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Fundamental and Clinical Medicine

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Vol 2, No 3 (2017)
6-12 444
Abstract
Aim. To estimate the ovarian reserve in preterm girls at birth and in puberty. Materials and Methods. We recruited 100 either preterm or full-term infant girls and 200 adolescent (15-16 years of age) girls born either preterm or full-term (n = 100 per each group) following clinical and ultrasound examination. Results. The levels of pituitary hormones in preterm newborn and adolescent girls were higher while the levels of ovarian hormones were lower compared to those born full-term. Furthermore, both average ovarian volume and average antral follicles count were lower in preterm newborn and adolescent girls in comparison with those born full-term. Conclusion. Ovarian reserve in preterm girls is lower compared to those born full-term and remains depleted at least until the puberty.
13-20 479
Abstract
Aim. To perform a health assessment of full-term neonates born either using assisted reproductive technology (ART) or as an outcome of a spontaneous pregnancy. Materials and Methods. We examined full-term neonates born either utilizing ART (n = 79) or as an outcome spontaneous pregnancy (n = 1185). Anthropometric indicators, somatic health, and anatomy of external genital organs were considered as the health criteria. Results. Unexpectedly, we did not and any deterioration of physical development in neonates born using ART; however, they had a higher prevalence of intrauterine hypoxia, central nervous system disorders, and respiratory distress syndrome at birth compared to those who were born due to spontaneous pregnancy. Risk factors of intrauterine hypoxia included maternal age < 30 years, genital disorders, and somatic diseases. Conclusion. Full-term neonates born using ART have a higher prevalence of diseases com-pared to those who were born as an outcome of a spontaneous pregnancy.
21-27 403
Abstract
Aim. To investigate the serum leptin level in pregnant women either with or without obesity and in their newborns. Materials and Methods. We examined 60 pregnant women with or without obesity (n = 30 per each group) at 38-40 weeks’ gestation along with their newborns following measurement of serum and cord blood leptin level using an enzyme-linked immunosorbent assay.Results. Leptin serum level was significantly higher in obese women compared to those with a normal body weight. Strikingly, the cord blood level of leptin in newborns was lower than in their mothers and did not depend on either maternal body weight or maternal serum leptin level. Conclusions. Serum leptin level in pregnant women is determined by the body weight but does not define cord blood level of leptin in their newborns.
28-34 502
Abstract
Aim. To investigate the levels of proinflammatory cytokines [tumor necrosis factor (TNF)-α, interleukin (IL)-6, IL-8, interferon (IFN)-γ), lactoferrin (LF), and α2-macroglobulin (α2-MG) in serum and follicular fluid of women with uterine infertility at the start of in vitro fertilization (IVF) program. Materials and Мethods. We collected 100 samples of follicular fluid and serum from women with uterine infertility following measurement of TNF-α, IL-6, IL-8, IFN-γ, and LF by enzyme-linked immunosorbent assay and α2-MG by rocket immunoelectrophoresis. Out of 100, 38 patients suffered from chronic endometritis, 25 were diagnosed with adenomyosis, and 37 women had primary tubal infertility. Results. No statistically significant differences were found between the patients with chronic endometritis and primary tubal infertility. Furthermore, there were no significant differences in serum cytokine, LF, or α2-MG levels between the patients with adenomyosis and primary tubal infertility. Strikingly, we detected higher serum levels of TNF-α and LF and reduced level of α2-MG in women with a negative IVF outcome. Follicular fluid of women with adenomyosis was characterized by an increased level of IFN-γ, which was also associated with the negative outcome of IVF. Conclusion. Imbalance of TNF-α, LF, and α2-MG in follicular fluid and serum of women with uterine infertility is associated with negative IVF outcome.
