bluuebunny/crossref_metadata_2025 huggingface dataset:
The spectrum of mutations in the patients presenting with ABCA4-associated Stargardt's disease in a Russian population
Authors: Zol'nikova Inna Vladimirovna , Ivanova M. E , Strel'nikov V. V , Levina D. V , Demenkova O. N , Tanas A. S , Rogatina E. V , Egorova I. V , Rogova S. Yu , Prikazyuk E. Yu
Published: September 2020

Introduction. Stargardt's disease is a hereditary retinal dystrophy characterized by the early manifestation and the progressive deterioration of visual acuity. The spectrum of mutations in the ABCA4 gene associated with this pathology in the Russian Federation has not been fully investigated. Aim. The objective of the present study was to elucidate the spectrum of mutations in the ABCA4 gene in the Russian patients presenting Stargardt's disease. Materials and methods. The study included a total of 38 unrelated patients at the age varying from 6 to 48 (mean 20 ± 8.9) years having the clinically confirmed diagnosis of Stargardt's disease. The search of mutations in DNA extracted from the peripheral blood lymphocytes of the patients was carried out with the use of a set of oligonucleotide primers (Ion Ampliseq Inherited Disease Panel; Life Technologies, USA). The Ion Torrent PGM Sequencer (Life Technologies, USA) was used for the parallel semiconductor sequencing of the gene-coding regions. All the patients underwent the standard ophthalmological examination, electroretinography, optical coherence tomography, and fundus autofluorescence. Results. We established the spectrum of mutations in the ABCA4 gene in the patients of a Russian population suffering from autosomal-recessive Stargardt's disease. We identified 45 alleles responsible for the development of this condition. 14 of them had been earlier described in the Russian patients while 19 were discovered for the first time in this country although they had been known to occur in other populations. Moreover, we described 12 novel heterozygous variations, viz. c.230T>A (rs61748527), c.4956T>G (rs61750561), c.2820>G (rs81749445). c.5226delT, c.2537A>T, c.57353T, c.893delG, c.702 insATC, c.3896T>G, c.1356delA, c.1341delGAT, and c.231insGAAAA. Discussion. The study has revealed the rather variable phenotype in the patients presenting with ABCA4-associated Stargardt's disease. A wide variety of mutations were shown to be responsible for the difference of the clinical picture of this condition in individual patients. The comparison of the genotypes and the phenotypes has demonstrated the differential effect of the concrete mutations. Conclusion. The spectrum of mutations in the patients presenting with ABCA4-associated Stargardt's disease in the surveyed Russian population is different from that in other populations. We have revealed 12 previously unknown mutations; moreover 19 mutations have been described for the first time in this country although they had been previously known to occur in other populations.
Drainage surgery of glaucoma
Authors: Stepanov Anatoliy Viktorovich , Gamzaeva U. Sh
Published: September 2020

One of the topical problems facing modern ophthalmology is the treatment of glaucoma which holds the leading position among the disabling eye diseases. Refractory glaucoma is known to be one of the most complicated forms of this pathology due to its resistance to the medical treatment. The most effective method for the management of this variety of glaucoma is drainage surgery. The present review of the literature was designed to analyze the results of the studies reported by the foreign and Russian authors with special reference to the effectiveness of antiglaucoma drainage and its role in the treatment of glaucoma with special emphasis placed on refractory glaucoma. Different approaches and methods for microdrainage implantation are considered.
On the problem of the classification of congenital glaucoma
Authors: Katargina L. A , Tarasenkov Andrei Olegovich , Mazanova E. V
Published: September 2020

Objective. To monitor congenital glaucoma and to determine the proportion of the exposed stage of the disease revealed during the initial examination and the long-term follow up. Materials and methods. The present study included 27 children (47 eyes) at the age ranging from 8 to 17 years presenting with various forms of compensated congenital glaucoma at the initial, advanced, and terminal stages of the disease. Results. The clinical and functional characteristics of the eyes at each stage of congenital glaucoma were analyzed during the initial examination and the long-term follow-up period. It was found that the currently universally accepted classification of congenital glaucoma that subdivides the disease into stages based on the structural anatomical changes in the eyes ceases to adequately reflect the objective state of the visual system as the child grows. Conclusion. The study has demonstrated that the stage of congenital glaucoma needs to be corrected in accordance with the age and growth of the child and the possibility of its examination with the use of the psychophysical methods and the evaluation of visual acuity.
OPTICAL BIOMETRY OF THE EYE: THE PRINCIPLE AND THE DIAGNOSTIC POTENTIAL OF THE METHOD
Authors: Kiseleva T. N , Oganesyan O. G , Romanova L. I , Milash S. V , Penkina A. V
Published: September 2020

Optical biometry is based on the laser interferometry technique for the measurement of the biometric characteristics of the eyes, such as the antero-posterior axial length, anterior chamber depth, lens and retina thickness, corneal diameter and parameters of keratometry. The present article was designed to overview the basic principles of this method, its advantages and disadvantages, indications and contraindications for its application. The comparative analysis of the characteristics of the following optical biometric devices was undertaken: IOL-Master 500, Lenstar LS 900, Aladdin, OA-1000, OA-2000, Al-3000, Al-Scan, Galilei G6, IOL-Master 700.
THE ANALYSIS OF THE DEMOGRAPHIC SITUATION AND THE STATE OF THE PERINATAL CARE IN THE ALTAI REGION (PART 1)
Authors: Lebedev Vladimir Il’ich
Published: September 2020

