blood loss occurred in 41 cases (8.17%). For the model based on clinical-anamnestic predictors, the prediction performance for postpartum hemorrhage comprised: sensitivity = 12.2% (95% confidence interval (CI) 4.1–26.2); specificity = 99.3% (95% CI 98.1–99.9); positive predictive value = 62.5% (95% CI 24.5–91.5); negative predictive value = 92.6% (95% CI 89.9–94.8); area under the ROC curve = 0.864 (95% CI 0.807–0.920), p &lt; 0.001. The prediction performance for the model based on three ultrasound predictors (asymmetry coefficient of placental thickness, uterine wall bulging in the scar and myometrial thickness in the placentation zone) comprised: sensitivity = 85.4% (95% CI 70.8–94.4); specificity = 98.5% (95% CI 96.9–99.4); positive predictive value = 83.3% (95% CI 68.6–93.0); negative predictive value = 98.7% (95% CI 97.2–99.5); area under the ROC curve = 0.919 (95% CI 0.855–0.983), p &lt; 0.001. No significant difference was revealed for the performance of the models ( p = 0.170). For the model based on ultrasound predictors and placenta previa, the prediction performance comprised: sensitivity = 85.4% (95% CI 70.8–94.4); specificity = 98.5% (95% CI 96.9–99.4); positive predictive value = 83.3% (95% CI 68.6–93.0); negative predictive value = 98.7% (95% CI 97.2–99.5); area under the ROC curve = 0.955 (95% CI 0.912–0.999), p &lt; 0.001. The model based on clinical-anamnestic and ultrasound indicators predicted postpartum hemorrhage with sensitivity equal to 85.4% (95% CI 70.8–94.4); specificity — 98.9% (95% CI 97.4–99.6); positive predictive value — 87.5% (95% CI 73.2–95.8); negative predictive value — 98.7% (95% CI 97.1–99.5); area under the ROC curve — 0.984 (95% CI 0.966–1.0), р &lt; 0,001. Thus, this model outperformed the model based on clinical-anamnestic data (p &lt; 0.001), based on ultrasound predictors (p = 0.006) and revealed no difference with the model considering placenta previa and ultrasound predictors (p = 0.127). Using prenatal prediction of postpartum hemorrhage based on ultrasound features, the incidence of massive blood loss at delivery decreased from 6.88/1000 deliveries (2019–2020) to 4.18/1000 deliveries (2021–2022) (p &lt; 0.001).Conclusion. Ultrasound predictors in pregnant women with uterine scar increase the sensitivity of antenatal prediction of postpartum hemorrhage based on the assessment of clinical and anamnestic risk factors, thereby enabling preventive measures to be scheduled in the risk group and incidence of massive blood loss to be reduced.

Predicting the development of vulvar lichen sclerosus

Relevance. The issue of timely diagnosis and treatment of vulvar lichen sclerosus has become especially acute in recent years due to the “rejuvenation” of the disease and the risk of its malignancy. In this regard, it is urgent to search for effective methods for predicting and early detection of the disease. The aim of the study - to develop amodel for predicting vulvar lichen sclerosus based on established clinical and anamnestic risk factors. Materials and Methods. The prospective case-control study included 404 women aged 20 to 70 years, of which 344 were patients with vulvar lichen sclerosus and 60 were women without vulvar diseases. At the first stage, acomparative statistical correlation analysis of the clinical and anamnestic data of the subjects was carried out using the Spearman correlation coefficient (R0.15), Chi-square tests, Phi and Cramer statistics, the Mann-­Whitney U test and the Student t test (p 0.05). The data obtained were used to develop aneural network model for predicting vulvar lichen sclerosus in the second stage of the study. Results and Discussion. Based on established reliably significant (p0.05) obstetric-­gynecological, somatic, infectious, hygienic and household factors influencing the risk of developing vulvar lichen sclerosus (Rindicator - from 0.16 to 0.38 confirms the statistical significance of correlations), aneural network model for predicting vulvar lichen sclerosus was developed (the percentage of correct classification on the test sample is the maximum possible value - 100%) and acomputer program was written that automates the procedure for predicting the disease. Conclusion. The neural network model for predicting the disease, developed on the basis of reliably (p0.05) significant risk factors for vulvar lichen sclerosus, has high prognostic properties, and acomputer program written on its basis allows the doctor in amatter of minutes to identify the patient at risk for the development of vulvar lichen sclerosus and give she needs preventive recommendations aimed at preventing or early detection of the disease.