35-41 595
Abstract
Aim. To determine prevalence and features of human papillomavirus (HPV) infection in human immunodeficiency virus (HIV)-infected women.Materials and Methods. We recruited 150 imprisoned women aged 25 to 59 years (mean age 37.3 ± 8.0) following clinical examination and analysis of medical documentation including HIV status. Identification of high-risk HPV strains (16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59) was carried out using real-time polymerase chain reaction. Results. High-risk HPV strains, particularly HPV-16, -39, and -52, were detected in 58.2% of HIV-infected and 23% of HIV-negative women (p < 0.001). Furthermore, the combination of ≥ 4 HPV genotypes was more prevalent in HIV-infected women (p = 0.043). Strikingly, HIV-infected women with shorter duration of HIV-infection and/or taking antiretroviral treatment were less frequently infected with high-risk HPV (p < 0.05).Conclusions. A significant proportion of HIV-positive women is infected with HPV-16, -39, -52, or combination of ≥ 4 HPV strains.
42-45 1406
Abstract
Aim. To identify the risk factors of placental abruption. Materials and Methods. We retrospectively investigated 80 case histories of women either with or without placental abruption (40 case histories per group) who delivered within 2011-2016 in Reshetova Kemerovo Regional Perinatal Center.Results. A number of risk factors of placental abruption has been identified including smoking (OR = 13.0, 95% CI = 1.6-107.2), placenta previa (OR = 7.4, 95% CI = 2.2-24.6), arterial hypertension (OR = 6.3, 95% CI = 1.3-31.1), uter-ine scar (OR = 6.3, 95% CI = 1.3-31.1), placental insufficiency (OR = 3.4, 95% CI = 1.0-11.8), and low level of education (OR = 2.9, 95% CI = 1.1-7.1). Other predictors were not statistically significant. Conclusions. Abovementioned risk factors of placental abruption should be considered in management of the pregnant women.
46-51 423
Abstract
Aim. To investigate the association of leptin serum level and metabolic features in pregnant women with a reduced body mass index (BMI). Materials and Methods. I recruited 100 pregnant women with either reduced or normal BMI (50 women per group) and then evaluated features of their protein, lipid, and carbohydrate metabolism following measurement of a serum leptin level. Results. Almost all pregnant women with a reduced BMI were diagnosed with protein and albumin deficiency (55.9 ± 0.6 g/L and 53.4 ± 1.3%, respec-tively) while those with a normal BMI had both total protein and albumin serum levels within the reference values (60.9 ± 1.06 g/L and 55.8 ± 1.6%, respectively, р < 0.001). Furthermore, fasting glucose level in women with a reduced BMI was lower compared to those with a normal BMI (4.2 ± 0.07 mmol/L and 4.46 ± 0.13 mmol/L, р < 0.001). Finally, women with a reduced BMI had lower concentrations of total cholesterol (5.8 ± 0.16 mmol/L), triglycerides (2.92 ± 0.12 mmol/L, high-density lipoprotein cholesterol (1.78 ± 0.03 mmol/L), low-density lipoprotein cholesterol (2.25 ± 0.19 mmol/L), and atherogenic index (2.4 ± 0.19) in comparison with those with a normal BMI (6.2 ± 1.1 mmol/L, р = 0.0125; 3.31 ± 0.14 mmol/L, р < 0.001; 1.85 ± 0.15 mmol/L, р = 0,0017; 2.57 ± 0.21 mmol/L, р < 0,001; 2.61 ± 0.20, р < 0.001, respectively). Serum level of leptin in women with a reduced BMI was decreased compared to those with a normal BMI (9.3 ± 1.0 ng/mL and 21.45 ± 2.2 ng/mL, respectively, p < 0.001).Conclusions. Metabolic disturbances are characteristic for pregnant women with a reduced BMI, and serum leptin can be suggested as a specific diagnostic biomarker.