Purpose. The objective of the present study was to analyse the demographic situation in the Altai region with special reference to the survival rate among the newborn infants and the influence of neonatal mortality on the demographic characteristics of the population. Material and methods. We undertook the statistical analysis of the Altai region demographic yearbook for the last 11 years (from 2005 to 2016). Results and conclusions. The study has demonstrated the steady decline (between 46% and 43.8%) in the population of the Altai region (mostly in the rural areas) during the period from 2006 to 2016. Despite the decline of the total population, there has been a tendency toward the growth of the children’s population (apparent since 2011) that increased by 28.997 persons. The relatively stable birth rate is associated with the increased number of the premature babies in the neonatal population structure including the infants with the extremely low body weight (from 56 born in 2008 to 88 in 2015). Simultaneously, there has been a significant reduction in the infant mortality rate within the first 168 hours after birth. Conclusion. Optimization of the system for monitoring and treatment of premature infants at risk of retinopathy of prematurity in the Altai region characterized by low population density and non-uniform distribution is the urgent challenging necessity.
THE HISTOLOGICAL STUDY OF THE STRUCTURES OF THE ANTERIOR CHAMBER ANGLE IN THE CHILDREN OF DIFFERENT GESTATIONAL AGE UNDER THE NORMAL CONDITIONS AND IN THE PRESENCE OF CONGENITAL GLAUCOMA
Authors: Zertsalova Marina Andreevna , Fedotova E. P , Brzheskiy V. V , Nasirov R. A
Published: September 2020

Purpose. The objective of the present study was to obtain and investigate the tissue samples taken from the anterior chamber angle of the children of different gestational age under the normal conditions and in the presence of congenital glaucoma; the secondary objective was to carry out the histological study of the pieces of tissues removed from the glaucoma patients of different gestational age undergoing hypotensive filtration surgery (sinusotrabeculectomy). Materials and methods. The anterior chamber angle histological preparations from a total of five enucleated eyes were available for the intravital investigation of the trabecular meshwork (two of them were obtained from the full-term infants and one from a premature baby). Results. The histological study of the structures of the anterior chamber angle of the enucleated eyes has demonstrated the presence in all the cases of cornea, Descemet’s membrane, trabecular meshwork, Schlemm’s canal, and iris. The morphological structure of the anterior chamber angle associated with congenital glaucoma shows up some peculiar features compared with the normal one, such as its block by the permanent fibrous membrane which penetrates deep into the trabecular meshwork that, in its turn, is formed from the rough and thickened tissue. The histological picture of the fetal eye at different gestational age exhibits the open anterior chamber angle, the well developed porous trabecular meshwork, and fragmentation of Descemet’s membrane near the trabecular meshwork. No signs of fibrous degeneration of the trabecule have been apparent. Conclusion. The intravital investigation of the trabecular meshwork has demonstrated some peculiar features that differ depending on the gestational age in birth. In the full-term babies, it is hypoplastic and covered with the rough fibrous membrane at certain places. Its histological picture is similar to that of the preparations of the enucleated eyes. In the premature babies, the trabecular meshwork is fibrous and characterized by enhanced cellularity; it undergoes fibrous degeneration that becomes apparent after the birth of the premature child (it is supposed to be related to the proliferative processes inherent in such babies).
A CHANGE OF THE LENGTH OF THE ANTERO-POSTERIOR AXIS OF THE EYE IN THE CHILDREN PRESENTING WITH HYPEROPIA FOLLOWING FEMTOSECOND LASER-ASSISTED IN SITU KERATOMILEUSIS: 3 YEAR FOLLOW-UP
Authors: Kulikova I. L , Pashtaev N. P , Gagloeva Anastasiya Vladimirovna , Shlenskaya O. V , Chapurin N. V
Published: September 2020

Aim. The objective of the present study was the analysis of the changes in the length of the antero-posterior axis of the eye (AL) in the children and adolescents presenting with hyperopia and anisometropia in 3 years after femtolaser-assisted in situ keratomileusis (FS-LASIK). Material and methods. The study included 33 patients at the age from 5 to 16 years divided into two groups. Group 1 was comprised of the patients having initially the mean spherical refractive equivalent (SE) +3.69 D. Those of group 2 had initial SE +5.88 D. In all the patients, FS-LASIK was carried out at the amblyopic eye in the absence of the positive results of the conventional conservative treatment. Results. During three years after FS-LASIK, AL of the treated patients in the first group increased by 0.41 mm and reached the mean value of 22.41 mm while the spherical refractive equivalent became equal to 0.25 D. During the same period, AL in the contralateral eye increased by 0.92 mm and became equal to 23.47 mm on the average with SE equaling +0.81 D. AL of the patients in the second group increased by 0.29 mm and reached the mean value of 21.59 mm while the spherical refractive equivalent became equal to 0.25 D. During the same period, AL in the contralateral eye increased by 0.97 mm and became equal to 23.32 mm on the average with SE equaling +0.62 D. Conclusion. During three years after hyperopic S-LASIK, the minimal growth of the antero-posterior axis of the eye was documented in the children presenting with hyperopia (+5 D) whereas its length increased by more than 0.29 mm. In the children with hyperopia of less than +5 D, it increased by 0.41 mm. It is concluded that prognosis of the results of femtosecond laser-assisted in situ keratomileusis leading to the alteration of the refraction in the amblyopic eye with the initially moderate or high-degree hyperopia should be made taking into consideration that AL continues to change in the cource of further growth of the child.
MACULOPATHY AND CHORIORETINOPATHY IN CHILDREN WITH RETINOBLASTOMA RECEIVING CHEMOTHERAPY: CLINICAL TRIALS AND MORPHOMETRIC ANALYSIS
Authors: Saakyan S. V , Myakoshina Elena В. , Polyakov V. G , Ushakova T. L , Ismailova D. M
Published: September 2020

