Vol 36, No 5 (2019)

Aim. To study the puerperal complications in women with disturbance of fat metabolism associated with hypovitaminosis D3.

Materials and methods. One hundred and two puerperal women were examined after giving birth to a child at the City Perinatal Center.

Results. The number of puerperal complications in the group of women with obesity and hypovitaminosis D occurred twice as more often than in women with normal body mass. From all complications, there prevailed lactostasis and hypogalactia. Only in the group of puerperas with high body mass index and low vitamin D content combined, there were detected subinvolution and puerperal endometriosis.

Conclusions. Patients with obesity and low vitamin D3 content need more thorough preparation to delivery and lactation at “The Mother’s School” when they are observed during pregnancy. Personnel of maternity hospital and patient’s relatives ought to take an active part in puerperal care and promote early activation of puerpera with obesity to reduce possible complications.

Aim. To estimate the informativity of the technique of magnetic resonance tomography (MRT) of pelvic organs in diagnosis of genital endometriosis in women of reproductive age.

Materials and methods. The results of pelvic organs MRT from 415 women aged 18–45 years were analyzed. The examination was implemented using the apparatus Philips Intera 1.5 Tl. The method of copying the results of MR-investigations was used to receive the data on localization, degree of dissemination of endometriosis foci and concomitant diseases of female reproductive system, which were later compared with the results of the existing echographic studies of pelvic organs.

Results. The study demonstrated higher informativity of magnetic resonance tomography in diagnosis of different forms of endometriosis and gynecological pathology associated with it, unlike echography. Out of 415 women, who underwent magnetic resonance tomography of pelvic organs, endometriosis was diagnosed in 20 % of the examined women, while echographic study – only in 4 %. When implementing ultrasound, the signs of malignant neoplasms of the uterine neck and ovaries were not detected in a part of patients, whereas revealed with MRT of pelvic organs and further confirmed by the results of histological studies.

Conclusions. Application of magnetic resonance tomography permits to improve significantly diagnosis of endometriosis that is important for determination of adequate tactics of treatment, taking into account the existing concomitant gynecological pathology.

Aim. Blood serum and urinary procalcitonin (PCT) concentration in healthy persons was studied.

Materials and methods. A single-stage observational study of “case-control” type was performed. The study included 32 men and 37 women of middle age (53.4 ± 16.4 years) with normal renal function. PTC concentration was determined with the method of solid-phase enzyme immunoassay using test-system (Procalcitonin IFA-BEST, Russia).

Results. Blood serum PCT concentration in the examined persons was 0.029 ± 0.016 ng/ml (M ± SD). The number of blood serum samples with PTC level > 0.05 ng/ml was 5.8 % (4 from 69). The mean urinary PTC concentration by 72.59 times exceeded the mean blood serum PTC content and was 2.12 ± 1.832 ng/ml (р < 0.000001).

Coefficient of variation of results for the urine by 1.57 times exceeded the analogous index for the blood serum. When comparing the results of blood serum and urine analyses, no statistically significant differences between men and women were revealed. When estimating the coefficients of linear correlation between PTC content in the blood serum and urine, a weak positive dependence was established (R = 0.302782).

Conclusions. High PTC concentration in the urine permits to suppose that one of the ways of procalcitonin removal from the blood plasma is its elimination by kidneys in unchanged type by means of glomerular filtration.

Aim. To assess the immune status in children of primary school age with functional disorders of the respiratory system, who live in the territory with location of industrial enterprise, producing aluminium.

Materials and methods. Fifty-two children aged 7–11 years with respiratory system disorders, who live in the zone of exposure of aluminium-producing enterprise were examined. Cellular differentiation marker CD127, protein Bcl-2 and TNFR receptor expression levels were identified using the method of flow cytometry. Phagocytic activity of the cells was studied using formalinized sheep erythrocytes; IgG content was determined with radial immunodiffusion method; beta2-microglobulin level – with enzyme immunoassay. Functional status of respiratory system was assessed using spirometry, rhinomanometry methods but functional reserves – with calculated Skibinskaya index.

Results. The prevalence of allergic diseases in the examined children was 2,4 times higher and allergic rhinitis was diagnosed 3,2 times more often than in the group of comparison. The prevalence of bronchial asthma, clinical signs of chronic lympho-proliferative diseases reliably exceeded the level observed in children of comparison group (29.4 %, р = 0.001). There were established the changes in immune reactivity versus the comparison group, manifested by increase in percentage of phagocyting cells, beta2-microglobulin protein, IgG, CD127^–, TNFR and specific IgG to aluminium by 1.1, 1.2, 1.0, 1.7, 2.5 and 1.2 times, respectively; suppression of protein

Bcl-2 expression by 2,6 times (p < 0.05) was registered.

