Hasil untuk "Gynecology and obstetrics"

Luky Satria Marwali, Marcel Ezra Setiawan, Malvin Emeraldi et al.

Objectives: This study aims to determine the impact of oxidized regenerated cellulose (ORC) during cystectomy and drainage on recurrence and ovarian reserve. Materials and Methods: Women aged 18–45 years with endometrioma (pathologically confirmed) who underwent conservative laparoscopy surgery (cystectomy and drainage) using ORC at Fatmawati General Hospital Jakarta, Indonesia, were included in this study. All surgeries were done by complete excision of all endometriosis lesions (especially for excision of deep infiltrating endometriosis and adenomyosis resection). All patients were followed up for 1 year, and the recurrence rate and postoperative anti-Mullerian Hormone (AMH) were evaluated. Results: Twenty patients were included in the cystectomy group and 19 in the drainage group. The researchers found the result was not significant (P = 0.622) in recurrence rate. AMH was decreased from 3.0 ± 1.8 to 2.1 ± 1.5 in cystectomy with ORC group. Conversely, AMH decreased from 1.4 ± 1.25 to 1.1 ± 0.9 in the drainage with ORC group. The reduction of AMH level was more significant in the cystectomy group (P = 0.002) than in the drainage group (P = 0.124). Conclusion: Cystectomy with ORC significantly reduces ovarian reserve. Drainage followed by insertion of ORC to the cyst cavity can be an option to maintain ovarian reserve with a risk of recurrence that is not significantly different from cystectomy.

I.S. Samolygo, K.A. Andrianova, M.A. Manina et al.

<p style="font-weight: bold;"> I.S. Samolygo, K.A. Andrianova, M.A. Manina, A.S. Pestova, S.I. Erdes </p> <p> I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russian Federation </p> <p> Focus on health of children and adolescents is a key part of socio-demographic policy of any state. Preventive vaccination remains one of the most efficient public healthcare tools that can significantly reduce infection dissemination and child mortality. The review highlights current trends, issues and challenges facing the healthcare system in the Russian Federation and worldwide. An alarming increase in morbidity of vaccine-preventable infections including measles, pertussis, pneumococcal and rotavirus infections associated with decreased vaccination coverage, increasing anti-vaccination trends, global migration and the COVID-19 pandemic effects is reported. Analysis of current national vaccination schedules, vaccination coverage, reasons for immunization refusals, as well as specific features of immune response formation in children with various immunobiological agents is presented. Special attention should be given to importance of comprehensive preventive work including not only extended vaccination schedules, but also enhanced educational and public awareness activities among parents and a medical community. A need for systemic measures to increase confidence in vaccination, to ensure equal access to vaccines, and to improve immunization coverage in children is emphasized. </p> <p> <span style="font-weight: bold;">Keywords:</span>&nbsp;pediatric health, preventive vaccination, vaccine-preventable infections, vaccination, measles, pertussis, pneumococcus, rotavirus. </p> <p style="font-style: italic;"> <b>For citation:</b><span style="font-style: italic;">&nbsp;Samolygo I.S., Andrianova K.A., Manina M.A., Pestova A.S., Erdes S.I.</span>&nbsp;Modern challenges of preventive vaccination in children: from epidemiological trends to social barriers: literature review. Russian Journal of Woman and Child Health. 2025;8(4):366–371 (in Russ.). DOI: 10.32364/2618-8430-2025-8-4-13 </p>

Rui-Ling Liu, Zhi-Lei Xu, Yu-Ling Hu et al.

Environmental factors, particularly various components of fine particulate matter (PM2.5) (i.e., sulfate [SO42-], nitrate [NO3-], ammonium [NH4+], organic matter [OM] and black carbon [BC]), are increasingly recognized as potential risk factors for poor ovarian response (POR) in fertility treatments. However, existing research is limited, and the critical periods of vulnerability to exposure to PM2.5 and its components remain unclear. In this retrospective cohort study, we included 38,619 patients undergoing their first in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) treatment, defining POR as the primary outcome based on the POSEIDON criteria. We divided the six months prior to oocyte pick up (OPU) into different exposure windows and used logistic regression models to assess the association between pollutants and POR. Results showed that exposure to PM2.5 and its components in the three months before OPU significantly increased the odds of POR. The distributed lag nonlinear model (DLNM) analysis revealed the lagged effects of PM2.5 component exposure, particularly during lag weeks 2–5, where exposure was significantly associated with the occurrence of POR. This period may represent a sensitive window for exposure. Meanwhile, the restricted cubic spline (RCS) analysis indicated that the odds of POR gradually increased with higher pollutant concentrations. These findings underscore the urgent need for public health measures during sensitive stages of follicular development, particularly policies aimed at reducing environmental pollutant exposure among women of reproductive age to protect reproductive health.