Purpose. This research is to evaluate patients with retinoblastoma, who receive chemotherapy, with Spectralis optical coherence tomography with enhanced depth imaging to compare the signs of chorioretinopathy and maculopathy. Material and methods. 74 patients were examined and treated, 125 eyes with retinoblastoma in age at average of 24 ± 1.6 months. Group 1 - 31 patients, 62 eyes after intravenous chemotherapy, 2 - 24 patients, 25 eyes after intravenous and superselective intraarterial or intravitreal chemotherapy. Group 3 (control) - 19 patients (38 eyes) with primary retinoblastoma. The condition of the retina, choroid and macula was assessed using Ret Cam II and Spectralis optical coherence tomography with enhanced depth imaging. All patients had complete tumor resorption after treatment. Results. In group 1, after 3 courses of chemotherapy Spectralis optical coherence tomography with enhanced depth imaging showed a decrease of caliber of retinal vessels; wavelength of photoreceptors, hyperreflective round foci and calcinates in the retinal pigment epithelium; choriocapillary hyperreflexivity, choroid thinning; in the sclera - hyperreflective foci with visualization of the scleral vessels. In the macula - disorganization of retinal pigment epithelium, cystic edema, smoothness of the papillomacular bundle, coracoid form of the fovea, retinal thickening. After 3 courses of systemic chemotherapy and superselective intraarterial chemotherapy (group 2) - peritumoral increase in the caliber of retinal vessels. After systemic superselective intraarterial and intravitreal chemotherapy (group 2) - epiretinal membranes, punctate hyperreflective foci in the inner layers of the retina. In group 3 (control), before treatment, a normal anatomical and topographic state of the macula was observed with extracentral localization of retinoblastoma. Conclusions. Profound morphometric disturbances that come with combined chemotherapy (intravenous, superselective intraarterial and intravitreal chemotherapy treatments) call for a more careful treatment with methods selected in terms of Spectralis optical coherence tomography with enhanced depth imaging findings and specific chemotherapy contraindications.
Successful use pulsed radiofrequency spinal ganglions in patient with chronic stump pain. Case report
Authors: Genov Pavel G. , Smirnova O. V , Timerbaev V. H
Published: September 2020

About 50-85% of patients suffer from stump and phantom pain after amputations. These chronic pain conditions are often debilitating and result in disability, sleep and psychosocial disorders, impairment of day-work and the substantial decline in the quality of life. In some patients pharmaceutical therapy may fail to bring satisfactory pain relief or follows severe adverse events. Operations such as rhizotomy, cordotomy and stump revision are often unsuccessful in treating post-amputation chronic pain. The solitary case reports about the using of minimally invasive technique of pulsed radiofrequency (PRF) for treatment of chronic stump and phantom pain have been published only. Our current clinical observation is about successful using of the PRF spinal ganglions in patient with chronic pharmaceutical-resistant post-amputation stump pain.
THE USE OF LIDOCAINE INFUSION FOR ANALGESIA AND PREVENTION OF ILEUS AFTER MAJOR ABDOMINAL SURGERIES
Authors: Sholin Ivan Y. , Avetisyan V. A , Ezugbaia B. S , Zhikharev V. A , Koriachkin V. A , Felker E. Y
Published: September 2020

Objective. To assess the effect of infusion of lidocaine solution in patients after extensive abdominal operations. Material and methods. Were examined 42 patients with cancer of the pancreas, which is made pancreatoduodenal resections. The patients were divided into two comparable groups. Patients of the first group (n=21) before surgery injected bolus 1.5 mg/kg lidocaine, followed by infusion at a rate of 1.5 mg/kg*h during the first 24 hours after surgery. Patients of the second group (n=21) started epidural infusion of 0.2 % ropivacaine solution at a rate of 5 ml/h. The intensity of pain syndrome was evaluated on VAS at rest and during mobilization, bowel actions, the time of first flatus and first stool, the need for additional analgesics and lenght of stay in the intensive care unit. Results. The intensity of pain in the first day was significantly (p
DEXMEDETOMIDINE AS A COMPONENT OF ANESTHESIAAND PROMISING BASE FOR OPIOID FREE ANALGESIA
Authors: Ovechkin Alexei M. , Politov M. E , Bulanova E. L
Published: September 2020

Data suggests that intravenous infusion of dexmedetomidine, started 15-20 minutes before the induction of general anesthesia, can significantly reduce the doses of intravenous anesthetics, MAC of inhalation anesthetics, and requirements in opioid analgesics during the surgery. Intraoperative infusion of dexmedetomidine prolongs the time of the first requirement of analgesics after surgery, reduces the average pain intensity in the early postoperative period, and also requirements in opioid analgesics.
SPINAL ANESTHESIA AND CORTISOL LEVEL IN PATIENTS WITH LOWER LIMB SURGERY
Authors: Marochkov Aleksei V. , Pechersky V. G , Lipnitski A. L , Abelevich A. I , Artiukhova A. A
Published: September 2020