Obstetric, somatic and infectious risk factors for vulva sclerotic lichen

Relevance. Until now, disputes among scientists about its etiology, pathogenesis, nomenclature and risk factors for the development of vulvar lichen sclerosis have not subsided, which actualizes the need for scientific research aimed at solving these problems. The aim of the study - to establish statistically significant clinical and anamnestic risk factors for vulvar lichen sclerosis. Materials and Methods. An electronic database was formed with data from 344 patients with lichen sclerosus of the vulva and 60 women without vulvar diseases aged 20-70 years on hereditary, obstetric-­gynecological, somatic and infectious history. Astatistical comparative correlation analysis of the obtained data was carried out using the Spearman correlation coefficient (R0.15), nonparametric Mann - Whitney U test and Student t test (p0.05), Chi-square tests, Phi and Cramer statistics. Results and Discussion. Statistically significant (p0.05) risk factors for the development of vulvar lichen sclerosus (R, in descending order) were established: the presence of fibrocystic mastopathy (-0.29); late menarche (15 years and older) (-0.28); onset of menopause (-0.25); recurrent vulvo-­vaginal infections (-0.18); recurrent bacterial vaginosis (-0.18); autoimmune thyroiditis(-0.16) and stage II obesity (-0.16). Also, the average number of abortions and births (1.23 and 1.49, respectively) in the group of patients with lichen sclerosis of the vulva is statistically significantly greater (p0.05) than the average value (0.27 and 1.13, respectively) in control group. Conclusion. The data obtained on the impact of obesity and autoimmune thyroiditis on the risk of developing vulvar sclerotic lichen are consistent with the results of global studies and confirm the association of the disease with autoimmune and metabolic disorders. Recurrent vulvo-­vaginal infections and dysbiotic processes in the vagina can be both acause and aconsequence of vulvar lichen. The relationship between fibrocystic mastopathy and vulvar lichen sclerosus remains debatable and requires further research. Late menarche, the onset of menopause, alarge number of abortions and childbirth can also be considered triggers for vulvar lichen sclerosus in patients with agenetic predisposition to the disease.

A European Multicentric Investigation of Atypical Melanocytic Skin Lesions of Palms and Soles: The iDScore-PalmoPlantar Database.

Background: The differential diagnosis of atypical melanocytic palmoplantar skin lesions (aMPLs) represents a diagnostic challenge, including atypical nevi (AN) and early melanomas (MMs) that display overlapping clinical and dermoscopic features. We aimed to set up a multicentric dataset of aMPL dermoscopic cases paired with multiple anamnestic risk factors and demographic and morphologic data. Methods: Each aMPL case was paired with a dermoscopic and clinical picture and a series of lesion-related data (maximum diameter value; location on the palm/sole in 17 areas; histologic diagnosis; and patient-related data (age, sex, family history of melanoma/sunburns, phototype, pheomelanin, eye/hair color, multiple/dysplastic body nevi, and traumatism on palms/soles). Results: A total of 542 aMPL cases-113 MM and 429 AN-were collected from 195 males and 347 females. No sex prevalence was found for melanomas, while women were found to have relatively more nevi. Melanomas were prevalent on the heel, plantar arch, and fingers in patients aged 65.3 on average, with an average diameter of 17 mm. Atypical nevi were prevalent on the plantar arch and palmar area of patients aged 41.33 on average, with an average diameter of 7 mm. Conclusions: Keeping in mind the risk profile of an aMPL patient can help obtain a timely differentiation between malignant/benign cases, thus avoiding delayed and inappropriate excision, respectively, with the latter often causing discomfort/dysfunctional scarring, especially at acral sites.

Клинико-анамнестические факторы риска развития преэклампсии как осложнения гестационного сахарного диабета

Aim. To identify the clinical and anamnestic risk factors of preeclampsia (PE) in gestational diabetes mellitus (GDM). Design. Open-label observational prospective study. Materials and methods. The study enrolled 204 pregnant women with GDM, 70 of which had their pregnancy complicated with PE (study group) and 134 patients did not have PE (controls). In the study group, clinical and anamnestic risk factors were searched for by tracing data from primary medical records. The age of participants was 21 to 46 years old. Extragenital conditions were studied as possible risk factors of PE in GDM. Results. It has been established that GDM with PE was more likely to be associated with chronic arterial hypertension (CAH) (χ2 = 7.72, р = 0.006, odds ratio (OR) = 8.52, 95% confidence interval (CI): 1.76–41.29); a history of respiratory diseases — severe sore throat (χ2 = 6.2, р = 0.01, OR = 3.98, 95% CI: 1.40–11.27), chronic tonsillitis (χ2 = 12.84, р &lt; 0.001, OR = 4.81, 95% CI: 2.03–11.40), acute bronchitis (χ2 = 6.0, р = 0.02, OR = 7.33, 95% CI: 1.48–36.32) than GDM without PE. Conclusion. Clinical and anamnestic risk factors of PE in women with GDM are CAH, a history of respiratory diseases (acute bronchitis, severe sore throat, chronic tonsillitis). Keywords: gestational diabetes mellitus, preeclampsia, risk factors.

