Vol 6, No 2 (2015)

Nutrition is of great importance for the preterm infant. It is not only essential for survival, but also makes provision for rapid development of many organs outside the uterus which process normally takes place in the third trimester of pregnancy. It is for future life essential that all factors that might influence the development are as optimal as possible, including nutrition. However, there might also be an upper limit to the intake of some ingredients in the neonatal period. The rate of growth of the preterm infant is five times higher compared to term infants and the breast of the mother delivering preterm might yet be ready to produce the optimal composition of milk. Preterm infants receiving mothers milk only are known to show a lower gain in weight and length than the so called reference fetus. It is therefore at least questionable if preterm human milk can be used to define the nutritional needs of the preterm infant. To define the optimal composition and amounts of nutrients for the preterm infant a factorial approach can be used. The estimated requirements are calculated from the calculated requirements for maintenance and growth. Though some studies have shown that the protein content of milk from mothers who delivered preterm can be higher in the first few weeks after birth compared to milk of term delivering mothers, soon after there is a rapid decline in protein content after which period the content is not different from the term delivered mother. Providing exclusively mothers own milk leads to suboptimal growth and insufficient accretion of minerals. The needs of the preterm infant in energy, protein, lipids, carbohydrates, minerals, pro- and prebiotics to provide optimal nutrition in the first days after birth are discussed in the paper. It is concluded that nowadays early, aggressive nutrition directly after premature birth with the immediate introduction of amino acids and rapid introduction of lipids is advised. Enteral feeding should be started very soon after birth, preferably on the first day of life and increased in the days thereafter. The first choise for enteral feeding is mothers own milk, supplemented from the second week with a fortifier. Special preterm formula might serve as a good alternative in case when breast milk is not available.

The syndrome of thyrotoxicosis is the second occurrence in endocrine diseases giving way to the only diabetes. The most common cause of hyperthyroidism is Graves' disease. Nodular toxic goiter is following Graves' disease. Then more rare causes are solitary toxic adenoma and thyroiditis. Epidemiological studies carried out at the turn of XX-XXI centuries in the developed countries of Europe and North America have shown that a history of hyperthyroidism episode increases the relative risk of development of ovarian cancer by 80 % and breast cancer by 45-60 %. It has been shown that hyperthyroidism including subclinical one is a risk factor for morbidity and mortality from malignant neoplasms of different localizations as breast cancer, thyroid cancer, pancreatic cancer and lung cancer. In this case, drew the fact that significant differences in the risk of morbidity by specific disease forms depends on the ethnic composition of the population. In Russian Federation the similar epidemiological studies have not been carried out yet. We obtained the results of an epidemiological retrospective multicenter randomized clinical simultaneous analytical comparative study of the “case-control” among women treated for diffuse toxic goiter and nodular toxic goiter in 1999-2009. The study involved 1135 patients with hyperthyroidism in anamnesis. The comparison group included 953 patients with eu- and hyperthyroid status. The risk of malignancies in women with hyperthyroidism in anamnesis was 2.36 (95 % CI 1.63-3.42, p < 0.01). The risk of hormone-dependent tumors was 2.65 ( 95 % CI 1.7-4.13, p < 0.01). The aim: to evaluate the risk of malignancies in women with long flowing hyperthyroidism.

In recent years the Russian Federation among the causes of maternal mortality extragenital diseases occupy the first place (37.7 % in 2012). There is an increasing group of children with chronic diseases. Objective: to make an analysis of the gynecological pathology in girls with decompensated chronic extragenital pathology. Methods. A total of 1682 patients aged under 18 years who are treated in the Saint Petersburg State Pediatric Medical University’s multidisciplinary clinic and directed clinicians to consult a gynecologist. We used anamnestic, clinical and laboratory methods of investigation and analysis of medical records. Results. As a result of analysis, we found that the structure of gynecological pathology identified in patients with decompensated extragenital diseases, 44 % are menstrual disorders, 37.9 % - an inflammatory disease, 14.2 % - non-inflammatory problems, 12.7 % - other. In this case, gynecological pathology, of course, is associated with somatic. So, the girls suffering from connective tissue, often recorded long and heavy menstruation (38.9 %), diseases of the gastrointestinal tract and urinary system - painful (45.9 and 55 %, respectively), endocrine pathology often accompanied by rare, scanty menses (56.8 %). Conclusions. Given the importance of extragenital pathology in the implementation of fertility, it is important to pay particular attention to: a) development of an algorithm for monitoring, treatment, rehabilitation of girls suffering from extragenital pathology, which should include a compulsory inspection gynecologist; b) the participation of gynecologist in the regular medical check observation girls with chronic extragenital pathology in the case of existing combinations with gynecological diseases. Such an approach should be further consolidated when transferring patients under the supervision of an adult network.