Objective: to evaluate the possibility of the cortisol control in patients with lower limb surgery of various degrees of trauma, as a criterion for achieving an absolutely effective analgesia. Materials and methods. In 15 patients of both sexes aged between 29 and 68 years (57 (53; 61)), 15 operations were performed on the lower extremities (knee replacement - 2, hip replacement - 3, metal osteosynthesis - 4, knee arthroscopy - 6). For analgesia was used spinal anesthesia with 0.5% solution of bupivacaine and levobupivacaine 2.5-3.0 ml. In all patients, effective anesthesia was achieved. The control of the cortisol level was carried out by the method of radioimmune analysis at 4 stages of the study: 1 stage - before surgery, on the operating table; Stage 2 - 30-40 minutes after the beginning of the operation; Stage 3 - the end of the operation, suturing of the skin; Stage 4 - 2 hours after the operation. The obtained data were processed quantitatively using nonparametric analysis. Results. Before the operation, the cortisol in the blood serum was 747.6 (507.4; 807.1) nmol/l. After 30-40 minutes after the beginning of the operation, the cortisol level decreased to 655.5 (512.2; 876.8) nmol/l, but no significant differences were found compared to the level of cortisol before the operation. At the end of the operation, the level of cortisol in the study group was 686.5 (470.1; 856.6) nmol/l and did not differ significantly with the stages before and during the operation. Two hours after the operation, there was an increase in cortisol to 760.4 (517.6; 842.1) nmol/l, but there was no significant differences compared to serum cortisol before and during surgery. Conclusion. Control of cortisol level shows the effectiveness of anesthesia in operations of varying severity.
EFFECTIVENESS OF INTRAVENOUS INFLUENCE OF LIDOCAIN AT ANALGEESIA AFTER VIDEO-ASSISTED TORACCOSCOPIC LOBECTOMY
Authors: Zhikharev Vasiliy A. , Bushuev A. S , Sholin I. Yu , Koriachkin V. A
Published: September 2020

Objective: Effect of perioperative intravenous lidocaine infusion after video-assissed toraxoscopic lobectomy. Materials and methods. 90 patients who underwent lobectomy with a video assisted thoracoscopic method were examined. In the first group (n = 30) for analgesia, intravenous infusion of lidocaine was used, in the second group (n = 30) - narcotic analgesics, in the third group (n = 30) epidural analgesia was used. An evaluation of the extubation time and the severity of the perspiratory response to the endotracheal tube was performed. The intensity of the postoperative pain syndrome was assessed on a 10-point visual analogue scale every 15 minutes for an hour, then every 4 hours after the first day. In all groups, during the first 24 hours, the consumption of narcotic analgesics was recorded, as well as the frequency of postoperative nausea and vomiting and the need for rehabilitation bronchoscopy. Results. The time of extubation in patients of the 1 st group was significantly greater than in the patients of the 2 nd and 3 rd groups. In patients of the 1 st group, the severity of the pressor response to extubation was significantly lower. The strength of pain in rest and motion, as well as the overall postoperative need for analgesics (promedol) were significantly lower (30.1 ± 2.25 mg and 51.1 ± 9.16 mg compared to 122.2 ± 14.18 mg, in groups of epidural analgesia and lidocaine group.In the postoperative period, there was a significantly lower level of postoperative nausea and vomiting in patients of Group I. The need for sanation PBS was noted in 2 (6.7%) patients in Group 1 and 5 (16.7%) patients in Group 2. In patients of the 3rd group, sanation bronchoscopy was not performed. Conclusion. An intravenous infusion of lidocaine at anesthesiology maintenance operations on light has a marked analgesic effect, which by its severity inferior epidural block, but greater than the systemic administration of narcotic analgesics, has opiodsberegayuschim effect, reduces the incidence of postoperative nausea and vomiting, is not accompanied by clinical signs of systemic local anesthetic toxicity. Infusion of lidocaine as a method of analgesia can be utilized in the case where the execution epidural impossible or not desirable.
Estimating the incidence of dpinal epidural hematoma after central neuroaxial blockades: a retrospective review of 38,168 cases in cancer clinic
Authors: Garjaev Roman V. , Gorobets E. S , Feoktistov P. I , Karmanov I. E
Published: September 2020

Neuraxial blockades provide effective pain relief. There are some benefits of prolonged epidural analgesia versus systemic opioids via PCA. Unfortunately, severe hemorrhagic complications can occur after application of these blockades. Methods: poll of all anesthesiologists working in cancer clinic during 2001-2015, search of data in medical archive. Results: it was revealed 2 cases of spinal hematoma following 30,042 epidural anesthetics and 0 cases among 8,126 spinal techniques. Both of complications were associated with evidence of hemostatic abnormality, there were no neurologic symptoms; patients had a conservative treatment and good outcomes. Conclusions: the incidence of spinal epidural hematoma after prolonged epidural analgesia was 0.67 per 10,000 (95% CI 0.57-0.76per 10,000), after spinal anesthesia - 0 per 8,126.
Diagnosis, treatment and preventive measures in congenital adrenal hyperplasia due to 21-hydroxylase deficiency in patients in adulthood
Authors: Molashenko Natalya V. , Sazonova A. I , Troshina E. A
Published: September 2020

In the article there are presented main approaches to the diagnosis, treatment and follow-up of patients with classical and nonclassical forms of 21-hydroxylase deficiency. The techniques of diagnostic tests and parameters of hormonal indices for the assessment of the adequacy of replacement therapy with glucocorticoids and mineralocorticoids are considered.
Tactics of the surgical treatment of torsion of the SINGLE uterine appendages in nulliparous women
Authors: Ishchenko Anatoly I. , Ishchenko A. A , Bakhvalova A. A , Devitskiy A. A , Maksimov A. I
Published: September 2020