Clinical and anamnestic risk factors for early delivery and severity of viral pneumonia in pregnant women: a retrospective cohort single-center study

Clinical and anamnestic risk factors for early delivery and severity of viral pneumonia in pregnant women: a retrospective cohort single-center study

DETERMINISTIC BEHAVIORAL AND ANAMNESTIC RISK FACTORS INDUCING MISCARRIAGE (according to the results of a sociological study)

Background. Every year there are 23 million miscarriages and approximately 15 million premature babies are born in the world. Prematurity induces an increase in the hospitalization of newborns, creates a significant economic burden on families and the burden on health care systems, and increases the risk of developing psychological and mental disorders, which determines this pathology as a priority in the search for ways to solve it.&#x0D; Aim: to establish the most significant behavioral risk factors for miscarriage, which are actually modifiable, which will be one of the key elements in solving the problem of preventing miscarriage.&#x0D; Materials and methods. During the scientific study, two groups of women were formed. The study group consisted of 403 women after spontaneous abortion, premature birth or threatened miscarriage, and the control group included 402 women with a physiological gestation course and parturient women with a full-term pregnancy.&#x0D; Results. According to the results of the study, theку was a significant impact of an external stress factor during pregnancy, noted by 23.08% [19.1-27.31] and 3.73% [2.10-5.80] of the respondents of the study and control groups, respectively (p &lt;0.01), as well as nervous system overload at the workplace, noted by 42.43% [37.65-47.29] and 29.35% [25.01-33.9] of women, respectively (p&lt;0.01).&#x0D; The negative impact of physical activity such as running or jogging, as well as professional sports, which were indicated by 17.87% [14.28-21.75] and 8.71% [6.15-11.66], and 6 .20% [4.06-8.76] and 2.24% [1.02-3.91] of the respondents of the study and control groups, respectively (p&lt;0.01), have been proven.&#x0D; It was established that the proportion of females who drank wine was 39.70% [34.98-44.52] in the study group, while they were 17.66% [14.09-21.54] (p&lt;0.01) in the control group, and the share of women who drank low-alcohol beverages was twice as prevalent in the control group, 13.93% [10.72-17.48] compared to 7.20% [4.88-9.92] in the study group (p&lt;0.01).&#x0D; The preventive effect of additional intake of micronutrients, namely folic acid and iodine, was noted. 37.47% [32.81-42.25] of women in the study group took folic acid at 400 μg per day from the moment they found out about their pregnancy until the end of the 16th week of pregnancy, which was 1.4 times less than in the control group, accounting for 51.00% [46.11-55.87] (p&lt;0.01). Only a quarter of 25.06% [20.96-29.41] women of the study group and almost half of 45.27% [40.44-50.15] women of the control group (p&lt;0.01) took iodine supplements containing 200 μg of iodine per day from the beginning to the end of pregnancy.&#x0D; The expediency of limiting sexual life during critical periods of pregnancy, namely during the 8-12, 18-22, and 28-32 weeks of pregnancy, was proven, as noted by 31.27% [26.84-35.87] of the respondents of the study group and 47.26% [42.4-52.15] of subjects in the control group (p&lt;0.05).&#x0D; Conclusion. Based on the results of the study, the most significant behavioral risk factors were established, which are mainly manageable and modifiable. The obtained results will be used in the formation of groups with an increased risk of miscarriage among women of reproductive age and in the development of a personalized risk-oriented model for the prevention of miscarriage.

Assessment of endothelial function in pregnant women with normal pregnancy and pregnancy complicated by hypertensive disorders

Objective. To assess the vascular endothelial function in the first trimester of pregnancy using the method of skin thermometry in the aspect of the development of hypertensive complications.&#x0D; Materials and methods. One hundred women in the first trimester of pregnancy were examined. Based on the gestation outcomes they were divided into two groups: group 1 consisted of 80 patients without pregnancy complications, group 2 included 20 women whose pregnancy was complicated by hypertensive disorders. Clinical and anamnestic risk factors were evaluated; blood pressure level, uterine artery pulsation index, pregnancy-associated plasma protein A were measured; endothelial function was assessed using high-resolution skin thermometry.&#x0D; Results. Analysis of the obtained data showed significant differences in the body mass index, systolic and diastolic blood pressure levels and values of pulsation index in the uterine arteries. An increase in the indicators during the first trimester of pregnancy was observed in patients from the group with hypertensive disorders. The results of measurements of blood flow fluctuations in the microcirculatory system showed no significant differences in the compared groups.&#x0D; Conclusions. The obtained results of measuring the amplitudes of blood flow fluctuations in the microcirculatory system indicate the absence of initial endothelial dysfunction in the maternal body. However, an increase in the body weight, initial level of systolic and diastolic blood pressure, uterine artery pulsation index have an important role in predicting the development of hypertensive disorders in pregnancy.

