Aim. Immunoprevention represents a well-established tool to prevent and eliminate life-threatening infectious diseases. However, low adherence in the population is a major obstacle to achieve the full coverage of preventive vaccinations. Here we studied the adherence of various population groups and healthcare workers to vaccination.

Materials and Methods. We conducted an original survey among 1147 university students, 214 parents and 512 physicians.

Results. Among the students of humanitarian and technical faculties, only 33% and 37% respectively showed a positive attitude to immunoprevention. This indicator, however, was higher in medical students and physicians (76% and 80%, respectively). Overall awareness of all population groups on immunization is insufficient to perform such measures efficiently. The reasons of low adherence include anti-vaccine propaganda, negative attitude and lack of awareness of healthcare workers on immunoprevention efficiency.

Conclusion. Further large efforts are urgently needed to increase the adherence to immunization both in general population and healthcare professionals. The primary task is to eliminate the lack of information on the role and importance of immunization in maintaining population health.

Aim. To develop a tool for the prediction of perinatal complications in pregnant women with gestational diabetes utilizing conventional and ultrasound markers of diabetic fetopathy.

Materials and Methods. We analyzed 128 case histories of women who suffered from gestational diabetes. Among their newborns, 35 had clinical manifestations of maternal hyperglycemia (birth weight > 90th percentile, neonatal hyperglycemia, respiratory distress syndrome, and neonatal jaundice) while 74 were free of the indicated signs and symptoms.

Results. Risk factors of maternal hyperglycemia manifestations in neonates included family history of diabetes mellitus type 2, obesity, and pre-eclampsia. Maternal hyperglycemia was significantly associated with the higher risk of adverse perinatal outcomes. A combination of ≥ 4 ultrasound оценке markers of a diabetic fetopathy permitted the diagnosis of the fetal macrosomia. Conclusion. Ultrasound markers of diabetic fetopathy have limited sensitivity in the prediction of perinatal complications after gestational diabetes.

Aim. To determine the level of IgA and IgG to estradiol, progesterone, and benzo[a]pyrene in women with or without preterm labor and to assess whether the administration of progestagens affect these parameters.

Materials and Methods. We measured the levels of IgA and IgG to estradiol, progesterone, and benzo[a]pyrene in serum of 199 pregnant women (68 with PL and 81 with normal delivery) with the following analysis of associations between progestagen administration and these parameters.

Results. The level of IgA to estradiol in patients with preterm labor was significantly higher than in women with normal delivery, and the administration of progestagens did not reduce their level in women with preterm birth.

Conclusions. Measurement of the antibodies to estradiol may help in predicting pregnancy complications such as preterm birth.

Aim. To study the course of pregnancy, childbirth and the postpartum period in pregnant women with placental microbial colonization; to investigate placental morphology during the microbial colonization.

Materials and Methods. We retrospectively investigated 128 case histories of the pregnant women with or without (n = 64) placental microbial colonization.

Results. Enterobacteriaceae spp., Enterococcaceae spp. and Staphylococcaceae spp. were respectively isolated from placentas of 24 (37.5%), 19 (29.7%), and 19 (29.7%) women with placental microbial colonization. Candida albicans was isolated in 2 (3.1%) cases. All placentas excised from women without placental microbial colonization were sterile. Vaginal delivery occurred in 61 (95.3%) women with placental microbial colonization but only in 24 (37.5%) women without (p = 0.001). Subinvolution was revealed in 10 (15.6%) and 4 (6.3%) (р = 0.09), lochiometra was found in 4 (6.3%) and 2 (3.1%) (р = 0.409), and wound infections were observed in 5 (7.8%) and 1 (1.6%) (p = 0.095) women with or without placental microbial colonization, respectively. Therefore, prevalence of postpartum complications did not differ significantly between the groups. Placental inflammation was detected in 27(42.2%) and 14 (21.9%) (p = 0.014) patients with or without placental microbial colonization, respectively.

Conclusions. Placental inflammation is associated with microbial colonization which is more common in women who undergo vaginal delivery.

Aim. To evaluate the surgical treatment of pelvic organ prolapse grade 3 in elderly women.