There are considered two clinical cases of torsion of the single uterine appendages in patients of reproductive age without pregnancies in a history. Both patients previously were undergone to adnexectomy due to adnexal torsion. After clinical and laboratory examination and intraoperative endoscopic visualization of the pelvic organs it was decided advisory to limit the amount of surgical intervention by means of unwinding the uterus by laparoscopic method. Taking into account the adnexal torsion on the opposite side (with subsequent adnexectomy) in a history the main stage of the surgical treatment was supplemented by ovariopexy to prevent disease recurrence. Postoperative control for the restoration of blood supply to the ovarian tissues includes programmed laparoscopic examination, monochrome ultrasound scanning, color Doppler mapping (CDM), the study of blood levels of sex hormones, a common clinical and biochemical analyzes of blood, coagulogram.
HISTORY AND PRINCIPLES OF ULTRASOUND DIAGNOSIS OF TUMORS OF THE FEMALE REPRODUCTIVE SYSTEM
Authors: Vostrov Aleksandr N. , Kazakevich V. I , Mitina L. A , Stepanov S. O , Guts O. V , Novikova E. G , Mukhtarullina S. V
Published: September 2020

The lecture is devoted to topical issues of ultrasonic diagnostics in oncogynecology. The stages of the development of the ultrasound method in oncogynecology, the possibility of the method in the diagnosis of cervical cancer, uterine cancer and ovarian cancer are denoted. The possibilities and disadvantages of the method in the assessment of the prevalence of the tumor process are estimated.
RISK FACTORS OF DISTROPHIC DISEASES OF VULVAE: CLINICAL-EPIDEMIOLOGICAL RESEARCH
Authors: Porsokhonova Delya F. , Rakhmatullaeva S. N , Yakubovich A. I , Novoselov V. S , Novoselov A. V , Kaptil’nyy V. A , Sosnova E. A
Published: September 2020

The results of epidemiological studies of risk factors for the development of dystrophic diseases of the vulva (DDV) in women of reproductive and perimenopausal age are presented. Authors executed the testing of DDV patients according to specially developed questions of the questionnaire, aimed at the obtaining of the most complete information about the lifestyle of patients, social and medical factors, possibly contributing to the occurrence and formation of DDV. Also, the authors performed an examination of patients for the most common sexually transmitted infections (STIs), and urogenital infections in order to clarify the infectious factor in the genesis of dystrophy of the vulva. Direct and indirect factors that contribute to the formation of dystrophic diseases of the vulva in women are established to be as follows: perimenopausal age; endocrine diseases; emotional stress of a social character; more than 3 pregnancies in anamnesis; presence of STIs (herpes simplex virus, cytomegalovirus) and inflammatory diseases of the pelvic organs; presence of Candida fungi, Ureaplasma urealyticum bacteria, human papillomavirus - HPV 16/18, HPV 31/33 and some other infections on the background of DDV; lack of information about the disease; discharge from the genital tract; lack of treatment-effect; inappropriate treatment. The identified factors should be taken into account in the development of therapeutic and preventive measures in relation to DDV in women.
JUSTIFICATION OF THE APPLICATION OF THE METHOD OF THREE-DIMENSIONAL PHOTODYNAMIC THERAPY OF DISEASES AND PROCESSES OF MICROBIAL AND NEOPLASTIC NATURE IN CLINICAL GYNECOLOGY
Authors: Aleksandrov M. T , Zuev Vladimir M. , Pimancheva Yu. I , Pashkov E. P , Bagramova G. E
Published: September 2020

There were executed experimental studies on test subjects of microbial (Staphylococcus aureus and Pseudomonas aeruginosa) and neoplastic nature (in vitro - suspension of cells of the line of chronic myelogenous leukemia K562 in a volume of 60 μl and in an amount of 60 ± 1 × 103, in vivo - mice infected with Ehrlich carcinoma) on the substantiation the use of chlorophyll-containing drugs activated for photodynamic therapy (PDT) outside the biological object. No additional PDT activation of the drug was performed.The high bactericidal (on the test objects of microbes) and anti-tumor PDT efficacy of chlorophyll-containing preparations activated outside the organism was substantiated, with their subsequent administration per os and accumulation in practically all organs and tissues of the body was validated. The developed medical diagnostic technology in its clinical application has proved its effectiveness in women with inflammatory and/or neoplastic processes of the pelvic organs. The used equipment and preparation are approved for clinical use.
HYPERPLASTIC PROCESSES OF ENDOMETRIUM IN WOMEN OF PERIMENOPAUSAL AGE: CLINICAL ASPECTS OF THE PROBLEM
Authors: Baburin Dmitry V. , Unanyan A. L , Sidorova I. S , Kudrina E. A , Ishchenko A. I
Published: September 2020

