The concomitant estrogen-dependent diseases and the ovarian reserve condition for patients with severe peritoneal endometriosis, included in the vitro fertilization programmes

Aim. Is specification of the nature and frequency of concomitant forms of genital endometriosis and other estrogen-dependent diseases (EDD) for the infertile women with severe peritoneal endometriosis (PE), as well as the assessment of the ovarian reserve condition for the patients of different ages. Materials and methods. The total 142 infertile women with severe peritoneal endometriosis (IIIIV stage of the external genital endometriosis according to the American Fertility Society classification) were examined at the age of 32.33.2 years (minmax = 2340 years). The clinical status assessment was conducted, using a standard set of diagnostic procedures, prescribed for the inclusion of patients in the IVF program. The ovarian reserve was estimated by the level of the anti-Mullerian Hormone level determined by the immunoenzyme method. Results. The concomitant 2-sided endometriotic ovarian cysts (96%), myoma (19.7%) and the adenomyosis (16.9%) were most common for the patients with severe peritoneal endometriosis. The severely reduced the anti-Mullerian Hormone rates (0.4 ng/ml) were much higher among patients 35 years old (24.6% compared to 10.6% for younger patients; p=0.028). Conclusion. The infertility for severe peritoneal endometriosis is supported by concomitant estrogen-dependent diseases, of which 2-sided endometriomas, adenomyosis and uterine myoma are of the most pathological. The low efficiency of IVF in the treatment of patients with severe peritoneal endometriosis and concomitant estrogen-dependent diseases is explained by the aggravation of the embryonic and endometrial factors for the infertility. The other reason that worsens the results of IVF for such patients is late reproductive age (35 years) that increases the observed reduction of the ovarian reserve.

EVALUATION OF IMMUNOLOGICAL CHANGES IN PATIENTS WITH DIFFUSE FORM OF AUTOIMMUNE THYROIDITIS DURING LASER PHOTODYNAMIC THERAPY

The purpose of the study. To study the nature and dynamics of changes in humoral and local immunity during laser photodynamic therapy in patients with diffuse forms of autoimmune thyroiditis. Materials and methods. Laboratory tests of blood plasma were performed on 160 patients with long-lasting autoimmune thyroiditis in different age groups to determine humoral and local immunity. Here, information on the level of immunoglobulins A, G, M (IgA, IgG, IgM), the amount of interleukin-1 β (IL-1 β), tumor necrosis factor α (TNF-α) was determined in blood samples by the immunoenzyme method. The dynamics of laboratory parameters in all three groups of patients were studied on days 7 and 15 of treatment. These values were determined using reactives from “VectorBest” LLC (Russia). Results. In elderly patients with long-term autoimmune thyroiditis, a downward trend in TNF indices has been observed, which is an indication of the severity of the pathological process. The higher the amount of α2-MG in autoimmune thyroiditis and diffuse toxic urination, and the slower the normalization during treatment, the higher the probability of recurrence of the process. Conclusion. The combined use of modern laser technology in the treatment of patients with autoimmune thyroiditis expands the possibilities of conservative therapy and complements the arsenal of effective methods of treatment of this disease. The simplicity of the methods, ease of application, reliability, the absence of thermal effects on the thyroid gland creates ample opportunities for the application of this method in clinical practice.

THE NEUROENDOCRINE SYSTEM RESPONSE OF 2-5 G COMMUNICATION ELECTROMAGNETIC FIELD ANIMAL EXPOSURE

Background. The neuroendocrine effect on the hypothalamus-pituitary-adrenal cortex axis is significant example stressor of electromagnetic exposure for biological object. Aim. The neuroendocrine effect investigation of multi-frequency electromagnetic field laboratory animals’ exposure from 2-5 generations cellular base stations Methods. The neuroendocrine status evaluated by corticosterone and adrenocorticotropic hormone (ACTH) concentrations in blood exposed and sham rats. ACTH and corticosterone rat blood assessed by immunoenzyme method. Results. The results of the multi-frequency electromagnetic field laboratory animals’ exposure from 2-5 generations cellular base stations in a chronic experiment showed wave-like changes in the hypothalamic-pituitary-adrenal function. These changes are manifested in an immediate increase in corticosteroids secretion and depression of the corticosteroid response to normal or subnormal levels. After 3 month chronic exposure there was a secondary rise in hormonal secretion.