Фактори ризику виникнення запальних захворювань кишечника в дітей раннього віку

In recent decades, there has been a rapid increase in the incidence of inflammatory bowel diseases in the children's population, especially in the age group under 6 years old. Risk factors significantly affect the reactive response of the child's organism and the probability of a pathology occurrence. Purpose - to analyze risk factors for the development of inflammatory bowel diseases with very early onset in children. Materials and methods. The anamnestic data of 78 examined patients with inflammatory bowel diseases - 17 patients with inflammatory bowel diseases with a very early onset and 61 children with inflammatory bowel disease that debuted over 6 years of age - were studied in detail retrospectively. Results. The anamnestic risk factors that were significantly more often observed in patients with inflammatory bowel diseases with a very early onset compared to children with inflammatory bowel diseases with an onset after 6 years of age included: spontaneous abortion in patients' mothers anamnesis, autoimmune diseases in relatives, the presence of concomitant autoimmune diseases in patients, early introduction of artificial feeding and the presence of an infectious disease just before the onset of inflammatory bowel disease. Conclusions. Taking into account the identified risk factors of inflammatory bowel diseases with a very early onset will ensure the improvement of prevention and early diagnosis of this gastrointestinal disease in young children. 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 institution mentioned in the work. The informed consent of the children’s parents was obtained for the conducting the studies. No conflict of interests was declared by the authors.

COVID-19 infection and hypertension disorders during pregnancy

The objective: to determine the impact of COVID-19, which occurred before or during pregnancy, on the frequency of development and features of the course of gestational hypertension and preeclampsia.Materials and methods. An observational retrospective study with parallel control one was conducted. The pregnancy course and its outcomes in 178 women during the period of the COVID-19 pandemic – from March 2020 to January 2022 – who were observed in the women’s consultation of a private medical center, were analyzed. It is important to note that the medical documentation was taken one after the other, without being specially selected according to any principle, that is, the analysis carried out had the character of continuous screening.Out of 178 pregnant women, 125 (70.2%) persons were sick with COVID-19, they were included in the main group; 53 (29.8%) women who were part of the comparison group did not get sick. The groups are comparable by age and body mass index. The age of the women was 19–51 years; in the main group – 30.5±4.9 years, in the comparison group – 30.9±5.6 years. Body mass index (kg/m2) at the beginning of pregnancy in women of the main group was 21.6±4.3; comparison group – 22.9±4.8. There were 104 (58.4%) primigravida, 74 (41.6%) – multigravida. 117 (65.7%) women were primipara, 61 (34.3%) – multipara.All pregnant women were performed with a standard examination in accordance with the Order No. 417 of the Ministry of Health of Ukraine dated 15.07.2011. Clinical and anamnestic risk factors for the development of preeclampsia were assessed in all women without exception, on the basis of which 3 women were assigned to the risk group. In addition, 158 (88.8%) pregnant women as part of the first combined screening had an additional examination to determine the risk of developing preeclampsia, as a result of which additional 23 women were included in the risk group. As a result, 26 (14.6%) pregnant women from 12 weeks of gestation were prescribed prophylaxis using acetylsalicylic acid.Results. In women who have had COVID-19, hypertensive disorders of pregnancy develop statistically significantly less often than in those who have not had the disease. After mildly symptomatic COVID-19 the risks of hypertensive disorders in pregnant women are statistically significantly reduced: gestational hypertension – RR=1.15, 95% CI: 1.0–1.3; preeclampsia – RR=1.1, 95% CI: 1.0–1.2, all hypertensive disorders – BP=1.3, 95% CI: 1.1–1.6.The groups did not differ among themselves in the prevalence of generally accepted risk factors. The frequency of hypertensive disorders depending on the vaccination was analyzed. The risk of gestational hypertension in vaccinees who did not suffer from COVID-19 is reduced by 1.4 times (RR=1.4, 95% CI: 1.0–1.9), the risk of all hypertensive disorders in pregnant women in this same group is reduced 2 times (RR=2.0, 95% CI: 1.2–3.5).The development of preeclampsia also probably depends on the vaccination status (χ2=4.0; p=0.04; φ=-0.17). In non-vaccinated persons it increases by 1.1 times (RR=1.1, 95%CI: 1.2–1.8). The risk of all hypertensive disorders is also higher in the group with a negative vaccine status (RR=1.3, 95%CI: 1.0–1.7) only at the level of significance p=0.06, that is, it appears as a certain tendency.Conclusions. Hypertensive disorders associated with pregnancy are less likely to develop in women who have experienced COVID-19 in the preconception period or during pregnancy. Vaccination against COVID-19 reduces the frequency of hypertensive disorders in pregnant women, regardless of the disease presence.Since immune mechanisms, along with placental-vascular mechanisms play a significant role in the pathogenesis of preeclampsia, let’s assume that the experienced coronavirus infection or vaccination against it disrupts certain links of immunity, which results in a decrease in the frequency of hypertensive disorders in pregnant women.