The aim of the study is to identify the most significant clinical and anamnestic risk factors for the onset and progression of endometrial hyperplastic processes and the development of malignant transformation of endometrium in women of perimenopausal age, with taking into account their importance on the basis of statistical analysis. Methods. Based on Spearman’s correlation analysis and determination the degree of dependence of the development of endometrial cancer (from 0 to 1) on clinical-anamnestic and diagnostic risk factors (risk ratio (RR) in groups), there were obtained coefficients for a mathematical model allowing with the use of the binary logistic regression method predict the risk of the appearance of endometrial cancer. Results. The most clinically and statistically significant risk factors for the progression of the pathological process of the endometrium, having a high RR (greater than 1) and a confidence interval of 95% (p < 0.05), are (in the order of significance): recurrence of the endometrial hyperplastic process, obesity, the pronounced blood flow in Ultrasound with color Doppler mapping, polycystic ovary syndrome, abnormal ovarian formations, infertility (primary and secondary), type 2 diabetes mellitus, combined uterine pathology (myoma and/or adenomyosis), hereditary predisposition to cancer development, hypertension, age of 50 years and older. Conclusion. The tactics of the management and treatment of patients with hyperplastic endometrial processes should be based on the detection of the degree of the risk of the progression of pathological processes and the development of the malignant transformation of the endometrium. The study of the individual prognosis of endometrial cancer in patients with hyperplastic endometrial processes currently is becoming increasingly important due to the need to construct a rational treatment plan of the management and performing the follow-up dispensary observation on the basis of a scientifically justified forecast. Results obtained during our work allowed us identify statistically significant risk factors for the development of endometrial cancer. There were obtained coefficients for the creation a reliable mathematical model. With the use of the method of binary logistic regression, it is possible to calculate the risk of developing cancer and choose an effective management tactic for patients with hyperplastic endometrial processes at the perimenopausal age.
STRUCTURE OF INFECTIOUS SCREENING OF PREGNANTS: RUSSIAN AND OVERALL PRACTICE
Authors: Naumenko Natalya S. , Nikonov A. P , Astsaturova O. R , Belova A. V
Published: September 2020

Infectious diseases are still one of the main causes of perinatal losses worldwide. The consequences for the fetus and the newborn vary from asymptomatic infection to sepsis, malformations and the fetal death. Examination of pregnant women for the presence of infectious agents is an important part of the antenatal care program. The purpose of the work was to assess the structure of infectious screening in various medical institutions in Moscow, as well as the comparison of the recommended in Russia examinations with the main programs of antenatal monitoring in the world. Material and methods. The retrospective study was executed on the basis of four medical institutions: two state women’s clinics and two commercial clinics (the total number of patients - 902 people). The comparison was made with antenatal care programs of the antenatal observation in Centers for Disease Control and Prevention (CDC), 2015 (Centers for Disease Control and Prevention) in the United States of America, and the National Institute for Health and Care Excellence (NICE), 2017 (National Institute for Health and Medical Quality assistance), Great Britain. Results. Basic screening of pregnant women for infection in the Russian Federation includes 8 items (serological study of the blood for syphilis, HIV, hepatitis B and C, rubella, toxoplasmosis, microscopic examination of genital secretions on Neisseria gonorrhoeae and fungi of the genus Candida), which is significantly higher than in the USA and Great Britain (5 and 4 respectively). According to the results of our study, the volume of the compulsory examination of pregnant women is wider than abroad, due to serological examination of blood for the presence of antibodies to cytomegalovirus (CMV) and herpes simplex virus (HSV) of types 1 and 2, microbiological examination of genital secretions, molecular biological diagnosis (polymerase chain reaction - PCR, real-time PCR). Conclusion. Screening of pregnant women for infection in public and commercial clinics has a number of differences. The actual scope of the survey is higher than recommended by the state. The Russian list of tests in comparison with foreign analogs is much wider in terms of the number of nosologies and the frequency of the research. It is necessary to conduct multicenter epidemiological studies throughout the Russian Federation to create optimal regional programs for examining pregnant women for infection that meet the criteria for effective screening.
ENDOMETRIOSIS AND INFERTILITY. OPERATION OR ASSISTED REPRODUCTIVE TECHNOLOGIES?
Authors: Kuzmina Natalya S. , Bezhenar V. F , Kalugina A. S
Published: September 2020

The aim of the study was to study the influence of the ovarian endometrioma on the ovarian reserve, the ovarian response in ovarian hyperstimulation, and outcomes of assisted reproductive technologies (ART). Material and methods. The study included 43 infertility patients underwent the surgical treatment of an ovarian endometrioma in the history. During the study, the follicles were counted separately (according to transvaginal ultrasound), eggs and embryos were obtained from the operated and intact ovaries. Results. The number of follicles in the ovary, operated due to endometriosis, is significantly lower than in the contralateral ovary (p = 0.005). The number of ovules punctured from the ovary, operated for endometriosis, is less than the number of ovules obtained from the intact ovary, but the difference does not reach statistical significance (p = 0.07). The number of high-quality embryos obtained from the ovary, operated for endometrioma, is statistically significantly lower than the number of similar embryos obtained from the intact ovary (p = 0.013). Conclusion. According to the conducted study, it can be concluded that the surgical treatment of endometrioma in infertility patients with the need for the implementation of the reproductive function reduces the number of follicles in the operated ovary and, accordingly, does not lead to an improvement in indices of the infertility treatment using ART. At the same time, the very presence of endometrioma is also known to negatively impact on outcomes of ART. Therefore, in infertility patients with the reduced ovarian reserve, individualization of approaches to treatment is extremely important.
LACTOFERRIN, FLUORESCENT TECHNOLOGIES AND THEIR ROLE IN THE DIAGNOSIS AND TREATMENT OF INFLAMMATORY DISEASES OF THE FEMALE SEXUAL SPHERE
Authors: Zuev V. M , Gulenkova D. G , Goldman I. L , Sadchikova E. R , Aleksandrov M. T
Published: September 2020

