Vol 11, No 1 (2020)

Objective. Establish the relationship between the action of antiangiogenic factors sFLT-1 and endoglin, as well as marinobufagenin in the formation of symptoms of preeclampsia in the clinic and experiment.

Materials and methods. In the first experimental phase, preeclampsia-like state was simulated in pregnant rats, the changes in the content of substances reflected in the target tissues were studied, as well as the effect on their concentrations of anti-marinobufagenin antibodies. In the second (clinical) phase, changes in the content of sFlt-1 and endoglin-1 in placental tissues, as well as marinobufagenin in blood plasma and activity of Na⁺/K⁺-ATPase of erythrocytes in pregnant women with preeclampsia were studied.

Results. In rats, an increase in systolic blood pressure, and marinobufagenin plasma levels was observed during the formation of a preeclampsia-like condition. Administration of antibodies to marinobufagenin caused a decrease in blood pressure. Found that during the formation of a preeclampsia-like condition, there is an increase in the content of sFlt-1 in the placenta and thoracic aorta and endoglin in the placenta. In patients with preeclampsia, it was found that the increase in blood pressure occurs against the background of an increase in the content of marinobufagenin in blood plasma, as well as a decrease in the activity of Na⁺/K⁺-ATPase of erythrocytes. The formation of preeclampsia is accompanied by a significant increase in the level of antiangiogenic factors endoglin and sFlt-1 in the placenta.

Summary. In patients with preeclampsia, the development of clinical symptoms is accompanied by an increase in the placental tissues of the content of antiangiogenic factors endoglin and sFlt-1 and the content of marinobufagenin in blood plasma. The obtained data are confirmed by the results of an experiment performed on pregnant rats with modeling of preeclampsia-like condition.

Objective: to study the relationship of the main mediators of atopy and clinical and morphological characteristics lesions of the stomach with its secretory-motor disorders in children with atopic dermatitis. We study 134 patients aged 7 to 14 years with atopic dermatitis and 30 healthy children as control group. All children passed general clinical and laboratory instrumental investigations. In addition, children with manifestations of atopic dermatitis and secretory-motor disorders of the stomach Fibroesophagogastroduodenoscopy, topographic intragastric pH-metry with aspiration biopsy of the gastric mucosa were performed, followed by morphological investigations. In sick children, an increase in the levels of total IgE, histamine and serotonin was detected in the blood, combined with a tendency to decrease acid-forming function, endoscopic and morphological changes in the gastric mucosa. It is assumed that concomitant atopic dermatitis secretory-motor disorders of the stomach are manifestations of gastrointestinal syndrome, which can be both secondary and primary in relation to skin manifestations and in both situations contribute the formation of endoallergens and maintain a vicious cycle of the pathological process.

Asthenic type of constitution and low body weight are traditionally associated with hereditary disorders (dysplasia) of connective tissue (HDCT). Another specific signs of HDCT is dolichostenomelia (skeletal imbalances). The prevalence of signs of dysembryogenesis and skeletal imbalances in young people depending on sex, type of constitution and body mass deficiency have not been previously assessed.

Materials and methods. We examined 967 practically healthy people aged 18 to 25 years (330 boys and 637 girls) and 119 boys with a diagnosis of “body weight deficiency” by help general examination, phenotypic and anthropometric examinations.

Results. Most bone signs of dysembryogenesis significantly often detected in young men: keel-shaped chest deformity (4% vs 1%, p < 0.01) and funnel chest deformity (19% vs 9%, p < 0.01) deformations of thorax, high palate (39% vs 28%, p < 0.01), the growth of teeth (36% vs 19%, p < 0.01) and dolichostenomelia. Girls are characterized by a high frequency of joint hypermobility (50% vs 24%) and atrophic striae (30% vs 14%, p < 0.01). The bone signs (symptoms of arachnodactyly and chest deformities) detected more often in people with body weight deficiency, and the skin signs and joint hypermobility revealed more often in young people with normotrophy. Comparison of the frequency of signs of dysembryogenesis and skeletal imbalances in groups with asthenic and normal constitution did not reveal differences. All of external signs were found with equal frequency in individuals with different types of physique.

Conclusions. Body weight deficiency in young men is closely related to bone signs of dysembryogenesis, while the asthenic type of constitution is not a reliable marker of connective tissue defect.

A study of intrahepatic blood flow by polyhepatography and evaluation of endothelial function by peripheral arterial tonometry in patients with essential hypertension and coronary heart disease was conducted. The study included 105 people. The subjects were divided into three groups: patients with hypertension, coronary heart disease in combination with hypertension, and a group of healthy people. In all observed cases, except for the healthy group, hemodynamic changes were detected. The features of impaired intrahepatic blood flow in patients with cardiovascular pathology were revealed. The nature of blood flow disorders largely depended on the etiologic factor. The endothelial dysfunction revealed in patients with cardiovascular disease. In patients with arterial hypertension in combination with or without coronary heart disease, a relationship was found between endothelial dysfunction and intrahepatic hemodynamic disorders. The relationship of endothelial dysfunction and intrahepatic hemodynamic disorders was established, in patients with hypertension in combination with coronary heart disease or without it. Therefore, the liver is involved in the pathological process, regardless of the form of myocardial damage in cardiovascular pathology. It is accompanied by varying degrees of severity of intrahepatic microcirculation disorders and endothelial dysfunction of the peripheral vascular bed. This may be a consequence of the universal reaction of the endothelium due to realized effect of risk factors for the development of cardiovascular diseases. In this regard, the liver can be considered as one of the target organs in patients with cardiovascular pathology.

