Ultrastructural markers of tissue endometrial receptivity in patients with recurrent implantation failure.

The scanning electron microscopy of the endometrial surface epithelium during the 'implantation window' was performed in 119 patients with uterine factor of infertility or recurrent miscarriage due to endometrial hypoplasia. Ultramorphological picture of the surface endometrial epithelium was characterized by aplasia and hypoplasia of pinopodes (67.39%), dense cell - cell contacts (69.53%), heteromorphy of secretory cells (15.22%) in combination with atypia of microenvironment cells (50%) in patients with infertility. The asynchronous development of pinopodes (46.67%) and the absence of intercellular contacts separation during the 'implantation window' (84.44%) was observed in patients with recurrent miscarriage. The revealed disturbance determines the mechanisms of the blastocyst adhesion violation and trophoblast invasion in the different stages of implantation in patients with uterine factor of infertility and recurrent miscarriage.

Pathogenetic role of vitamin D deficiency in the development of menstrual dysfunction in pubertal girls: a literature review.

In the literature review, 50 scientific sources surrounding the problem of vitamin D deficiency, 80% of which amounted to the issuance of the last 5 years, have been analyzed. Despite the impact of vitamin D deficiency on the health of children and adolescents has been studied for a long time, the information on the role of vitamin D in the formation of menstrual function in pubertal girls is scant and ambiguous. Among the hypotheses of menstrual dysfunction with vitamin D deficiency, neurohumoral regulation of the hypothalamic-pituitary-ovarian system is considered to be essential due to the localization of vitamin D receptors (VDR), unlike other vitamins, in the nuclei of various tissues and organs. However, in the last 10 years, data on the role of genetic polymorphism of the VDR gene in the pathogenesis of various manifestations of menstrual dysfunction have been accumulated. Some studies indicated a beneficial effect of cholecalciferol on such menstrual dysfunctions as oligomenorrhea and dysmenorrhea. Regarding numerous data on the role of vitamin D, both traditional and recently published, there is a strong correlation between vitamin D deficiency and other various factors, determining a wide range of polymorphic clinical manifestations where menstrual dysfunction is essential in girls at the age of puberty.

Risk factors of cerebral ischemia in infants born to mothers with gestational diabetes.

OBJECTIVES: Gestational diabetes mellitus (GDM) is carbohydrate intolerance that occurs during pregnancy. The present study was arranged to determine the risk of cerebral ischemia (CI) in infants born to mothers with gestational diabetes mellitus and MTHFR gene polymorphism. MATERIAL AND METHODS: The study includes 70 pregnant women with GDM, divided into two groups depending on existence of cerebral ischemia (CI) in newborn infants. All patients were tested for coagulation cascade components, polymorphisms of the methylenetetrahydrofolate reductase (MTHFR) gene and assessed by thromboelastography (TEG). RESULTS: We observed that there was an increased frequency (74.2%) of 1298С MTHFR genotype carriers among women with CI newborns. The state of hypercoagulation according to both coagulation cascade tests and TEG data was diagnosed in women of this group. CONCLUSIONS: The results of this study suggest that hyperglycemia may program the development of cerebral ischemia in infants born to women with 1298С MTHFR gene polymorphism.

[CHARACTERISTICS OF THE CONDITION OF FULL-TERM NEWBORNS FROM THE GROUP OF HIGH PERINATAL RISK DURING VACCINATION PERIOD IN THE MATERNITY HOSPITAL].

AIM: Evaluation of the volume of immune prophylaxis work at the stage of administering aid to newborns at the early neonatal period. MATERIALS AND METHODS: Case-control type cohort retro- spective study was carried out, 160 medical reports of deliveries and histories of development of illness of newborns during the period of March-October 2014 were analyzed. Statistical treatment of data was carried out using Statistica 7.0 package. RESULTS: Principal nosologic units in pregnant women and their newborn children, volumes of primary vaccination (against viral hepatitis B, tuberculosis) in maternity hospitals in children with perinatal pathology and healthy newborns, reasons for medical counterindications,were determined. CONCLUSION: The process of vaccination in perinatal center has its own features: a high amount of medical counterindications and thus a low coverage of primary vaccination of newborns, not exceeding 40%. Each child requires indi- vidual approach, the question of sequence and calendar of vaccination is solved taking into con- sideration the health condition. Healthy newborns are vaccinated according to the national vac- cination calendar except those children whose parents reject vaccination.

Epidemiology of critical states during pregnancy after assisted reproductive technologies.

