The present article is concerned with the study of glial fibrillary acidic protein (GFAP) level in the blood serum of pregnant women with post–trauma brain injury syndrome (post-TBI syndrome) as the marker of hematoencephalic barrier status and predictor of obstetric and perinatal complications development.
A retrospective analysis of the course of pregnancy and childbirth during the birth of a child with a congenital pathology «ichthyosis» was carried out. This clinical case is interesting because fetal ichthyosis was not diagnosed during pregnancy, but all the signs of this disease were revealed in the newborn after the birth.
The role of VDR gene BsmI (rs1544410) and FokI (rs10735810) polymorphisms in postmenopausal osteoporosis formation has been confirmed by the results of fairly large number of studies. However, pharmacogenetic aspects of above polymorphisms have not been adequately studied. The aim of this work is to study the serum levels of certain biochemical parameters, bone turnover markers, vitamin D and parathyroid hormone in women with postmenopausal osteoporosis in the dynamics of treatment by ibandronic acid, depending on VDR gene rs1544410 and rs10735810 polymorphisms. We examined 117 women in dynamics of postmenopausal osteoporosis treatment. The 12-month course therapy included ibandronic acid, calcium and cholecalciferol according to the standard regimen. Detection of genetic polymorphisms was carried out by polymerase chain reaction method in real time. Twice, before the therapy start and at the end of one, the basic biochemical parameters, as well as β-Crosslaps, osteocalcin, 25(OH) D and parathyroid hormone were studied in women blood serum. Women with postmenopausal osteoporosis in treatment dynamics are characterized by significant decrease in serum β-CrossLaps, osteocalcin and alkaline phosphatase (p<0.01), as well as an increase in 25(OH)D concentrations (p<0.01). Prior to the initiation of therapy, GG genotype of the rs10735810 polymorphism of the VDR gene was associated with lower osteocalcin concentrations than in AA genotype (p<0.01). Holders of GG genotype of VDR gene rs1544410 polymorphism, in comparison with other women, are characterized (p<0.01) by lower levels of alkaline phosphatase (before treatment) and calcium (before and after treatment), higher levels of parathyroid hormone (before and after treatment). The obtained results can be used to develop personalized antiresorptive therapy regimens in postmenopausal osteoporosis.
Aim: to assess the efficacy of penicillamine for the complex prevention of pelvic peritoneal adhesions in appendicitis associated with the acute conditions of uterine appendages (appendicular-genital syndrome, AGS) based on the changes in the levels of hydroxyproline and the major clinical symptoms of pelvic inflammatory disease. Patients and Methods: 157 women of reproductive age with AGS who were urgently or routinely admitted to a gynecological or surgical hospital were examined. Comparison group women were prescribed with conventional anti-inflammatory treatment or surgery as needed. Study group women additionally received penicillamine 250 mg twice daily for a month. Pre- and post-treatment non-invasive assessment of the peritoneal adhesive process was performed by measuring the levels of protein-bound and free hydroxyproline. Treatment efficacy was evaluated after 1 month by the changes in hydroxyproline levels, major clinical symptoms, and ultrasound. Results: it was demonstrated that pelvic acute inflammatory disease results in > 1.5-fold increase in the levels of protein-bound and free hydroxyproline. Penicillamine as a component of the complex treatment for pelvic inflammatory disease reduces the levels of hydroxyproline to normal ranges. The changes in the major clinical symptoms and ultrasonic findings after penicillamine therapy were more significant compared to the standard treatment. Conclusions: penicillamine as a component of the complex treatment for pelvic inflammatory disease significantly accelerates the improvement of symptoms and remission as well as the formation of peritoneal adhesions. This prevents both pelvic adhesive disease and tubal- and peritoneal-factor infertility. KEYWORDS: appendicular-genital syndrome, inflammation, hydroxyproline, penicillamine, pelvic peritoneal adhesions, prevention, adhesion formation. FOR CITATION: Simrok V.V., Popova I.A., Mel’nikova D.V. Clinical pathogenic basis for anti-adhesive treatment for appendicular-genital syndrome in women of reproductive age. Russian Journal of Woman and Child Health. 2020;3(4):228–232. DOI: 10.32364/2618-8430- 2020-3-4-228-232.
Цель работы – исследовать сывороточные уровни маркера резорбции костной ткани (β-Crosslaps), маркеров остеогенеза (остеокальцин, щелочная фосфатаза), а также кальция, 25-гидроксивитамина D (25(ОН)d) и паратгормона в динамике лечения женщин с постменопаузальным ОП препаратом ибандроновой кислоты. Материал и методы. Обследовано 117 женщин с постменопаузальным остеопорозом в динамике лечения. Контрольную группу составили 75 практически здоровых женщин в постменопаузе. Женщины с остеопорозом были обследованы до и по окончании 12 месячного курса лечения, включавшего прием ибандроната, кальция и холекальциферола в стандартных дозах. В динамике лечения оценивались показатели прироста минеральной плотности кости и изменения вышеуказанных сывороточных факторов. Результаты. Установлено, что пациенты с постменопаузальным остеопорозом по сравнению со здоровыми женщинами характеризуются более низкими значениями веса и индекса массы тела (р<0,001), увеличенной активностью щелочной фосфатазы (р<0,01), повышенными концентрациями в сыворотке крови β-CrossLaps и остеокальцина (р<0,01). Прирост минеральной плотности кости в ответ на 12 месячный курс терапии у женщин с постменопаузальным ОП составил от 2,71±0,53% в зоне шейки левого бедра до 4,55±0,51% в поясничных позвонках L1-L4 (р<0,001). Терапия женщин с постменопаузальным остеопорозом сопровождалась снижением до значений контрольной группы показателей щелочной фосфатазы, β-CrossLaps и остеокальцина (р<0,01), а также уменьшением удельного веса среди них дефицитных по витамину D пациентов (от 60,7% до 20,2%; р<0,001). Заключение. Полученные результаты необходимо использовать как для ранней диагностики постменопаузального остеопороза, так и при лечении женщин с вышеуказанным заболеванием. Ключевые слова: постменопаузальный остеопороз, лечение, костные маркеры, витамин D, паратгормон.
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