We evaluated the influence of hypoxic hypoxia on lactate, creatinine and urea concentrations in the amniotic fluid (AF) of rabbits on 27-28th day of pregnancy. Rabbits were randomly sudivided into two groups: experimental (n=9) and control (n=6). Rabbits of experimental groups were placed in a hypoxic chamber containing 10±2% oxygen and 90±2% nitrogen for 1 h and then were euthanized, AF was extracted from the amniotic sacs via disposable syringe. Acute hypoxic hypoxia had no effect on the AF volume, increased (1.4-fold) lactate, (1.3-fold) creatinine and (1.1-fold) urea concentrations in AF. In contrast to animals of the control group, lactate concentration in the groups with hypoxic hypoxia correlated with the creatinine (r=0.71, p<0.0001, n=35) and urea concentrations in the AF (r=0.81, p<0.0001, n=35). These results suggest that acute hypoxic hypoxia in late pregnancy causes changes in the biochemical composition of AF; these changes are characterized by high lactate concentrations, and the fetus and uterus can be the source of increased lactate level in AF.
AIM: This study was aimed to determine predictors of severe lesions of the central nervous system in newborns from mothers with preterm labor complicated by premature rupture of membranes, and to develop a model for predicting adverse outcomes based on clinical data and biochemical markers. MATERIALS AND METHODS: At the first, retrospective, stage of the study, in order to determine clinical predictors of severe cerebral injury, we studied anamnesis data and features of pregnancy and delivery in 101 patients with premature rupture of membranes, expectant management tactics and subsequent delivery at 2633.6 weeks of gestation. At the second stage, in the prospective study, which included 33 patients, we evaluated the level of neuron-specific enolase in the amniotic fluid and determined its diagnostic significance as a predictor of severe lesions of the nervous system. RESULTS: The following factors were determined as clinical predictors of severe cerebral ischemia in premature infants: delivery time, duration of the latency period, the proportion of stab leukocytes in the leukocyte formula, and the presence of funiculitis in the histological examination of the placenta. A prognostic model with sensitivity of 98% and specificity of 80%, including clinical predictors and neuron-specific enolase, was developed. CONCLUSIONS: Prediction of severe cerebral ischemia and correction of the latency period allows for improving perinatal outcomes in premature infants and starting rehabilitation measures after birth in a timely manner.
THE AIM: to determine reference limits of volume, osmolality and concentration of Na+, K+, Cl−, non-organic phosphate (Pi ), and Ca2+ in amniotic fluid (AF) of rabbits on 27-28 day of gestation. MATERIALS AND METHODS: during research on first-pregnant rabbits (n=6), received 37 samples of AF, determined fetal mass, fetal part of placenta mass, volume, osmolality and concentration of Na+, K+, Cl−, Pi , and Ca2+. RESULTS: obtained reference limits of volume (0,09–1,63 ml), osmolality (210,0–267,0, mOsmol/kg), concentration of ions Na+ (110,0–146,0 mmol/l), K+ (6,0–12,4 mmol/l), Cl– (87,0–117,0 mmol/l), Ca2+ (1,88– 2,89 mmol/l) and Pi (0,56–1,57 mmol/l) in AF. Reverse correlation of AF volume with fetus mass (r = -0,525, p < 0,001) and positive correlation between fetus mass and AF osmolality (r = 0,375, p = 0,022) were determined. Concentrations of Na+, K+, Cl− are correlated with placenta mass (r = 0,368, p = 0,025; r = 0,353, p = 0,032; r = 0,381, p = 0,020, respectively). AF osmolality correlated with concentrations of Na+ (r = 0,514, p < 0,001) and Cl(r = 0,510, p < 0,001). CONCLUSION: results could be used for developing animal models of medicamental influence on AF volume, osmolality and ion composition on late gestation.
The paper analyses the tactics of managing patients with malignant neoplasms in the pancreatobiliary area complicated by obstructive jaundice in two nosologically and clinically comparable groups of patients. The aim of the research. To evaluate the effectiveness of complex palliative treatment with the use of photodynamic therapy in patients with malignant neoplasms in the pancreatobiliary area complicated by obstructive jaundice. Material and methods. In the main group, which consisted of 41 patients, palliative complex treatment was carried out using local and systemic photodynamic therapy of neoplasms in the pancreatobiliary area complicated by obstructive jaundice, purulent cholangitis. In the comparison group, which consisted of 165 patients, palliative complex treatment of complications was carried out without the use of photodynamic therapy. Complex palliative treatment in both groups included the following surgical interventions: percutaneous transhepatic mono- and bilobar drainage of the bile ducts, stenting of the bile ducts under ultrasound and X-ray control as well as bypass biliodigestive anastomoses. Symptomatic conservative treatment included infusion, detoxification, analgesic, hepatoprotective and antibacterial therapy. Results. Against the background of local and systemic photodynamic therapy in the main group, a decrease in the largest size of the neoplasm in patients with malignant neoplasms of the pancreas from 42.5 mm to 38 mm within a week after treatment was established according to the data of multispiral computed tomography of abdominal organs with intravenous bolus contrast. The largest neoplasm size decreased from 40.5 mm to 31 mm within a month after treatment according to the ultrasound examination of the abdominal cavities. Restoration of bile excretion into the intestine in 100% of patients with malignant neoplasms of the bile ducts and the head of the pancreas was registered, as well as an increase in life expectancy of patients by more than 1 year, a decrease in the risk of complications due to a slowdown in the growth of neoplasms associated with a decrease in the concentration of the cytokine TNF-α. Conclusion. Complex treatment with the use of photodynamic therapy of malignant neoplasms of the pancreatobiliary area allows reducing the largest size and rate of neoplasm invasion and to increase the survival rate of patients.
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