AIM: The aim of this research was to have a thorough study of predictors of critical states during pregnancy after assisted reproductive technologies. MATERIALS AND METHODS: A retrospective study of 303 patients with "near-miss," out of which 37 are pregnancy cases after ART (the main group) and 265 are spontaneous pregnancy cases (the control group). RESULTS: Pregnancy after ART constituted 12.3% of all critical states. In the main group (10.8%), severe ovarian hyperstimulation prevailed over all possible reasons for critical states within the period of up to 22 weeks of gestation, whereas bleeding predominated in the control group (57.1%). When pregnancy terms exceeded 22 weeks, the leading reason for "near-miss" in the main group was preeclampsia (59.5%) with underlying thrombophilia (29.7%) and gestation pancreatic diabetes (32.4%); bleeding was the main factor in the control group (36.6%). CONCLUSION: Women after assisted reproductive technologies constitute a high-risk group for critical obstetric states not only in the nearest time period but also long after ART.

The molecular and genetic aspects of adolescent girls anomalous uterine bleeding: the role of endothelial dysfunction syndrome.

The objective of the study is to assess NOS3 and ESR1 gene polymorphism in adolescent girls born with low birth weight (LBW) and suffered by anomalous uterine bleeding (AUB). A total 95 adolescent girls were studied including 32 born with LBW and AUB; 36 girls with normal birth weight and AUB; and 27 healthy girls. Single allele gene polymorphism NOS3 786T > C, 894G > T, ESR1 351A > G and 397T > C was studied. The existence of polymorphous allele С gene NOS3 786Т > С (for homozygote OR = 2.03; 95% CI: 1.12-3.68; p = 0.04; for heterozygote OR = 1.68; 95% CI: 1.09-2.60; p = 0.046) and genotype Pvull-CC ESR1 (OR = 4.58; 95% CI: 0.97-21.68; p = 0.04) was detected in LBW girls with AUB. It was suggested that intrauterine programming of endothelial dysfunction syndrome could play a significant role in the development of AUB in adolescent girls born with LBW.

Maternal and newborn infants amino acid concentrations in obese women born themselves with normal and small for gestational age birth weight.

This study was undertaken to compare amino acid concentrations in maternal and newborn infants' serum in normal pregnancy and two groups of obese women who were born themselves with normal and small for gestational age (SGA) birth weight. Maternal cholesterol, lipoproteins concentrations and maternal and infants amino acid concentrations were evaluated at the time of delivery in 28 normal pregnancies, 46 obese pregnant women with normal birth weight (Ob-AGA group) and 44 obese pregnant women born themselves SGA (Ob-SGA group). Mean birth weight of newborn infants in Ob-SGA group was significantly less than in normal and Ob-AGA groups. Cholesterol and lipoproteins were significantly elevated in obese women (more prominent in Ob-SGA group). Most amino acid concentrations and fetal-maternal amino acid gradients were significantly lower in Ob-SGA group. These data suggest significant changes in placental amino acid transport/synthetic function in obese women who were born themselves SGA.

Design and electronic structure of new styryl dye bases: steady-state and time-resolved spectroscopic studies.

A comprehensive investigation of the electronic structure and fast relaxation processes in the excited states of new styryl base-type derivatives was performed using steady-state, pico-, and femtosecond time-resolved spectroscopic techniques. Linear photophysical parameters of new compounds, including steady-state absorption, fluorescence, and excitation anisotropy spectra, were obtained in a number of organic solvents at room temperature. A detailed analysis of the fluorescence lifetimes and ultrafast relaxation processes in the electronically excited state of the styryl bases revealed an important role of solvate dynamics and donor-acceptor strength of the molecular structures in the formation of their excited state absorption spectra. Experimental data were in good agreement with quantum chemical calculations at the time dependent density functional theory level, combined with a polarizable continuum model.

[Heparin electrophoresis by sinusoidal modulated currents in the combined treatment of chronic fetoplacental insufficiency]. / Geparin-élektroforez sinusoidal'nymi modulirovannymi tokami v kompleksnom lechenii khronicheskoi fetoplatsentarnoi nedostatochnosti.

Physicochemical grounds are presented for application of heparin electrophoresis with sinusoidal modulated currents (SMC) for correction of impaired fetouteroplacental circulation and blood rheocoagulation basing on the evidence obtained in 95 gravidae on gestation trimester II. 25% of them were in the group of risk by chronic fetoplacental insufficiency (CFPI), 63% had compensated CFPI and 12% of patients--subcompensated CFPI. 50 patients were treated with drugs SMC heparin electrophoresis, 25 patients received SMC and basic medication, 20 patients were given drugs only. Compared to drugs or SMC treatment only, SMC heparin electrophoresis produced more beneficial effects on hemostasis, barrier placental function, reduced frequency of premature and operative labour.