The effectiveness of the treatment of chronic gastroduodenal pathology associated with Helicobacter pylori infection consists not only in the successful eradication of the pathogenic microorganism, but also in eliminating dyspeptic and abdominal pain syndrome, as the main clinical criteria for this pathology. Among the main reasons that affect the successful outcome of therapy, it can be distinguished strict adherence to the prescribed drug regimens. The aim of the work was to assess the effect of parental adherence to their child suffering from chronic gastroduodenal pathology, treatment on the patient's quality of life. 80 children of high school age suffering from chronic gastroduodenal pathology associated with Helicobacter pylori were examined. Anti-Helicobacter therapy using clarithromycin, amoxicillin, omeprazole for 14 days was held in all patients. The training of parental compliance in relation to ongoing therapy for their child was conducted before therapy in patients of the comparison group. The special questionnaire developed by us was used to assess the level of parental compliance. In addition, in all patients, the quality of life indices were studied using the SF-36 questionnaire at baseline and one month after the start of therapy. It was revealed that in children with chronic gastroduodenal pathology the initial indicators on all scales of quality of life were significantly lower compared to the children of the control group. It was found that the greater compliance of parents to their child's prescribed therapy leads not only to the successful eradication of Helicobacter pylori infection, but also to positive dynamics, both physical and psychological aspects of health.

Acute myocarditis by the World Health Organization is an inflammatory disease of the heart muscle, confirmed by histologically, immunologically and immunohistochemically. The diagnosis of acute myocarditis in children remains open due to the presence of a number of reasons. First of all, it is difficult to diagnose myocarditis in children due to the variety of clinical manifestations and the presence of nonspecific symptoms of the disease. What matters is the lack of accessibility in the routine practice of a doctor of certain research methods and a sharp limitation in the use of endomyocardial biopsy. The search for differential diagnostic algorithms of the disease continues. According to modern literature, much attention is paid to non-invasive methods for the diagnosis of acute myocarditis in children. The course of acute myocarditis can be complicated by life-threatening cardiac arrhythmias: ventricular extrasystole, lengthening of the corrected QT interval, atrioventricular block. The appearance of cardiac arrhythmias increases the risk of sudden cardiac death. Recommendations for the treatment of myocardium in children often undergo changes due to the small number of multicenter and controlled studies in the pediatric population. The article provides an overview of modern approaches to the treatment of acute myocarditis in children: the use of antiviral drugs, intravenous immunoglobulin, immunosuppressive therapy, especially the treatment of heart failure in acute myocarditis in children.

Epileptic encephalopathies of infancy are difficult-to-treat destructive cases of epilepsy in infants and young children, which include the two clinical observations of Coppola – Dulac syndrome (malignant migrating partial attacks of infancy) given in this article. Epileptic encephalopathies are a genetically heterogeneous group of disorders that are characterized by the presence of a convulsive syndrome and are accompanied by cognitive and behavioral disorders. As a result of intensive development of methods of molecular genetic research, ideas about the causes of epilepsy in children began to change, this fact led to the fact that the international League against epilepsy replaced the term “idiopathic epilepsy” with “genetic epilepsy”. To date, about 60 phenotypic variants of early epileptic encephalopathies have been registered in children, including those associated with mutations of genes that regulate the functions of voltage-dependent calcium and sodium channels. In our work, we consider clinical observations of genetic epileptic encephalopathies caused by mutations in the CACNA1A and SCN8A genes, respectively, which are channelopathy. Malignant migrating partial attacks of infancy (infant epilepsy with migrating focal attacks, Coppola – Dulac syndrome) are manifested at an early age, from the first days to 6 months of life, and are characterized by typical multifocal attacks with a tendency to change hemispheres and involve opposite limbs. G. Coppola based on the analysis of their own observations, described in 1995 a new age – dependent epileptic syndrome, introducing a definition for it – “migrating partial attacks of infancy”. Currently, it is recommended to use the term “infant epilepsy with migrating focal seizures”. We present our own clinical and neurophysiological observations of this rare syndrome.

Psychological sexuality features in people living with HIV with and without substance use as a determinant of the HIV epidemic growth were explored. The study involved 136 respondents (2 groups of 50 people with different infection routes: blood-borne infection route and heterosexual transmission; 36 individuals without HIV). The following research methods were used: a specially developed clinical map, an original author’s questionnaire « Infection risk and the disease situation» (allows to register the main characteristics of the life situation of the disease), the incomplete sentences test of Sachs – Levy, Freiburgh Personality Inventory, I-structure Ammon test. Data processing included the Fisher criterion (Fisher angular transformation), ANOVA, content analysis. Significant negative effects in sexual sphere related to gender and the presence of HIV were revealed in the study. It has been established that people living with HIV with and without substance use differ in the frequency of concealment of HIV status and the presence of destructive type of sexuality. It has been established that people living with HIV and healthy respondents differ in the frequency of unrealistic way of thinking regarding opposite sex. A frequent occurrence of negatively colored attitude towards opposite sex and positively colored attitude towards sexual relations was noted in all groups. The results of the study determine the need for timely preventive measures in all population groups and psychocorrectional measures among people living with HIV, which will allow to prevent an increase in the number of children and adolescents with HIV. Psychological sexuality features in people living with HIV in the Russian sample were studied for the first time. The results are partially confirmed in foreign literature.