Analysis of risk factors and predictors of pregnancy loss and strategies for the management of cervical insufficiency in pregnant women at a high risk of preterm birth.

AIM: To identify risk factors and predictors of pregnancy loss and to compare the efficacy of Arabin's pessary with cervical cerclage in women at a high risk of pregnancy loss. MATERIALS AND METHODS: This was a two-center retrospective case-control study that included 240 women at a high risk of preterm delivery. Group I (n = 161) included women who underwent insertion of the Arabin's pessary between 14 and 24 weeks of pregnancy. Group II (n = 79) included women who had undergone circular cervical cerclage during the current pregnancy. All women included in the study received micronized vaginal progesterone at the dose of 200 mg/day until and including 34 weeks of gestation. RESULTS: Threatened pregnancy loss defined as spotting or vaginal bleeding in the first trimester was diagnosed in 29.8% (48/161) of patients in Group I versus 37.9% in Group II (p = .448). Postpartum bleeding occurred in 8.1% (13/161) in women in Group I versus 22.8% in Group II (χ2 = 6.500; p = .011). Our study showed that cervical cerclage was most suitable for patients with history of obstetric complications, cervical length <15 mm, and large isthmic uterine fibroids. The use of the Arabin's pessary reduced the rate of preterm births by 1.7-fold. A cluster analysis demonstrated that predictors of preterm birth in women with a high risk of pregnancy loss included: threatened pregnancy loss associated with chorionic/placental abruption, cervical incompetence, uterine fibroid growth to a large size, history of multiple spontaneous pregnancy losses, cervical tears during past labor, and gestational diabetes diagnosed for the first time during the current pregnancy. CONCLUSIONS: Women with a high risk of pregnancy loss treated with Arabin's pessary or cerclage plus vaginal progesterone had a term delivery rate of 70.4% (169/240). The combined strategy of pregnancy management allowed to markedly reduce the number of preterm births.

[In vitro аntioxidant activity of spices used in human nutrition].

Spices are a traditional food ingredient containing phenolic antioxidants and other phytonutrients. 3 kinds of fresh herbs (dill, parsley, basil), 2 kinds of onions, 11 kinds of dried herbs (vanilla fruits, ground cinnamon bark, ground fruit of cardamom, ground ginger, ground turmeric root, nutmeg seeds, ground dried herbs basil, ground dried herbs marjoram, ground dried herbs of thyme, ground black pepper fruit, bay leaf) have been analyzed. Extraction of flavonoids and phenolic compounds from plants was carried out with 50% ethanol, then analyzed for phenolic compounds, flavonoids, antiradical activity by the DPPH method, reducing power by FRAP method, antioxidant activity in a system with linoleic acid. The results indicate a high potential of the dried herbs to block free radicals in the in vitro model experiments due to the presence of phenolic compounds (gallic acid, 900-1100 mg/100 g) compared with fresh herbs (300-400 mg gallic acid/100 g) . The highest antiradical activity among the studied plants has dried marjoram leaf extract (extract concentration required to bind 50% of the DPPH radical solution - 1 mg/ml). Antioxidant properties are most pronounced in the extract of parsley (inhibits oxidation of linoleic acid in the system at 74.6%). By the ability to exhibit the reducing ability against Fe ions, ground ginger extract differed significantly (68.04 mmol Fe2+/1 kg of raw material). Studies in vitro of antioxidant activity of herbs, spices and dried onions showed that these objects contain phenolic groups, flavonoids, in model experiments in vitro have high antiradical, antioxidant and reducing properties. This indicates a possible favorable role in human nutrition of herbs, onions and spices.

[Modifying effect of physical activity on genetic predisposition to obesity].

AIM: To evaluate the modifying effect of physical activity on the association of ADRB3, CLOCK, FABP2, FTO, PPARA, PPARD, PPARG, PPARGC1A, SHBG, UCP2 and UCP3 gene polymorphisms with body mass index (BMI), body fat mass, and risk of obesity. SUBJECTS AND METHODS: The investigation enrolled 582 students and 215 athletes who showed moderate and high physical activities, respectively. The students' body composition was estimated with a DIAMANT-AST bioimpedance analyzer. Gene polymorphisms were determined by polymerase chain reaction (PCR) or real-time PCR. RESULTS: No differences in the rate of obesity risk alleles were found between normal-weight, and overweight or obese students. Correlation analysis in the total group of students revealed an association of the A allele of the FTO gene with BMI (p=0.0011) and body fat mass (p=0.0031). Comprehensive analysis summarizing the total number of obesity risk alleles for 7 polymorphisms of the PPARA, PPARD, PPARG, PPARGCIA, FTO, FABP2, and UCP2) genes in each individual showed that a subgroup of male students having a large number of obesity risk alleles (4-9) had higher BMI (22.6 ± 2.73 kg/m2) than that of students having a small number of obesity risk alleles (20.8 ± 2.81 kg/m2; p=0.0209). This pattern was not observed in the group of athletes regardless of gender and sports specialization. CONCLUSION: This investigation has demonstrated that physical activity has modifying effects on individuals who are genetically predisposed to obesity. Moderate and high physical activity considerably reduces the risk of obesity even in the presence of genetic risk factors.

[Study on association of FABP2 gene Ala54Thr polymorphism with risk of obesity, body fat mass and physical activity].

Obesity is a multifactorial disease which depends on the interaction between genome and environment. Fatty acid-binding protein 2 (FABP2) regulates lipid transport, intestinal absorption and metabolism. The aim of the study was to investigate the interrelation between the FABP2 gene Ala54Thr polymorphism, body mass index and body fat mass and to study distribution of genotypes and alleles frequencies of FABP2 gene in athletes and individuals who are not involved in sports. 315 athletes of different sport disciplines and levels and 612 controls (predominantly students) participated in the study. Genotyping for the FABP2 gene Ala54Thr polymorphism was performed by PCR. Body composition was analyzed by bioimpedance method. The study did not confirm the association of FABP2 gene Ala54Thr polymorphism with the risk of obesity and body fat mass. However, the frequency of the Thr54 allele was significantly higher in elite stayers (50.0%, p = 0.025) and combat athletes (46.2%, p = 0.013) in comparison with controls (32.2%). Thus, FABP2 gene Ala54Thr polymorphism is associated with the predisposition to endurance athletic performance.

[Biochemical markers of bone formation in hemodialysis and after allotransplantation of cadaveric kidney].

AIM: To ascertain informative value of estimation of bone forming markers in patients on chronic hemodyalisis (CHD) and recipients of cadaveric kidney (CK). MATERIAL AND METHODS: Parathyroid hormone (PTH), beta-crosslaps (CTX), osteocalcin (OC), amino-terminal procollagen propeptide 1 (PINP), bone alkaline phosphatase (BAP), bone mineral density (BMD) were determined in 152 patients on CHD (89 males and 63 females aged 49 +/- 13 years) and 195 CK recipients (106 males and 89 females aged 42 +/- 12 years) 30 +/- 38 months after kidney transplantation. RESULTS: PTH, CTX and BAP determination specifies skeletal disease (secondary hyperparathyroidism or adynamic bone disease) in CHD patients. In patients with CK recipients osteoporosis differed from osteopenia by higher levels of PTH, CTX, OC in the absence of any differences in BAP, PINP. All bone forming markers were lower than CTX showing suppression of bone forming. Bone fractures in CK recipients' anamnesis were associated with OC and BAP decrease in men and low border of normal OC in women. Determination of bone formation and resorption markers in patients on CHD and CK recipients is of great clinical importance.