Materials and Methods. We consecutively recruited 86 elderly women (60 to 75 years old) suffering from pelvic organ prolapse grade 3. Out of them, 56 patients underwent vaginal mesh surgery while 30 refused surgical treatment. After 1 year, we assessed stress urinary incontinence using a cough test and Valsalva maneuver. Pain intensity was measured using the Numeric Rating Scale whereas quality of life was assessed by Pelvic Floor Disability Index (PDFI-20). The primary outcome measure was the prevalence of pelvic organ prolapse symptoms while the secondary outcome measure was the frequency of stress urinary incontinence and low quality of life upon 1 year of follow-up.

Results. After 1 year of follow-up, patients who received a surgical treatment were characterized by a statistically significant decrease in both frequency and intensity of complaints and symptoms of pelvic organ prolapse. Pelvic Organ Prolapse Distress Inventory score was 8.3 (4.2-12.5) and 79.2 (79.2-100) in patients with or without surgical treatment respectively. Similar results were showed using Colorectal-Anal Distress Inventory score (6.2 (3.1-6.2) and 68.8 (62.5-71.9) and Urinary Distress Inventory score (8.3 (4.2-8.3) and 83.3 (79.2-87.5), in treated and untreated individuals, respectively. Total Pelvic Floor Disability Index score was 22.8 (11.5-27.0) in women who underwent a vaginal mesh surgery and 227.2 (226.1251.0) in those who did not. All indicated differences were statistically significant.

Conclusions. Vaginal mesh surgery is efficient for the treatment of pelvic organ prolapse grade 3 in elderly women.

Aim. To determine the frequency of the polymorphisms within the genes encoding estrogen metabolism enzymes: CYP1A1 (rs4646903), CYP1A2 (rs762551), CYP19 (rs700519) and SULT1A1 (rs9282861) in women with early miscarriage.

Materials and Methods. We recruited 103 consecutive women who experienced early miscarriage (< 12 weeks of pregnancy, n = 103) and 257 women without past medical history of adverse pregnancy outcomes. Following DNA extraction, we genotyped all samples by means of restriction fragment length polymorphism analysis. We analyzed the polymorphisms within the CYP1A1 gene (T264 → C, rs4646903), CYP1A2 gene (C734 → A, rs762551), CYP19 gene (C → T, rs700519), and SULT1A1 gene (G638 → A, rs9282861).

Results. We found a significantly increased prevalence of the mutant allele C as well as T/C and C/C genotypes of the rs4646903 polymorphism within the CYP1A1 gene and mutant T allele along with the T/C genotype of the rs700519 polymorphism within the CYP19 gene in women with early miscarriage as compared with those having a normal pregnancy course. Concurrently, we detected a reduced frequency of the C/A genotype of the rs762551 polymorphism within the CYP1A2 gene in patients who suffered from early miscarriage. The risk of miscarriage was significantly increased in carriers of CYP1A2 (rs762551 C/C) + CYP1A1 (rs4646903 T/C + C/C) + CYP19 (rs700519 C/T), CYP1A2 (rs762551 C/C) + CYP1A1 (rs4646903 T/C + C/C) + SULT1A1 (rs9282861 G/G) + CYP19 (rs700519 C/T), CYP19 (rs700519 C/T) + SULT1A1 (rs9282861 G/G), (CYP1A2 (rs762551 C/C) + CYP1A1 (rs4646903 T/C + C/C); CYP1A2 (rs762551 C/C) + CYP19 (rs700519 C/T), CYP19 (rs700519 C/T) + CYP1A1 (rs4646903 T/C + C/C), and SULT1A1 (rs9282861 G/G) + CYP1A1 (rs4646903 T/C + C/C) haplotypes. Investigation of the possible gene-environment interactions found a considerable increase in CYP1A1 (rs4646903 T/C) + CYP1A2 (rs762551 A/A) and CYP1A1 (rs4646903 T/C) + SULT1A1 (rs9282861 A/A) haplotypes in conjunction with a CYP1A2 (rs762551 A/A) + SULT1A1 (rs9282861 G/A) haplotype.