The article reflects a modern view on the introduction of fluorescent methods of diagnostics and treatment of vaginal infections using lactoferrin in clinical microbiology, which made it possible to expand microecological studies. The suppression of the normal vaginal microflora was shown to promote a diverse pathology of both inflammatory and non-inflammatory genesis. Bacterial and fungal vaginosis were proved to be the most important risk factors for the development of infectious complications in the gynecological practice. There are given substantiated scientific evidence, indicating a large number of recurrences of bacterial and candidal vaginitis, despite the numerous studies and various treatment options. The relationship of bacterial vaginitis with infertility, the threat of miscarriage, premature birth, intrauterine infection of the fetus, etc. was established. Based on this, the search for alternative combined methods is relevant. The aim of the study was to increase the effectiveness of the treatment of recurrent candid vulvovaginitis and bacterial vaginosis by using lactoferrin. In the study, there were used fluorescent methods of the diagnosis, which made it possible to verify the diagnosis in the rapid assessment mode, as well as monitor treatment and improve its effectiveness.
METHODS OF PERFORMING A PLAIN AND ADVANCED COLPOSCOPY
Authors: Kaptilny Vitaly A. , Belova A. V
Published: September 2020

This review is devoted to the technique of the performing colposcopy in the modern obstetrical and gynecological practice. Special attention is paid to the value of this method, the diagnostic significance of the results of the survey. The preparation for the study, the purpose, and methodology of its implementation are considered. The presented photographs illustrate in detail all the stages of the course of colposcopy.
MARKERS OF ANTIOXIDANT PROTECTION SYSTEM IN DIAGNOSTICS OF EXTERNAL GENITAL ENDOMETRIOSIS IN INFERTILITY FEMALE PATIENTS
Authors: Khatlamadzhiyan M. G , Kharitonova E. V , Anisimova U. S , Shcherbakova Liya N. , Bugerenko A. E , Kalenikova E. I , Panina O. B
Published: September 2020

To identify markers of the antioxidant defense, 43 female patients with the infertility associated with external genital endometriosis were examined. The control group consisted of 19 healthy fertile women. In endometriosis patients, a statistically significant (p < 0.01) plasma level of coenzyme Q10 and α-tocopherol, determined by means of high-performance liquid chromatography with electrochemical detection, were noted to be lower in the comparison with the control group. On the basis of the data obtained, there was developed a prognostic scale that allows verifying the presence and severity of external genital endometriosis in infertility female patients.
ATYPICAL HEMOLYTIC-UREMIC SYNDROME IN GENERAL AND IN PREGNANCY
Authors: Novikov Aleksandr V.
Published: September 2020

Atypical hemolytic-uremic syndrome (aHUS) is an ultra-rare (orphan) disease, a form of thrombotic microangiopathy, which arises from a disturbance of the activation of an alternative complement pathway. Pregnancy is a frequent trigger for the onset of obstetric aHUS. Against the background of the disease in pregnant women, there is a high risk of developing pre-eclampsia, acute renal damage and consequently maternal mortality. In the world over the past 5 years, the number of confirmed cases of aHUS has increased. However, this is due not so much to the increase in the occurence of the disease as to the improvement in the methods of its diagnosis. The genetic nature of the aHUS dictates the need to create modern sensitive tests for the study of the complement system: measurement of the plasma concentration of factor H and factor I, C3, C4, genetic screening of regulatory genes, and others. It is also necessary to develop new drugs that, along with Eculizumabum (Soliris®, Alexion Pharmaceuticals, Cheshire, CT, USA) would be used in the therapy of aHUS.
LYMPHOGRANULOMATOSIS AND PREGNANCY: THE EDGE OF THE POSSIBLE
Authors: Ignatko Irina V. , Afanasyeva N. V , Samoylova Yu. A , Golubenko E. O , Dudina I. A , Matsneva I. A
Published: September 2020

The prevalence rate of Hodgkin’s lymphoma is the fourth among malignant neoplasms in women of the reproductive age, so the problem of the association of this disease with the pregnancy inevitably arises. The tactic of the management of the pregnancy and childbirth in such patients depends on the stage and time of the detection of the disease. This article presents a clinical observation of a patient whose pregnancy occurred in the fourth year of the sustained remission of stage IV lymphogranulomatosis and had a favorable outcome.
TACTICS OF MANAGEMENT OF PATIENTS WITH ATYPICAL ENDOMETRIAL HYPERPLASIA (LITERATURE REVIEW)
Authors: Bakhtiyarov K. R , Apsalyamova A. V , Bogacheva Natalia A. , Parsyan A. L
Published: September 2020

In the past few years, there has been a gain in the prevalence of hyperplastic processes of the reproductive system in women, among which atypical endometrial hyperplasia (AEH) occupies a special place. Such peculiarities of the clinical manifestation of this disease as the high prevalence, relapsing course, reduced reproductive function and high risk of malignancy reflect the urgency of the problem of prevention and increasing the effectiveness of treatment of endometrial hyperplastic processes. The purpose of the study is to analyze the data presented in modern literature on the tactics of management and treatment of AEH patients. Different tactics of management of AHE patients with effective methods of treating these patients are considered. Hysteroresectoscopy of hyperplastic areas before high-dose progestin therapy has been established to be a safe and highly effective approach to the management and treatment of AEH patients wanted to maintain their fertility. However, organ-preserving treatment must necessarily be accompanied by careful dynamic observation by the gynecologist or oncogynecologist. The optimal method of treating patients in pre- and postmenopausal disease is radical surgical treatment in the amount of extirpation of the uterus with appendages, which should be considered justified for this category of patients.
ACTUAL VIEW ON THE VITAMIN D EFFECT ON WOMEN’S HEALTH
Authors: Savchenko T. N , Dergacheva I. A , Ozolinya Lyudmila A.
Published: September 2020