[Clinico-pathogenetic variants of neurocirculatory dystonia in patients with a chronic focal infection of the upper respiratory tract]. / Kliniko-patogeneticheskie varianty neirotsirkuliatornoi distonii u bol'nykh s khronicheskoi ochagovoi infektsiei verkhnikh dykhatel'nykh putei.

Particular features have been studied of clinical course of neurocirculatory dystonia (NCD) in 604 patients with chronic focal infection (ChFI) of upper respiratory tract. Comprehensive paraclinical examination of patients included the analysis of actual psychoemotional state and certain psychophysiological parameters such as time for simple and complex sensomotor reaction, memory, attention; status of vegetative regulation (tone, reactivity, vegetative security of activity) and its neurohumoral and metabolic provision; adaptive potentialities of vegetative, neuroendocrine and cardiorespiratory systems to mental, psychoemotional and physical demands; tonsillocardiac and palatocardiac reflexes according to an original methodology. Described for the first time are two clinico-pathogenetic variants ("peripheral" and "central") of NCD in patients with ChFI, which can be distinguished by severity of clinical manifestations, as well as by degree of disturbances in homeostasis and adaptation in vegetative, neurohumoral, somatic and psychoemotional spheres. Practical significance of the aforementioned variants consists in feasibility of employing pathogenetic approaches to the treatment of NCD and ChFI patients. Pathogenetic method of treatment of patients with NCD and ChFI is discussed.

[Adaptation to physical and psychoemotional loads and mental work capacity in patients with neurocirculatory dystonia]. / Adaptatsiia k fizicheskim i psikhoémotsional'nym nagruzkam i umstvennaia rabotosposobnost' u bol'nykh neirotsirkuliatornoi distoniei.

Mental performance and adaptation to exercise and psychoemotional loads were studied in 119 patients with neurocirculatory asthenia (NCA), 245 patients with chronic focal infection (CFI) of the upper airways, and 247 NCA patients with CFI. Exercise tolerance was measured at spiroergometry, intellectual and psychoemotional adaptation were assessed by shifts in attention and fatigue while working with Schulte tables under conditions of time limits and the results criticism, vegetative reactivity was tested with insulin and epinephrine, variation pulsograms recorded vegetative provision of physical, intellectual and psychoemotional activity. Abnormalities in mental performance and the above adaptation related to clinical presentation of NCA and CFI as well as to vegetative regulation were registered in NCA+CFI patients. Mechanisms of the alterations observed and the role of CFI in their genesis are discussed.

[Neurocirculatory dystonia in patients with a chronic focal infection: the mechanisms of its formation and development]. / Neirotsirkuliatornaia distoniia u bol'nykh khronicheskoi ochagovoi infektsiei: mekhanizmy formirovaniia i razvitiia.

Clinical manifestations of neurocirculatory asthenia (NA) were analyzed in 604 patients with associated chronic focal infection. It is shown that the latter infection produces negative effects on clinical symptoms of NA, its course, temporary disability and effectiveness of treatment. Vegetative reactivity and vegetative activity in NA patients with the infection were affected to a greater degree than in NA patients without the focal infection. The role of afferent impulses from the nasopharynx reflexogenic zone in the genesis of clinical specificity and vegetative regulation defects in NA patients is discussed.

[Pre-clinical diagnosis of toxemia in the second half of pregnancy in a day-care hospital]. / Doklinicheskaia diagnostika toksikoza vtoroi poloviny beremennosti v usloviiakh odnodnevnogo statsionara.

In this study +the purpose to improve diagnostic precision in preclinical forms of late toxemia, the central and peripheral circulation and hemostasis have been evaluated in women during their four day-stay visits scheduled for a pregnancy. Transition of normal pregnancy to "++pre-toxemic" was most commonly seen in the second trimester. Platelet counts and levels of fibrinogen and beta-fibrinogen proved to have the highest predictive value. A decision-making rule was designed for categorization of pregnancies into normal and "++pre-toxemic" and was found to have a 90% efficiency.

[Improving specialized services for women with habitual abortion and for premature infants]. / Sovershenstvovanie okazaniia spetsializirovannoi pomoshchi zhenshchinam s nevynashivaniem beremennosti i nedonoshennym detiam.

The package of specially developed organizational and therapeutic measures ensuring the life protection in perinatology++ and first postnatal months was found to be mandatory for reaching a higher survival rate in premature children. The adequate structure of medical institutions responsible for the treatment of miscarried pregnancy and the care for premature children was considered as the most important constituent of the package.