Conclusion. Patients with early miscarriage more frequently have the mutant allele C as well as C/T or C/C genotypes of the rs4646903 polymorphism within the CYP1A1 gene and mutant allele T (in particular within the C/T genotype) of the rs700519 polymorphism within the CYP19 gene; in contrast, C/A genotype of the rs762551 polymorphism within the CYP1A2 gene was less common in these patients. Specific risk haplotypes revealed in our study may indicate a combination of estrogen-dependent and chemically induced process caused by the bioactivation of exogenous xenobiotics in patients with early miscarriage.

Aim: To study the level of thyroid-stimulating and thyroid hormones in pregnant women with obesity and their newborns.

Materials and Methods. We consecutively recruited 40 pregnant women and their newborns. Blood sampling in pregnant women was carried out at the end of the third trimester 12 hours after the last meal while in newborns it was conducted immediately after birth. Measurement of serum thyroid-stimulating hormone, thyroxine, triiodothyronine, and free thyroxine was performed using chemiluminescent immunoassay.

Results. Thyroid disease was significantly more common in pregnant women with obesity. Clinical and latent hypothyroidism in obese pregnant women was observed 1.5-fold more frequently as compared with those having normal body weight. In keeping with these findings, goiter and elevated thyroxine were also more common in obese pregnant women. Newborns from obese women were more often characterized by a transient hypothyroidism in combination with an augmented thyroid-stimulating hormone.

Conclusion. Levels of thyroid-stimulating and thyroid hormones in obese pregnant women and their newborns significantly differ from the patients with normal body weight.

Aim. To identify associations of mtDNA polymorphisms with sudden cardiac death.

Materials and Methods. DNA was isolated from the cardiac tissue excised during the autopsy from individuals who died from sudden cardiac death (n = 260). The frequencies of the most common European mtDNA haplogroups (H, U, T and J) were determined using restriction fragment length polymorphism analysis. In addition, we performed a comparative analysis using previously published data on mtDNA polymorphisms in the West Siberian population.

Results. The distribution of mtDNA haplogroups in the patients who died from sudden cardiac death was similar as in the general population: 40% for haplogroup H, 23% for haplogroup U, 12% for haplogroup T and 6.5% for haplogroup J. We found no significant differences regarding the frequency of mtDNA haplogroups in individuals who died from sudden cardiac death and the population level.

Conclusion. We discovered no associations of H, U, T, and J mtDNA haplogroups with sudden cardiac death. These results indicate the necessity of a detailed analysis of mitochondrial genome to determine mtDNA variants associated with sudden cardiac death.

Aim. To optimize hematoxylin and eosin staining protocol for heart, blood vessels, liver, and spleen.

Methods. Heart (ventricles), abdominal aorta, liver (right lobe), and spleen (left part) of the Wistar rats were excised, fixed in 10% neutral phosphate buffered formalin for 24 h, washed in tap water for 2 h, dehydrated in ascending ethanol series (70%, 80%, and 95%) and isopropanol, embedded into paraffin and then sectioned (5 μm) using rotary microtome. For regressive staining, incubation time in Harris hematoxylin was 5 or 10 minutes, time of exposure to differentiation alcoholicaqueous eosin was 1 or 2 minutes. For progressive staining, incubation time in Carazzi’s hematoxylin and eosin was the same but the differentiation solution was not utilized.

Results. Progressive staining retained tissue integrity and accelerated staining protocol as compared to regressive staining due to absence of exposure to aggressive acid alcohol differentiation solution. The optimized protocol for heart, aorta and liver, similar for regressive and progressive staining, included incubation in hematoxylin for 10 minutes and eosin for 2 minutes. Time of exposure to differentiation solution (2 or 10 seconds) was defined by the desirable shade. For spleen, however, the optimized protocol included staining in hematoxylin for 5 minutes and eosin for 2 minutes, with 10 seconds in differentiation solution for regressive staining.

Conclusion. Progressive hematoxylin is preferable over regressive hematoxylin for staining of heart, aorta, liver, and spleen.

Aim. To estimate the dynamics of 24-hour blood pressure pattern in patients with resistant hypertension after renal denervation in comparison with the conservative treatment group.

Methods. We enrolled 45 patients (21 men and 24 women, mean age 53 (43-66) years) with resistant hypertension. Renal denervation was performed in 25 patients using Vessix renal denervation system while the conservative treatment group included 20 patients. Monitoring of 24-hour blood pressure pattern was performed before renal denervation and after 1 year of follow-up.