Conclusions. Among children aged 7–11 years, who live in the territory with localized aluminium-producing enterprise, the diseases of respiratory organs with allergic component, reliably associated with aluminium compound contamination, were diagnosed more often than in children of comparison group. Immunologic study detected imbalance between humoral and cellular components of immunity: hyperproduction of specific IgG to aluminium, excess expression of proteins and beta2-microglobulin receptors, IgG, CD127^–, TNFR and deficit of Bcl-2.

Aim. To analyze the epidemiological indices of thyroid tumors in iodine deficiency region.

Materials and methods. The morbidity and mortality of thyroid cancer in Udmurt Republic was analyzed using the data of state statistical accounting documentation of Republican Information Analytical Center and “Republican Clinical Oncological Dispensary named after S.G. Primushko” for 10 years (2007–2018).

Results. In 2018, one hundred thirty two persons in Udmurt Republic were diagnosed thyroid cancer for the first time, 40 (30.6 %) of them had advanced process. Thyroid cancer morbidity in Udmurt Republic increased from 5.39 cases per 100 000 in 2007 to 8.7 cases per 100 000 in 2018. A twenty-year gain was 61.4%. According to prognosis, thyroid cancer morbidity in Udmurt Republic in 2023 will reach 10.23 cases per 100 000 of the population.

Conclusions. According to prognosis, during the next 5 years the level of thyroid cancer morbidity in Udmurt Republic will be growing. Middle-aged women more often suffer from thyroid cancer. It should cause oncologic alarm in this group of the population, especially in iodine deficiency regions.

Aim. To study the knowledge of clinical recommendations of the Ministry of Healthcare of the Russian Federation, acquired by doctors providing dispensary observation regarding contraindications to administration of antihypertensive drugs.

Materials and methods. Questioning of 146 doctors, providing dispensary observation of adults using the standard questionnaire, containing 14 questions-tests. There was implemented the frequency analysis, calculation and comparison of the mean score, Median, Mode in relation to all the group and groups, singled out by the following two signs: work at the hospital for the recent 5 years and awareness of the content of clinical recommendations of the Ministry of Healthcare of RF. Correlation analysis between scores and age was conducted.

Results. The mean score was 3.6 ± 3.3 with maximum 14, Median 1, Mode 1. Nobody from respondents got the maximum score, the best result 12 scores was received by 0.7 % of respondents, 0 scores – 3 %. No correlation between scores and age (r = –0.1, p = 0.4) was revealed. In the group of doctors, working at the hospital for the recent 5 years, during half a year the mean score 5.4 ± 3.5 was significantly higher (t = 3.8, p = 0.001) than in the group of those who did not work 2.9 ± 2.7. In the group of respondents, who indicated their knowledge of the content of clinical recommendations, the mean score 3.6 ± 3.4 (t = –0.4, p = 0.89) did not significantly differ from the mean score 3.5 ± 3.3 in the group of doctors who were not aware of clinical recommendations on arterial hypertension in adults.

Conclusions. The knowledge of clinical recommendations, confirmed by the Ministry of Health of the Russian Federation, should be regularly estimated among the doctors, providing dispensary observation. Practice-oriented training of clinical recommendations is also needed.

Aim. To reveal the regional features and causes of worsening of health among pupils using the results of survey.

Materials and methods. The method of questioning was used to study the prevalence of the factors, conditioned by the mode of life, educational process, informativity of pupils regarding the main risk factors, their loyality to healthy way of life. The study included 247 pupils of the 8–9 forms from 12 secondary schools of the city.

Results. The paper is devoted to the study of the causes of worsening of health among pupils, living in small cities of Russia. There is singled out and presented a group of unfavorable factors, conditioned by pupils’ way of life: malnutrition, intensive educational load, long use of computers and prevalence of bad habits, which negatively influence the development and health of the growing organism.

Conclusions. To preserve pupils’ health in modern conditions, it is necessary to optimize the conditions of training and way of life taking into account regional features. First of all, the manageable factors ought to be used, which do not need additional financial costs: observation of hygienic regime and nutrition at school and at home; improvement of internal environment, perfection of curriculum, health-improving measures, training of healthy way of life.

Unsaturated fatty acids is the key block of cellular membranes, they determine the specificity of high-differentiated cells and are the precursors of eicosanoid synthesis (prostaglandins, thromboxanes, leukotrienes). A marked antiinflammatory, antisclerotic, antiarrhythmic, anticoagulant, neuroprotective and other effects of omega-3 polyunsaturated fatty acids, established in biochemical and experimental studies, stimulated implementation of a large number of epidemiological and clinical investigations. Successful application of polyunsaturated fatty acids in cardiology, neurology and other fields of therapy focuses on such spheres as obstetrics and gynecology.

October 24 marks the 75th anniversary of the birth of Academician Chereshnev Valery Alexandrovich