Megan E. Kalata, Ashley Pak, Jue Li

Jing Shi, Kai-Lun Hu, Xiao-Xue Li et al.

Abstract Background Bisphenol A (BPA) levels are high in women with polycystic ovary syndrome (PCOS). The mechanism by which BPA induces abnormal glucose metabolism in PCOS patients is largely unknown. Methods Serum and urine samples were collected from women with and without PCOS (control) at the reproductive medicine center with informed consent. Non-PCOS patients who received in vitro fertilization were recruited for collection of ovarian follicular fluid and granular cells. Wild-type C57BL/6 and AhR −/− mice were used to verify the effects of BPA on PCOS. Real-time PCR, western blotting, and ELISA were conducted to analyze the function of BPA. Chip-qPCR verified the role of AhR in GLUT4 transcription. Flow cytometry was performed to determine glucose uptake. Results A positive correlation was observed between BPA concentration and serum BPA levels in PCOS patients. BPA aggravated the changes in PCOS with abnormal glucose metabolism, impaired fertility, and increased body fat. Mechanistically, we showed that BPA activated AhR and led to decreased glucose transport via GLUT4 downregulation in ovarian granular cells. Therefore, the use of inhibitors or knockout of AhR could effectively rescue BPA-induced metabolic disorders in PCOS mice. Conclusions Our results revealed that BPA suppressed GLUT4 expression and induced abnormal glucose metabolism by activating AhR, causing insulin resistance, and is thus a potential contributor to the development of PCOS. Therefore, AhR could be a potential new therapeutic target for PCOS. Video Abstract

Xiling Shi, Qinghua Cai, Siming Xin et al.

Objective: This study aims to compare the efficacy of two insulin administration methods — continuous subcutaneous insulin infusion (CSII) and multiple daily injections (MDI) — in managing glycemic levels and influencing pregnancy outcomes in gestational diabetes mellitus (GDM) patients. Methods: In total, 118 GDM patients admitted between January 2021 and May 2023 were randomly allocated into two groups using a computer-generated sequence. Patients in the MDI group received multiple daily injections, while those in the CSII group received continuous subcutaneous insulin infusion via an insulin pump. The study duration lasted from diagnosis until delivery. Glycemic control was measured by monitoring fasting blood glucose (FBG), postprandial blood glucose (PBG), and bedtime blood glucose (BBG) levels. Pregnancy outcomes included the incidence of hypoglycemia, premature rupture of membranes, postpartum hemorrhage, fetal distress, macrosomia, neonatal asphyxia, and preterm delivery. Results: Post-treatment, the CSII group showed better control of FBG, PBG, and BBG, which were significantly lower compared to the MDI group (p < 0.05). Furthermore, the incidence rates of complications such as hypoglycemia, fetal distress, neonatal asphyxia were significantly lower in the CSII group compared to the MDI group (p < 0.05). Conclusion: CSII offers better treatment outcomes for GDM patients compared to MDI. It effectively regulates blood glucose levels, optimizes pregnancy outcomes, and minimizes the risk of neonatal complications. Hence, CSII deserves further clinical endorsement and application. Clinical Trial Registration: The study has been registered on Chinese Clinical Trial Registration https://www.chictr.org.cn/ (registration number: ChiCTR2400088927).

Lanfang Zhang, Yuan Li, Yan Zhang et al.