Results. Twelve months after renal denervation, patients with resistant hypertension had a significant reduction in office blood pressure (33 and 15 mmHg for systolic and diastolic blood pressure, respectively) and 24-hour average blood pressure (29 and 12 mmHg, for systolic and diastolic blood pressure, respectively). Another beneficial effect of renal denervation was a decrease in systolic blood pressure variability both throughout the day and at night (6 (5-12) and 7 (7-10) mmHg, respectively); however, no changes in diastolic blood pressure variability have been registered. Despite renal denervation did not affect the morning blood pressure surge, morning systolic blood pressure reduced from 174 (130180) mmHg to 156 (130-165) mmHg. After 1 year of follow-up, the proportion of dippers increased from 16 to 44%. In contrast to the patients who underwent renal denervation, there were no significant changes in 24-hour blood pressure pattern in the conservative treatment group.

Conclusion. After 1 year of follow-up, renal denervation can be considered as an option superior to conservative treatment in patients with resistant hypertension, as it significantly improved 24-hour blood pressure pattern.

Aim. To develop the methodology to assess the standards of physical development of children and adolescents.

Materials and Methods. We have analyzed the available literature and our previous results to identify current problems in evaluating physical development of children with the focus on regional standards.

Results. Current methodology in the field clearly needs standardization. We propose that “Standards of physical development of children and adolescents” software enables the objective evaluation of physical development in relation to children and adolescents and therefore can be suggested as a golden standard. Comparative analysis of the anthropometric data using this program and standard descriptive statistics (SPSS 21) showed the similarity of the results.

Conclusions. Contemporary problems in the study of physical development of children and adolescents include the lack of standardized methods, standards, and official documents. We suggest our novel approach as a promising solution.

Aim. To study whether the use of printed and electronic publications is associated with vision disorders.

Materials and Methods. We interrogated 100 high school students and 355 university students using a questionnaire developed by the Research Institute of Hygiene and Surveillance on Child and Adolescent Health. Further, 179 university students were examined utilising the automated system for the physiological testing while 100 high school students were examined by a certified ophthalmologist.

Results. Around the half of the students have self-evaluated their vision as reduced, without associating this with the use of electronic devices. Boys were more prone to underestimate their health (Pearson’s contingency coefficient C = 0.2, p < 0.001). Eye fatigue was significantly associated with higher frequency of using electronic devices regardless of their type (C = 0.7 for desktop computers and laptops, 0.8 for electronic books and 0.6 for tablets (p = 0.001)) while headaches were specifically associated with increased laptop use (C = 0.5, p = 0.02). Self-assessed reduced vision correlated with higher frequency of tablet use (C = 0.2, p = 0.004). Moderate or high myopia were also associated with a higher frequency of using desktop computer or laptop (C = 0.75, p = 0.001). The average time of work on a computer reached 2 and 3 hours on schooldays and on the weekend, respectively, in high school students. These numbers were significantly higher in university students (2.6 and 4.4 hours respectively for desktop computer and 2.9/3.7 hours for laptop). Functional vision loss was detected in 67.2% of high school students and 19% of university students while moderate or high myopia was diagnosed in 8.2% of high school students and 53.6% of university students. Mean visual acuity was 0.61 ± 0.25 (OD) and 0.64 ± 0.25 (OS).

Conclusions. Safety indicators of electronic publications are needed to be developed and properly regulated.

Increase in life expectancy is among the most significant achievements of modern medicine. Currently, the majority of patients are elderly, being characterised by multimorbidity and frailty. Sarcopenia, a progressive and generalized loss of skeletal muscle mass and strength, is associated with a reduced quality of life and high risk of adverse outcomes including disability and death in these patients. Age-related neuromuscular degeneration, decline of circulating anabolic hormones, chronic inflammation and oxidative stress considerably affect the development of sarcopenia. In addition, low intake of proteins and carbohydrates along with a decrease in physical activity also affect muscular homeostasis. Being combined with obesity, osteopenia/osteoporosis, and vitamin D deficiency, sarcopenia worsens the prognosis of the patient in terms of life expectancy. In this review, we discuss the current advances in epidemiology, pathophysiology, and diagnosis of sarcopenia.