[EPIDEMIOLOGY, STRUCTURE AND ALGORITHM OF MANAGEMENT OF PREGNANT WOMEN WITH EXTRAGENITAL PATHOLOGY OF THERAPEUTIC PROFILE].

Purpose of the study - the study of the extragenital pathology (EGP) structure in pregnant women according to the requests for medical help. The screening survey was attended by 742 pregnant women. Average age was 28,4±5,5 years. A retrospective analysis of the causes of calls to pregnant ambulance carriages was carried out for 2012-2013. On the basis of obtained data was suggested an algorithm of pregnant women with EGP management. In the structure of EGP in one profile led hematology - 306 cases (41.2%), followed by nephrology - 290 (39.1%) and gastroenterology (38.8%) - 288 cases, respectively. In the structure of requests for emergency medical care for pregnant first place occupied by respiratory diseases (2012 r - 28%, 2013- 30%), followed by urinary system diseases (2012 - 19.6% 2013 - 17.2% r ). Obtained data formed the basis for the algorithm to identify risks and provide medical care for pregnant women with extragenital pathology. In the structure of the screening study prevailed hematology profile diseases, and respiratory system diseases often were the reason for emergency medical care. The result of this study became the creating of the algorithm for medical care delivery.

[The possibilities of serum cystamine C in diagnostic of pyelonephritis in pregnant women Hematology.]

The cystamine C is considered as one of markers of functional condition of pregnant women. The actual study was carried out to assess possibility of applying cystamine C as a biological marker of pyelonephritis in pregnant women. The sampling consisted of 126 pregnant women with various terms of gestation. The participants were separated in two groups. The group I included 64 women with pyelonephritis and the group II included 62 women without pyelonephritis. Te serum values of cystamine C were detected using enzyme-linked immunosorbent assay. The statistical analysis was implemented using non-parametric methods, including Kruskal-Wallis criterion for comparison of 3 independent groups and Mann-Whitney (Wilcoxon) criterion for a posteriori comparisons. The comparative analysis of values of cystamine C in pregnant women discovered, depending on term, increasing of its level since term II - 0.815 (0.622; 0.914) and even higher values in term III - 1.076 (0.917; 1.463) (p=0.0007). This trend repeats at minute analysis of indices of cystamine C in each group separately. The differences in values of cystamine C in two groups in total and between terms were lower statistically significant levels. However, in the group of women with pyelonephritis its values in terms I and III were higher than in the group of women without pyelonephritis. The highest values of content of cystamine C in pregnant women (p=0.0007) were observed in term III. The inter-group differences of serum values of content of cystamine C were absent that does not allow to recommend it as a early marker of damage of kidneys in pregnant women with pyelonephritis.

[Nephrotic syndrome in a female patient with Rapunzel syndrome].

The Rapunzel syndrome is a rare complication of gastric trichobezoar, which may be long insidious. Systemic hair eating gradually leads to bezoar growth, gastritis, gastric mucosal ulcerations, and evacuatory disorders. The Rapunzel syndrome may cause acute and chronic bowel obstruction, peritonitis, pancreatitis, appendicitis, anemia, hypoalbuminemia, and allergic manifestations. Neither proteinuria nor nephrotic syndrome is depicted in any of the 38 Rapunzel syndrome cases described in the literature. The authors present the first case of gastric trichobezoar extending to the small bowel (its total length was 118 cm), which gave rise to chronic recurrent partial bowel obstruction, causing intoxication nephrotic syndrome in a 20-year-old women with trichotillomania. The nephrotic syndrome became a reason for her admission to a nephrology department and had specific features: it was unaccompanied by hypercholesterolemia, it rapidly regressed and completely disappeared after surgical removal of the trichobezoar weighing 1980 g.

[Difficulties in the differential diagnosis of splenomegaly]. / Trudnosti differentsial'noi diagnostiki splenomegalii.

The authors discuss diagnostic difficulties that may occur in the interpretation of splenomegaly. In some cases, other tumorous formations, palpable in the left hypochondrium (renal tumor and retroperitoneal fibroma in cases demonstrated) may be taken for splenomegaly. In other cases, diagnostic difficulties may be related to establishing the cause of genuine splenomegaly. Out of 10 patients with genuine splenomegaly, the cause of which could not be ascertained at the prehospital stage, the enlargement of the spleen in 2 was due to liver cirrhosis, in 3, to subleukemic myelosis, in 1, to splenic tuberculosis, in 2, to multiple capillary angiomas of the spleen, in 1, to chronic monocytic leukemia, and in 1 patient, to splenic echinococcosis. In 3 patients out of the 10, the diagnosis was verified by surgery followed by histological examination of the spleen. The conclusion is made about the necessity of the use of clinical and laboratory examinations, of patients with obscure "splenomegaly" together with the use of x-ray and ultrasonography of the spleen, kidneys, gastrointestinal tract, puncture of the bone marrow and spleen. In some cases, splenectomy may be performed along with histological examination of the spleen as the final stage of differential diagnosis of splenomegalies.

[Several aspects of alcohol use among students]. / Nekotorye aspekty upotrebleniia alkogolia studentami.

1458 students were surveyed by using the method of anonymous questionnaires. It was found that 35.3 percent of students consumed alcohol, and the incidence of alcohol abuse was increasing with years of study. The majority of students (62 percent) started to drink at the age of 15-18. Notwithstanding, only one-fourth of students received information on harmful effects of alcohol abuse at school, from teachers. All this necessitated to search for effective methods of early identification of alcoholization, and also more effective forms of anti-alcoholic education, more active involvement of students in these activities, in the struggle for healthy lifestyle.

[Detection of pathology of the urinary system in students during preventive mass screening]. / Vyiavlenie patologii organov mochevoi sistemy u studentov v usloviiakh massovogo profilakticheskogo osmotra.

Screening tests including the questionnaire method, urine analysis and radiorenography were used during mass screening of 1330 students. Comparison of the results of the first two methods showed a good informative value of the questionnaire method for the detection of pathology of the kidneys and urinary tracts. Radiorenography performed in 106 students with the detected nephrological symptom complex (risk group) revealed some changes practically in every other "risk group" student.