Analysis of published data on the diagnostic criteria used in the qualification of hyperkinetic syndrome found that along with the data on residual-organic failure CNS causes the development of hyperkinetic syndrome expanded range of studies on the endogenous nature of this syndrome. Thus the international “Genomics Consortium psychiatric” (Psychiatric Genomics Consortium) identify common loci in hyperkinetic disorder and schizophrenia which are located on the short arm of the 3rd chromosome (3r21) and on the long arm of chromosome 10 (10q24) and revealed single nucleotide substitutions (SNPs) in the two genes (CACNA1C and CACNB2) which encode proteins that are part of the channels regulating calcium transport into brain cells. Hyperactivity disorder (GR) as a mental disorder (F90) is multifactorial in nature, which requires consideration of clinical symptom in different planes with the release of endogenous and exogenous forms the primary etiological factor for differentiation therapy. Were studied 231 adolescents with a diagnosis of “Attention-Deficit hyperactivity Disorder” (mean age - 17,7 years). The main components of adolescents AHHD are given by BPRS: arousal (3,63 ± 0,06); cognitive (2,94 ± 0,06) and emotional (2,64 ± 0,06) disorder. Patients were split into threatment group: group 1 (n = 23) received Atomoxetine 25mg/day; group 2 (n = 20) received thioridazine 25mg/day, group 3 (n = 22) - pipophezine 50 mg/day. The positive dynamics of disregulatory-motor typeractivity, cognitive and emotional components of ADHD was observed. The aim: to evaluate the influence of Atomoxetine, Thioridazine, Pipophezine on the main psychopatological clinical-components of adolescents AHHD.

It has been established the close relationship between gene polymorphism of lactoferrin (LTF) with an incidence of mastitis and somatic cell counts in milk of mammals. Lactoferrin gene products are associated with resistance to several diseases, and particularly for mastitis. Lactoferrin (LTF) is a multifunctional small glycoprotein of milk. Its main function is to protect the breast. It is considered that genetic variants of DNA lactoferrin could be used as a marker for the prediction of somatic cells in milk and mastitis incidence. Allele A of LTF gene is associated with the incidence of mastitis in mammals such as cows. It has also been established that the polymorphism of BMP15 and GDF9 genes of sheep influence the number and rate of ovulation. Thus the alleles of Bone morpho-genetic protein (BMR15) gene influence the process of folliculogenesis in sheep. Sheep heterozygous on this locus ovulate two or three oocytes. The authors of this study recommend the use of polymorphism BMP15 gene as DNA markers to increase fertility in sheep. It is well known that products of GDF9 gene control the process of growth and development of follicles in cows. Polymorphisms of the gene is well studied in medicine. Women who have a mutation in the coding region of the gene GDF9 found signs of premature ovarian failure. The study of lactoferrin gene polymorphism has theoretical and practical importance since there is a positive correlation between the content in milk of somatic cells and genetic variants of lactoferrin. Thus, the authors suggest the use of GDF9 gene polymorphism in cows as a DNA marker for the prediction of reproductive function in mammals. The aim: to study DNA polymorphism of genes LTF, GDF9 and identified animals (Bos Taurus L) with the desired genotype for the studied loci to build model for searching new pharmacological agents.

A rat model of inflammatory and degenerative damages of the smooth parodont tissue by means of administration of 2 % formal-dehyde water solution into the smooth parodont tissues was described. The oxidative status of rats including lipid peroxidation and antioxidant defense system indexes was assessed because of their high sensitivity to inflammation process. The lipid peroxidation indexes (malonic dialdehyde and dienic conjugates level) were 2-3-fold higher in the blood serum and parodont tissue in 7 days after inflammation beginning. The system of antioxidant defense (recovered glutatione level and activity of superoxide dismutase) was more sensitive in comparison with lipid peroxidation. The recovered glutation content in the blood serum was decreased from 2.02 ± 0.09 till 0.88 ± 0.21 µM/ml, and superoxide dismutase activity was reduced from 0.78 ± 0.10 till 0.28 ± 0.04 А/mg protein, that was these indexes were decreased in 2.5-3 times. The same regularity was observed in the smooth tissues of the parodont. The recovered glutation level was decreased in 2.1 times and superoxide dismutase activity was reduced in 7 times. Therefore, the curative and prevention action of tooth pastes and stomatologic drugs could be assessed with this model of inflammation. In particular, the tooth pastes lesmin-dent > clamin-dent > zhemchug (in order of descending activity) attenuate or abolish signs of inflammatory and degenerative damages of the smooth parodont tissue in rats assessed on lipid peroxidation and antioxidant defense system indexes.