52-57 395
Abstract
Aim. To compare the outcomes of cesarean myomectomy to cesarean section alone. Materials and Methods. We consecutively recruited 70 women who underwent cesarean section in Reshetova Kemerovo Regional Perinatal Center. In 14 patients having uterine fibroid, we performed cesarean myomectomy following comparison of the outcomes to women either with or without a past medical history of cesarean section (n = 28 per group). Results. The mean duration of cesarean my-omectomy was 58.3±21.4 min. There were no significant intraoperative complications, with a mean blood loss of 750.0 ± 150.6 mL and no cases of blood transfusion. The mean hemoglobin level after cesarean myomectomy was 99.7 ± 12.5 g/L. There were no significant differences in the length of hospital stay between the patients who underwent cesarean myomectomy and cesarean section alone. Conclusion. Cesarean myomectomy significantly increases the blood loss. However, it neither causes major complications nor prolongs hospital stay compared to cesarean section alone and therefore can be considered as a possible surgical option.
58-62 393
Abstract
Aim. To determine the role of antibodies to estradiol (anti-Es), progesterone (anti-Pg), and benzo[a]pyrene (anti-Bp) in premature rupture of membranes (PROM). Materials and Methods. We recruited 68 women with PROM at 22+0-36+6 weeks and 81 women with a healthy pregnancy, with the further collection of venous blood at 22+0-36+6 weeks following measurement of anti-Es, anti-Pg, and anti-Bp IgA and IgG using enzyme-linked immunosorbent assay. Results. We detected the elevated levels of anti-Es, anti-Pg, and anti-Bp as well as increased IgA Bp/Pg, IgA Es/Pg, and IgG Bp/Pg ratios in women with PROM in 22+0-36+6 weeks compared to those without. Conclusions. Measurement of antibodies to estradiol, progesterone, and benzo[a]pyrene may be useful to predict PROM.
63-69 385
Abstract
Here we review the recent data on female psychophysiology as well as gender-related risk factors and features of various diseases. We further suggest a gender approach for teaching the new generations and for analyzing the emotional factors. Strikingly, females generally have a higher consumption of fresh vegetables and fruits and lower consumption of salt compared to males; however, abdominal obesity is more prevalent in females than in males, particularly in those with diabetes mellitus. Passive smoking is also more harmful for females in comparison with males; this should be of particular importance due to increasing number and proportion of female smokers. During the last four decades, cardiovascular mortality reduced in males but not in females. Therefore, society should focus the attention on the struggle with gender blindness.
70-75 478
Abstract
Obesity remains an imminent challenge in medicine and a major socio-economic problem. Here we discuss the pathogenesis of metabolic disorders and impaired lipid metabolism in female patients with obesity. We then consider obesity as a strong risk factor of gynecological diseases, particularly menstrual disorders. Finally, we describe the influence of obesity on reproductive health of adolescent girls, course of further pregnancy, and newborn health
76-81 454
Abstract
Here we discuss the risk factors and diagnosis of gestational diabetes mellitus (GDM), with the focus on widespread comorbidities including obesity, arterial hypertension, and insulin-dependent diabetes. We also cover the rare causes of GDM such as glucocorticoids, genetic abnormalities, and in vitro fertilization. Further, we describe controversial aspects of GDM diagnosis in different countries and results of the Hyperglycemia and Adverse Pregnancy Outcomes (HAPO) trial, a milestone in GDM research. Finally, we analyze the efficacy of the current Russian guidelines.
82-87 413
Abstract
Multiple organ failure is a leading cause of admission to the intensive care units, characterized by a high case fatality rate and significant financial costs. Here we review the mechanisms of multiple organ failure in pediatric patients (triggers, concomitant diseases, release of danger- and pathogen-associated molecular patterns, bacterial translocation, epithelial, endothelial, or mitochondrial dysfunction, and inadequate immune response) and recent diagnostic and prognostic scales.
88-92 559
Abstract
There is a widespread opinion that endometriosis is a disease specific for the childbearing period; however, there is extensive evidence on its occurrence also in postmenopausal women, with a prevalence reaching 5%. Since the malignant transformation of endometriosis is a rare but hazardous event, here we describe a case report of asymptomatic retroperitoneal endometriosis in a postmenopausal woman. Upon the excision of neoplasm, a histological examination confirmed endometriosis.


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ISSN 2500-0764 (Print)
ISSN 2542-0941 (Online)