Evaluation of monomeric prolactin level by TRACE method and precipitation with polyethylene glycol

Prolactin exists in various forms including the monomeric biologically active form (23kDa) and a higher molecular weight form, bound most commonly to IgG, known as macroprolactin (>100kDa). Macroprolactin lacks biological activity and is one of the causes of false-positive results. In Russian Federation the most common method for macroprolactin determination is PEG precipitation test. We had conducted a retrospective analysis of 37 samples of patients with hyperprolactinemia (3 of them were males). The mean age was 30 [25;35] years. Prolactin level was measured by the immunoenzyme method with manual PEG precipitation and TRACE. The mean values found by the immunoenzyme method with manual PEG precipitation were 461,6 [375,0;821,2] mU/l, by TRACE - 449,9 [357,2;749,2] mU/l. The number of patients with normal prolactin levels was 30% (11) confirmed by two methods, high prolactin level at 46% (17). The prevalence of clinical symptoms of hyperprolactinemia was not differ depend the groups. The phenomenon of macroprolactinemia was registered in 32% (12) of patients. In 8 persons of this group normal prolactin level was revealed and in 4 patients hyperprolactinemia was found by TRACE. Measurements of prolactin levels by the TRACE method is useful for correct diagnosis in patients with equivocal results received by traditional method with PEG precipitation.

P1391Plasma aldosterone level in different forms of atrial fibrillation

Background. Hyperactivation of the renin-angiotensin-aldosterone system plays a key role in the development of structural remodeling underlying the atrial fibrillation (AF). Nevertheless, the role of excessive aldosterone production in AF development has not been studied. Purpose. The study aims to evaluate the aldosterone levels in different forms of AF and sinus rhythm. Methods. The study included 130 patients (the main group) with non-valvular AF. Of these, 40 (30.8%) patients had permanent, 50 (38.4%) – persistent and 40 (30.8%) – paroxysmal AF. The control group consisted of 40 patients with cardiovascular pathology, who did not have a history of AF episodes. Plasma aldosterone levels were measured by immunoenzyme method. In patients with paroxysmal and persistent AF measurement was perfomed during AF episode before restoration of sinus rhythm. Aldosterone reference values was considered as 40-160 pg/ml. Results. Aldosterone levels were significantly higher in patients of the main group compared to the control (141.5 ± 41.8 pg/ml vs 105.0 ± 33.1 pg/ml, P < 0.001). It was the highest in paroxysmal and persistent AF and lower – in permanent AF. Hyperaldosteronemia (>160 pg/ml) prevalence was significantly higher among all patients of AF group compared to the control (32.3% vs 7.5%, respectively, P = 0.004), however multiple comparisons showed significant differences between paroxysmal AF (47.5%) and sinus rhythm only. Conclusion. Plasma aldosterone level is significantly higher in AF compared to sinus rhythm. In patients with paroxysmal and persistent AF it’s concentration is higher than in patients with permanent AF.

The availability of the vitamin D among children with allergic disease caused by the polymorphic gene VDR

Objective: The objective is to analyze the availability of vitamin D in children with allergic diseases (AD) in polymorphism of the vitamin D receptor (VDR) gene.Methods: The main group included 130 children with allergic diseases aged from 1.5 to 16 y.o. The control group included 41 apparently healthy children aged from 1 to 10 y.o. The analysis of polymorphic markers FokI (rs2228570), BsmI (rs 1544410) and TaqI (rs 731236) of gene VDR was carried out by polymerase chain reaction method in realtime mode using detecting amplifier DT-96 and DNA-diagnostics sets. The assay of metabolite 25(OH) D (25-Hydroxyvitamin D2 and D3) was carried out by an immunoenzyme method.Results: Children with AD demonstrated a significantly increased degree of incidence of A-allele in the site of BsmI gene VDR and carriage of homozygous (A/A) and heterozygous (G/A) of its genotypes. The statistically significant decrease of 25 (OH) concentration was established in heterozygous variant A/G and in homozygous variant G/G of FokI site of gene VDR.Conclusions: The findings lay the groundwork for development of individual approach to prevent vitamin D deficiency in children with AD.