Клинико-анамнестические факторы рецидивирующих полипов эндометрия в репродуктивном возрасте

The prevalence of endometrial polyps (EP) ranges from 7.8 to 34.9%, and in the group of patients with symptoms reaches 24%. The natural course of EP is unclear, the frequency of spontaneous regression of EP varies from 6.3% to 57.1%, but it is impossible to accurately predict the nature of the growth of an individual polyp and the probability of regression. A successful operation does not guarantee against recurrence of the disease: according to various authors, the frequency of postoperative recurrence of EP varies from 5.6% to 43.6%, depending on the duration of observa-tion and the nature of polyps. To improve the results of EP treatment, to determine the target groups for hysteroscopic polypectomy, it is impor-tant to have an understanding of the risk factors for recurrence of EP. The analysis of scientific publications in the databases eLibrary, PubMed, Cochrane Library, Science Direct was performed, according to the keywords endometrial polyps/endometrial polyp, recurrence/recurrence, risk factors/risk factors, reproductive age/reproductive age, premenopausal age/premenopausal age for 2013–2023. The obtained results of the liter-ature analysis allow us to conclude about the influence of age, multiple nature of polyps, chronic endometritis on the risk of recurrence of EP. In addition, other factors may be involved in the development of recurrent polyps. For a more accurate assessment of the contribution of various risk factors to the recurrence of EP, it is necessary to perform high-quality scientific research. The purpose of the work: to analyze the available literature data and summarize the information received to date on the clinical and anamnestic risk factors of EP.

The role of family history of preterm delivery in the individual risk of spontaneous preterm delivery: a case–control study

PurposeTo investigate the role of family history of preterm delivery (PTD) in the individual risk of spontaneous preterm delivery.MethodsA retrospective case–control study was conducted on 354 patients who delivered between 2018 and 2020. 177 women who delivered preterm were matched with 177 controls who had full-term delivery. A questionnaire was administered to investigate the family history of PTD of both the patient and her partner. Cases and controls were matched for the anamnestic risk factors for PTD.ResultsSeventeen of 173 women (9.8%) in the PTD group reported being born preterm, compared to five of 169 women (2.9%) in the control group (p = 0.01), with an odds ratio (OR) of 3.57 (95% confidence interval, CI 1.29–9.92). Women who delivered preterm also reported more frequently having a sibling who was born preterm (12.4% vs. 4.2%, p = 0.01), with an OR of 3.18 (95% CI 1.31–7.7). No association was found between the partner’s family history of premature delivery and the patient’s risk of preterm delivery in the present pregnancy.ConclusionsPregnant patients who were born prematurely or who have siblings born preterm have an increased risk of preterm delivery in their own pregnancies. Assessment of female personal and family history of PTD should be used to identify women at risk of having a PTD in the present pregnancy.

Прогнозування ризику розвитку бронхолегеневої дисплазії в передчасно народжених дітей

Bronchopulmonary dysplasia (BPD) is one of the most frequent outcomes of prematurity. Relatively late diagnosis and development of formidable complications that can affect the quality of life in adulthood, determine the need for early BPD prognosis for the timely appointment of effective therapy. Purpose - identification of informatively significant clinical and anamnestic risk factors of BPD based on retrospective analysis and mathematical model creation for the prediction of chronic respiratory disease risk development in prematurely born children. Materials and methods. A retrospective analysis of the medical histories of 280 prematurely born children who were treated in neonatal units was conducted. With the help of sequential Wald analysis, 53 clinical and anamnestic indicators were analyzed, for each of them the relative risk (RR) and diagnostic coefficient (DC) were calculated. Results. Significant, prognostically unfavorable factors for BPD development are gestational age ≤28 weeks (RR=20.30); birthweight ≤1500 g (RR=3.08); duration of non-invasive combined respiratory support over 18 days (RR=3.74); Apgar score 1-3 at the first minute (RR=4.69) and 4-6 at the fifth minute of life (RR=4.19); newborn anemia (RR=3.12); invasive artificial lung ventilation for more than 13 days (RR=5.12). The probability of BPD increases substantially with the presence of retinopathy of the II and III degrees (RR=16.4 and RR=10.15, respectively). Interestingly, breastfeeding markedly prevented BPD development (RR=0.29). Furthermore, a mathematical model is represented to determine BLD development prediction and to diagnose this disease. Conclusions. High validity indicators and ease of use of the mathematical model for the BPD development prediction in prematurely born children make it possible to recommend it in the practice of neonatologists and pediatricians. 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 author.