According to last research, receptors for vitamin D are found in many organs and tissues. Vitamin D deficiency leads to the development of pathological conditions in children and adults. The non-classical effects of vitamin D are important in modulating congenital and acquired immunity, regulating cell proliferation, in the progress of diabetes, the pathology of the cardiovascular system, and autoimmune diseases. The inverse correlation between the level of 25(OH)D3 and the incidence of cancer has been determined. Vitamin D affects the course of pregnancy, and the decidual and placental tissues synthesize 1.25(OH)2D. Vitamin deficiency is found in pregnant women with preeclampsia and gestational diabetes. Timely diagnosis and adequate correction of the level of vitamin D in the blood reduces the risk of developing diseases.
The effect of combined oral contraceptives and hormone therapy during assisted reproductive technologies on the function of the hemostatic system in non-pregnant and pregnant women
Authors: Kirakosyan E. V. , Sosnova E. A.
Published: September 2020

A review of 130 sources of world literature was conducted in the databases Scopus, Web of Science, MedLine, Cochrane CENTRAL, Cochrane Database of Systematic Reviews (CDSR), Database of Abstracts of Reviews of Effectiveness (DARE), EMBASE, Global Health, CyberLeninka, RSCI on the problem of the effect of combined oral contraceptives and hormone therapy during assisted reproductive technologies on the function of the hemostatic system in non-pregnant and pregnant women. In this review, we have summarized and analyzed information on the effect of sex hormones entering the womans body from the outside on individual links and the hemostatic system as a whole, determined the relationship between drug administration and thrombotic complications, optimized the sequence of diagnosis of conditions predisposing to thrombosis, substantiated the tactics of preparation and management patients taking exogenous hormones before and during pregnancy, including through in vitro fertilization.
Preeclampsia: definition, new in pathogenesis, guidelines, treatment and prevention
Authors: Kaptilnyy V. A. , Reyshtat D. Yu.
Published: September 2020

The review reflects current views on the diagnosis, etiology, classification, pathogenesis and methods of treatment and prevention of preeclampsia. Theories of pathogenesis are described in detail, methodical recommendations are given. Comparisons of guidelines of international societies, their goals and methods of treatment of preeclampsia are presented.
Features of the course of pregnancy at the preeclampsia of varying severity at the present stage
Authors: Simanov I. V.
Published: September 2020

Objective to study features of a course of pregnancy at a preeclampsia of varying severity and to compare them with data of control group of a research for the last 5 years.
Material and methods. 440 patients of fertile age with a preeclampsia of varying severity are inspected. 200 patients of similar age without preeclampsia made control group.
Findings. Data of the conducted research showed that the number of patients with toxicosis of the pregnant woman, threat of abortion and an iron deficiency anemia was statistically significantly 23 times more in the main group, than in control. In the second half of pregnancy at every fourth patient with a moderate preeclampsia and at every second from heavy the threat of premature births was observed. In the analysis of data the number of patients with threat of premature births in the main group was statistically significant in 35 times more, than in control, values of this complication varied from 25,2% (a moderate preeclampsia) to 50,8% (heavy). Premature amotio of normally located placenta took place at 6 of 63 patients with a heavy preeclampsia against the background of high figures of arterial pressure and heavy anemia.
Conclusion. Early diagnostics and treatment of complications of pregnancy at a preeclampsia will allow to improve the forecast for the forthcoming childbirth.
Potensi tepung daun sirsak, serai, kenikir, jeruk nipis, dan kluwih terhadap kumbang bubuk kedelai (Callosobruchus analis F.) pada kedelai (Glyxine max L.) dalam simpanan
Authors: Dzulhijja Laily Dwi , W Wagiyana , Prastowo Sigit
Published: September 2020

This study aims to determine the effect of soursop leaf flour, lemongrass flour, kenikir leaf flour, lime leaf flour, and kluwih leaf flour on: 1) mortality, 2) damage to seeds, 3) shrinkage of seed weight, 4) appearance of adult C. analysts on soybean seeds in deposits and 5) laying eggs of C. analis imago female eggs, 6) probit analysis LT50. The experiment was carried out using a Completely Randomized Design (CRD). As treatments are: A) controls; B) soursop leaf flour in doses of 1 g, 2 g, and 3 g; C) Serai leaf flour with doses of 1 g, 2 g, and 3 g; D) kenikir leaf flour with doses of 1 g, 2 g, and 3 g; E) lime leaf flour with doses of 1 g, 2 g, and 3 g; and F) kluwih leaf flour with doses of 1 g, 2 g, and 3 g. Each treatment uses five replications. The observed parameters were analyzed by "F" test variance then if it was significantly different to find out the difference in the effect of treatment, an Tukey HSD Test was conducted at a level of 5% distrust. The best mortality results using the treatment of soursop leaf flour dose 3 g on 5 days amounted to 1.80 tails; 1 month is 6.60; 2 months totaling 13.40; and 3 months totaling 11.20. The results of the observation of the number of eggs produced by C. analis the best analyst was the treatment of soursop leaf flour dose 3 g on 5 days amounting to 139 items, 1 month 119.20 items; 2 months 91.20 items; and 3 months 72.20 items. The best imago observation results were treatment of soursop leaf flour dose 3 g at 1 month amounting to 132.20 tails; while at 2 months there were 79 heads. The best observation of seed damage and shrinkage of seed weight was the treatment of soursop leaf flour with a dose of 3 g, in the damage of seeds of 67.40 grains of seed damage; while the seed weight is reduced by 17.94 g. The results of the best analysis of Probit LT50 were treatment of soursop leaf flour with a dose of 3 g because it could kill 50% of the population C. analis with a relatively short time were 9 days after treatment.