Clinical features of infectious mononucleosis in children, depending on the etiological factor

Objective: The objective is to analyze clinical and laboratory features of infectious mononucleosis (IM) depending on disease etiology.Methods: 102 children with IM aged from 1 to 15 y.o. were examined. Polymerase chain reaction and immunoenzyme method were used to verify disease etiology.Results: In patients with Epstein–Barr virus and mixed infection, the most pronounced manifestations of lymphoproliferative syndrome and tonsillitis, high content of atypical mononuclear cells in peripheral blood are detected. Aspects of IM of cytomegaloviral etiology were notable for the prevalence of toxic syndrome along with other less pronounced clinical and laboratory manifestations of the disease.Conclusions: The detected features of the aspects of IM depending on etiological factor allow to prognosticate a variant and a character of the disease course and to early improve the therapy.

Usage of ursodeoxycholic acid in cardiology (literature review and own data)

Ursodeoxycholic acid (UDCA) influences bile formation and excretion. Apart from that, UDCA has some pleiotropic effects, which can be a basis for usage of this drug for treatment of cardiovascular diseases. We held a scientific literature review in РubМed database and domestic literature sources according to key words “ursodeoxуcholic acid”, “chenodeoxуcholic acid”, “enterohepatic circulation”, “bile acids”. It was revealed that UDCA has a wide spectrum of action because of its cytoprotective, anti-apoptotic, anti-inflammatory, anti-oxidative and immune-modulating effects, which are of particular importance in cardiology. Some authors propose to use UDCA in patients with ischemic heart disease, especially in case of comorbid metabolic syndrome and nonalcoholic steatohepatitis. We determined the level of leptin in the blood by immunoenzyme method in 43 patients with arterial hypertension before and after a month of outpatient treatment by atorvastatin or ursodeoxycholic. It was shown that both drugs led to significant decrease of blood serum atherogenic influence due to decrease of total cholesterol and cholesterol of low-density lipoproteins (more expressed in the statin group) and due to decrease of previously increased leptin level (more expressed in the UDCA group). Investigation of drug influence on adipocytokinessynthesis in patients with cardiovascular diseases is perspective in terms of its correction possibilities.

Collective Immunity to Virus Measles of Medical Workers and Students of Medical Colleges in the Republic of Tatarstan

Relevance. Within the framework of the state assignment in the, Kazan Scientific Research Institute of Epidemiology and Microbiology together with the Department of Rospotrebnadzor in the Republic of Tatarstan, the analysis of the tensions of collective immunity to measles in at-risk groups among medical workers, students of medical colleges in Kazan, Naberezhnye Chelny, Buinsk and Muslyumovsky districts for the period 2015‒2017.Materials and methods. Immunoenzyme method of analysis studied the intensity of immunity against measles in 1107 serum samples of medical workers from 19 medical and preventive institutions in cities and some regions of the Republic of Tatarstan, and students of medical schools and colleges.Results. It was established that out of 480 medical personnel, 363 (75,63 ± 2,253%) were seropositive to the measles virus, and 117 (24.38 ± 3.969%) were seronegative. Coverage by vaccination and revaccination against measles among the sample group of medical workers did not reach the level of 93% (84.38 ± 1.657%), which does not prevent the outbreak of measles among this group. According to the results of a sample survey of antibodies to measles virus among students of medical schools and colleges of the Republic of Tatarstan (data for 2016 and 2017), it was found that the proportion of seronegative measles virus among students in large cities of the Republic of Tatarstan in 2016 was 52.35 ± 2,99%, and in 2017, 42.32 ± 2.958% of the people. The proportion of students who were seronegative for measles virus for two years of the study (2016–2017) averaged 45.07 ± 2.979%.Discussion and conclusions. The results indicate the need to continue conducting studies on seromonitoring of collective immunity to measles in medical workers, students in secondary and higher medical schools.