Development of an innovative technology for predicting the course of COVID-19 based on the analysis of clinical and anamnestic data

The aim – to determine a prognostically significant set of anamnestic (primarily cardiovascular) risk factors and indicators of the initial clinical condition in the population of patients with COVID-19, on the basis of which to develop a scale for assessing the clinical condition to identify patients with a more severe subsequent course of the disease for the individualization of treatment tactics.Materials and methods. The retrospective analysis included data on 104 patients with COVID-19 (50 men and 54 women, aged 24 to 84 years), who during 2020-2021 underwent treatment (16 days) in clinics of Ukraine within the framework of the program for studying the effectiveness of treatment COVID-19. Risk factors (advanced age, inflammatory diseases, hypertension, obesity, diabetes, coronary heart disease, heart failure (HF)), dynamics of the clinical state (heart rate, body temperature, blood pressure, SpO2, respiratory rate (RR), clinical symptoms and signs from all systems of the body) were assessed. Based on the dynamics of the clinical condition (according to a specially developed scale), all patients were divided into subgroup A (66 patients, more severe hospital course of COVID-19, ≥ 7 points) and subgroup B (38 patients, milder course of COVID-19, &lt; 7) points).Results and discussion. Among the anamnestic risk factors (RF) of a more severe hospitalization for COVID-19, the following were more informative than others: age &gt; 53 years (HR 1.8 (1.11–3.02)), history of coronary artery disease (HR 1.42 (1.09–1.85)) and SN (HR 1.67 (1.41–1.96)), as well as a model built taking into account all the estimated RFs according to their significance (HR = 1.88 (1.37–2.74), area under the ROC curve (ROC) 0.73). Among the clinical markers (CM) of the first day, the most informative were: RR &gt; 20/min (HR 1.74 (1.10–2.74)), body temperature &gt; 37.8 °C (HR 1.48 (1.13–1.94)) and a model with eight KM (HR 2.45 (1.55–3.87), ROC 0.80). The obtained scales were additive: the combined scale of RF and CM had ROC 0.84, value &gt; 21 units on the first day of COVID-19 had a sensitivity of 76 % and a specificity of 76 % (HR 2.38 (1.58–3.58)) in predicting the adverse course of the disease during the next 16 days.Conclusions. The risk assessment system developed by us, based on clinical and anamnestic data, on the first day of treatment for COVID-19 allows predicting a more severe course of the disease. The data obtained by us require further study in a prospective study.

Клинико-анамнестические факторы риска антенатальной смерти доношенного плода

Introduction. Current clinical and laboratory methods for assessing the intrauterine growth of a fetus are indirect and often have a low prognostic significance. Meanwhile, the determination of risk factors of antenatal death of a full-term fetus with the assessment of their prognostic significance and the possible preventability of adverse perinatal outcome will identify ways to reduce the stillbirth rate. Aim. Determine the clinical and anamnestic risk factors for antenatal death of a full-term fetus in the Chelyabinsk region. Materials and methods. A retrospective analysis of the medical records of all cases with antenatal fetal death at 37 weeks 0 days – 41 weeks 6 days of pregnancy, registered in the territory of the Chelyabinsk region from 2019 to 2021, was carried out. Two groups were assigned: group 1 – women with antenatal death of the full-term fetus (158 patients), group 2 – women with live full-term births (50 patients). Results. Women with antenatal death of the full-term fetus statistically significantly more often lived in the city of Chelyabinsk and big cities of the Chelyabinsk region, had secondary vocational education and used to smoke tobacco; they had first or second pregnancy and first delivery. Among these women, female pelvic inflammatory diseases, hypertension, endocrine system diseases and specific infectious diseases (HIV infection, hepatitis C and tuberculosis) were statistically more common. These women had statistically more pregnancy-related complications such as hypertension without significant proteinuria; diabetes mellitus arising in pregnancy; gestational edema; false labour up to 37 full weeks of pregnancy; placental disorders; maternal care for poor fetal growth; acute respiratory infections. The following factors have a direct impact on antenatal death at full-term pregnancy: a history of hypertension, moderate pre-eclampsia, placental disorders, and fetal growth retardation. Conclusion. In the presence of risk factors directly affecting the occurrence of antenatal death of a full-term fetus, we consider it appropriate to deliver at 37 weeks 0 days – 38 weeks 0 days of pregnancy in order to reduce the risk of an adverse outcome of pregnancy.