Nowadays gynecologists try to find less traumatic and more effective variants of surgical treatment. Minilaparoscopic surgery is a resultant achievement of developments in gynecology since the beginning of the 20th century. It is a novel real-time surgical method. During the last decade the authors have accomplished 270 minilaparoscopic operations. The present paper sums up our experience in minilaparoscopic operations involving the uterus, Fallopian tubes, ovaries (salpingolysis, decortication, endometriosis sites excision, gonadectomy, etc.). The advantages of this kind of surgical operation especially promising in infantile gynecology are disclosed. Among the advantages of minilaparoscopic approach in infantile gynecology the authors emphasize the decrease of preoperational period, optimization of diagnostics during the operation, sparing techniques, reduction of post-operational complications. The aforementioned features of laparoscopic surgery suggest breakthroughs in normalizing nature of treatment in gynecology improving reproductive well-being of females and reproductive potential of girls. As a result we expect better demographic and reproductive prospects in future.

The key immunology problem remains the understanding of the mechanisms for the effective protection of the body against various pathogens with simultaneous suppression of the immune response to autoantigens. The pathogenesis of neoplastic pathological processes includes violations of the mechanisms of normal cell growth and cell proliferation. Antitumor immune response is a complex event, involving many different cell types. But despite the ability of the immune system to recognize and respond to a variety of tumor-associated antigens, the neoplastic process overcomes the protective forces of the organism, grows and spreads. For cancer cells characterized by independence from antiproliferative signals, autocrine stimulation of growth disturbances in the system, induction of apoptosis and control of genome stability. As a result of accumulation of genetic and epigenetic changes in tumor cells differ significantly from the normal range and the level of expression of genes involved in the transformation process, the accumulation of mutations in key genes promoters and suppressors of tumorigenesis. This creates the opportunity for recognition by cells of the immune system. The study of changes in value and operation of the various elements of the immune system in the development of experimental neoplastic process allows you to identify the mechanisms of interaction in the system «malignant tumor-immune system, to assess patterns of interaction with other organs and tissues, to create a theoretical pathogenetically reasonable premise for the development of anticancer therapy.

In the paper, the life and scientific achievements of Nikolai Pavlovich Kravkov (1865-1924), a founder of the Russian pharmacology, head of the Department of Pharmacology, Military Medical Academy, St. Petersburg, were described. N. P. Kravkov carried out significant investigations in pharmacology of gas metabolism, drug toxicology, aged and evolutionary pharmacology, clinical pharmacology (discovery of intravenous and combined narcosis). The main achievement of N. P. Kravkov became the cycle of investigations on isolated organs (ear, heart, lung, spleen, pancreatic gland, thyroid gland, adrenal gland, uterus of the mammalians, head and gills of pike, human fingers, heart and spleen). In these investigations, the rhythmic oscillation of the vascular tonus was proved, the theory of phasic action of pharmacological drugs on tissues, presentations on sensitiveness limits of living protoplasma, possibilities of animation of mummified tissues were postulated. N. P. Kravkov created a large scientific school (S. V. Anichkov, M. I. Gramenitskii, G. L. Shkavera, M. N. Nikolaev, A. I. Kuznetsov, B. S. Sentyurin, V. V. Zakusov, V. A. Valdman). For 25 years (1899-1924) N. P. Kravkov headed the Department of Pharmacology of Military Medical Academy. Commission for awarding the prize V. I. Lenin for scientific work which included the most prominent scientists of our country (O. J. Schmidt was Chairman), A. N. Bach, P. P. Lazarev, S. G. Navashin and M. N. Pokrovsky decided to award the prize to N. P. Kravkov for proceedings in 1926 year.