Риски венозных тромбоэмболических событий при больших акушерских синдромах

Aim: Based on the study of the history, course of pregnancy and childbirth, to assess the risks of venous thromboembolic events among women with major obstetric syndromes. Design: Retrospective cohort study using the continuum sampling method. Materials and methods. 200 birth histories were analyzed: group 1 — 55 women with great obstetric syndromes, group 2 — 145 pregnant without them. The history of women, pregnancy outcomes were studied, and an analysis of the risks of venous thromboembolic complications was carried out. Results. Anamnestic risk factors for major obstetric syndromes were a family history aggravated by early thromboembolic events (RR = 3,13; 95% CI: 1,34–7,30), unemployed status (RR = 1,73; 95% CI: 1,32–2,65), preeclampsia in the past (RR = 23,46; 95% CI: 1,28–428,80), first pregnancy (RR = 1,63; 95% CI: 1,04–2,55), chronic arterial hypertension (RR = 8,45; 95% CI: 1,76–40,66). There was a significant increase in the risk of venous thromboembolic complications in patients of group 1 during pregnancy (1 (1–2) points; p &lt; 0.001) and in the postpartum period (3 (1–4) points; p &lt; 0.001). Conclusion. Prognostic markers of great obstetric syndromes were aggravated family and personal obstetric anamnesis, parity, low social status, chronic arterial hypertension. A significant increase in the risk of venous thromboembolic complications in pregnant women and puerperas with major obstetric syndromes was revealed. Keywords: great obstetric syndromes, preeclampsia, risk factors, venous thromboembolic complications.

Наружный генитальный эндометриоз: клинико-анамнестические факторы риска у женщин репродуктивного возраста

Aim. To identify clinical and anamnestic risk factors for the development of external genital endometriosis. Design. Prospective cohort study. Materials and methods. As part of the study, 80 women of fertile age were examined: 54 patients with external genital endometriosis, confirmed by laparoscopy and histological examination (main group), and 26 women of the control group without external genital endometriosis. All participants were interviewed and examined in accordance with the applicable regulatory documents. Results. There were no significant differences in average age, level of education, body mass index, menstrual and reproductive functions, frequency of smoking and the structure of surgical interventions between two groups. However, the endometriosis patients were distinguished by a higher frequency of the digestive system diseases, namely chronic gastritis (p = 0.019); anemia (p = 0.174); benign breast dysplasia (p = 0.304); adhesions in the abdominal cavity (p = 0.095). On the contrary, the frequency of chronic inflammatory diseases of the uterine appendages was higher in the control group (p = 0.0000), which can be explained by the inclusion criteria in this group (planned laparoscopy due to infertility and/or chronic pelvic inflammatory disease). Patients of both groups are characterized by a low parity — on average, less than 1 birth per woman, which can partly be explained by the high frequency of infertility in the studied cohort: 38.8% of all examined, 24.1% of women with external genital endometriosis and 69.2% of women in the control group with a statistically significant predominance in the latter (p = 0.0001). Conclusion. Insufficient diagnostic effectiveness of existing methods of noninvasive verification of external genital endometriosis dictates the need to develop techniques based, among other things, on the consideration of clinical and anamnestic risk factors for the disease development. In addition, the elimination of the detected risk factors can contribute to the prevention of endometriosis development and recurrence after its treatment. Key words: external genital endometriosis, risk factors, noninvasive diagnostics.

Особенности ранней диагностики новообразований яичников

Aim: to identify clinical and anamnestic risk factors for ovarian masses (OM), as well as to clarify the significance of various diagnostic criteria in the early diagnosis of ovarian cancer (OC). Patients and Methods: a retrospective analysis of 50 cases of patients with OM was conducted. The following groups were formed: the main group (50 patients with OM) and the control group — practically healthy female subjects (32 patients). Retrospectively, depending on the results concerning histology of the removed surgical material, the main group was divided into 2 subgroups: subgroup 1 — 37 patients with benign OM, subgroup 2 — 13 patients with borderline and malignant OM. The patterns of the anamnesis, the level of the Ca-125 tumor marker, the values of the Risk of Malignancy Index (RMI), and the tumor histology structure were assessed. Results: during the study, it was found that in patients with OM, diseases of the gastrointestinal tract (GIT), urinary system (24%), pelvic inflammatory disease (PID), as well as menstrual disorders of various types and uterine fibroids (p&lt;0.05) are more common. The incidence of gynecologic cancer in the family history is also significantly higher in patients with OM vs. the control group (36% and 3%, respectively, p&lt;0.05). Elevated Ca-125 values were noted both in the group with benign ovarian masses and in the group with borderline and malignant ovarian tumors.it has been established that the main risk factors for the OC development are diseases of GIT (Odds Ratio (OR) 2,09) and urinary system (OR 1,53), genetic predisposition to cancer of the reproductive organs (OR 1,86), menstrual disorder (OR 1,86), uterine fibroids (OR 1,74) and a history of PID (OR 1,83). Conclusion: despite a large number of studies devoted to the problem of OC early diagnosis, there is still no reliable criterion with high sensitivity and specificity. Female patients with postmenopause and adverse ultrasound criteria should have high oncological alarm of doctors, even with low values of the Ca-125 oncological marker. KEYWORDS: ovarian tumors, neoplasms, ovarian cancer, risk factors, Ca-125, malignancy index RMI. FOR CITATION: Smirnova A.V., Malyshkina A.I., Khrushkova E.P. Characteristics in early diagnosis of ovarian masses. Russian Journal of Woman and Child Health. 2023;6(2):105–111 (in Russ.). DOI: 10.32364/2618-8430-2023-6-2-105-111.

INFORMATION ON PROGNOSTIC MARKERS OF SEVERE ACUTE BRONCHITIS IN PRESCHOOLERS: A STUDY IN SUMY REGION IN NORTH-EASTERN UKRAINE

Introduction. Respiratory infections, especially in children, are a significant global health concern. Understanding the implications of respiratory infections like acute bronchitis is crucial for devising effective management strategies. These infections, including bronchitis, pneumonia, and influenza, contribute substantially to pediatric hospitalizations. Predicting the severity of acute bronchitis in children is essential for personalized treatment and resource allocation. Developing reliable prognostic tools for acute bronchitis can improve outcomes and optimize healthcare resource utilization. Methods. The study spanned four years (2018–2021) at "Saint Zinaida's Children's Clinical Hospital" and "Primary Health Care Center No. 2" in Sumy City Council. It involved 135 preschool children with acute bronchitis (study group) and 28 healthy children (control). The control group matched the age and gender of the acute bronchitis group. Inclusion criteria comprised parental consent, ages 3–6, and a diagnosis of acute bronchitis; exclusions included parental refusal, ages below 3 or above 7, concurrent somatic or allergic diseases, non-compliance, and diagnoses other than acute bronchitis. Various methods were employed, including clinical, laboratory, instrumental, and statistical analyses. The severity of acute bronchitis was gauged using the BSS-ped clinical tool. Immunological status assessment involved determining cellular immunity indicators via enzyme-linked immunosorbent assay. Hormonal status analysis included thyroid and cortisol levels via enzyme-linked immunosorbent assay. Statistical analysis utilized SPSS 26 and probabilistic modeling based on Bayes' theorem for building prognostic models and assessing risk factors for acute bronchitis. Fisher's criterion determined reliability at a significance level of 0.05, categorizing risk degrees from low to critically high based on a posteriori chances. Results. The study successfully identified key clinical, anamnestic, hormonal, and immunological risk factors for severe acute bronchitis in preschoolers, constructing a predictive mathematical model. Breastfeeding and mixed feeding in infants were not associated with increased severity, contrasting with chronic upper respiratory tract disease and parental habits, notably smoking, linked to heightened severity. Cough severity and auscultatory wheezing, with a BSS-ped score of 4, moderately impacted severe acute bronchitis. An outlined prognostic model confirmed hormonal indicators' influence, particularly elevated reverse triiodothyronine levels, on increased risk. Immune cellular activity, specifically CD8+, CD4+, and CD22+, demonstrated pronounced impacts on severe acute bronchitis in preschoolers. A combined aberration of CD3+ and free triiodothyronine, CD3+ and total triiodothyronine, or CD4+ and free triiodothyronine indicated a critically high risk. The model's reliability was affirmed via ROC analysis, displaying a sensitivity of 91.7 %, specificity of 68.2 %, and an AUC of 0.869, indicating its high quality. Conclusions. In summary, chronic upper respiratory tract disease and parental smoking, particularly when both parents smoke, are significant clinical and anamnestic risk factors for severe acute bronchitis in preschoolers. Cough severity and wheezing on the BSS-ped scale contribute to its development. Hormonal indicators, especially reverse triiodothyronine, display notable impacts, with weaker associations observed for total triiodothyronine and cortisol. Immunological status indicators such as CD22+, CD4+, and CD8+ are also linked to severe acute bronchitis. Combinations of altered CD4+ and free triiodothyronine, CD3+ and free triiodothyronine, CD3+ and total triiodothyronine intensify the risk. When evaluating preschoolers with acute bronchitis, attention to clinical history (chronic upper respiratory disease, parental smoking, severe cough, and pulmonary rales) and specific laboratory parameters (concentration of triiodothyronine, cortisol, and serum levels of CD22+, CD4+, and CD8+) is advisable.