Background: Psoriasis is a chronic, inflammatory skin disease with autoimmune characteristics. Recent research has made significant progress in the field of psoriasis metabolomics. However, there is a lack of bibliometric analysis on metabolomics of psoriasis. The objective of this study is to utilize bibliometrics to present a comprehensive understanding of the knowledge structure and research hotspots in psoriasis within the field of metabolomics. Methods: We conducted a bibliometric analysis by searching the Web of Science Core Collection database for publications on metabolomics in psoriasis from 2011 to 2024. To perform this analysis, we utilized tools such as VOSviewers, CiteSpace, and the R package ''bibliometrix''. Results: A total of 307 articles from 47 countries, with the United States and China leading the way, were included in the analysis. The publications focusing on metabolomics in psoriasis have shown a steady year-on-year growth. The Medical University of Bialystok is the main research institution. The International Journal of Molecular Sciences emerges as the prominent journal in the field, while the Journal of Investigative Dermatology stands out as the highly co-cited publication. A total of 2029 authors contributed to these publications, with Skrzydlewska Elzbieta, Baran Anna, Flisiak Iwona, Murakami Makoto being the most prolific contributors. Notably, Armstrong April W. received the highest co-citation. Investigating the mechanisms of metabolomics in the onset and progression of psoriasis, as well as exploring therapeutic strategies, represents the primary focus of this research area. Emerging research hotspots encompass inflammation, lipid metabolism, biomarker, metabolic syndrome, obesity, and arthritis. Conclusion: The results of this study indicate that metabolism-related research is thriving in psoriasis, with a focus on the investigation of metabolic targets and interventions within the metabolic processes. Metabolism is expected to be a hot topic in future psoriasis research.

Zuwei Yang, Wei Wu, Yi Yu et al.

Background: Atosiban is commonly used to delay premature labor in pregnant women and is thought to have few side effects. Objectives: To report a case of acute pulmonary edema (APE) following administration of atosiban and conduct a systematic review to identify common characteristics and risk factors of atosiban-associated APE. Methods: Searches were performed in Pubmed, Embase, and Web of Science using the keyword “Atosiban” combined with the terms “Pulmonary edema” or “Dyspnea” or “Hypoxia” on 9th July 2022. Only case reports of atosiban-associated APE were included without language restrictions. Data were extracted from the reports, and median, range, and percentages were calculated as applicable. The risk of bias was assessed using the Joanna Briggs Institute critical appraisal checklist for case reports. Results: Seven cases of atosiban-associated APE were included in the systematic review, including our case. APE occurred at a median gestational age of 32 + 6 weeks. Most patients were nulliparous (6/7, 85.7%) and were in multiple pregnancies (5/7, 71.4%). All patients were prescribed antenatal corticosteroids and tocolytics, with three (42.9%) receiving only atosiban and four (57.1%) receiving atosiban and other tocolytics. The median interval from starting atosiban administration to APE onset was about 40 h, and three patients (42.9%) showed symptoms 2–10 h after the end of atosiban treatment. Radiographic examinations (chest X-ray and/or computer tomography scan) confirmed APE in all patients and pleural effusion in four patients (57.1%). Five patients (71.4%) underwent emergency cesarean section, one patient (14.3%) with twin pregnancy had vaginal delivery with the help of suction cup and forceps, and another patient (14.3%) continued the pregnancy. All patients recovered well after administration of oxygen, diuresis, and other supportive therapy. Conclusion: Atosiban may cause acute pulmonary edema in patients with underlying risk factors. This complication remains rare, but caution during tocolytic treatment using atosiban is recommended.

Kate L. Sheahan, Ilene Speizer, Siân Curtis et al.

Reproductive autonomy necessitates that women have access to high quality family planning information and services. Additionally, closely spaced pregnancies increase maternal and infant morbidity and mortality. Although integrating family planning into child immunization services may increase access to information and services and postpartum contraceptive use, evidence on how integration affects service delivery and health outcomes is scarce. One limitation of previous studies is the use of binary integration measures. To address this limitation, this study applied Provider and Facility Integration Index scores to estimate associations between integration and contraceptive use, receipt of family planning information, and knowledge of family planning services availability. This study leveraged pooled cross-sectional health facility client exit interview data collected from 2,535 women in Nigeria. Provider and Facility Integration Index scores were calculated (0–10, 0 = low, 10 = high) for each facility (N = 94). The Provider Integration Index score measures provider skills and practices that support integrated service delivery; the Facility Integration Index score measures facility norms that support integrated service delivery. Logistic regression models identified associations between Provider and Facility Integration Index scores and (a) contraceptive use among postpartum women, (b) receipt of family planning information during immunization visits, and (c) correct identification of family planning service availability. Overall, 46% of women were using any method of contraception, 51% received family planning information during the immunization appointment, and 83% correctly identified family planning service availability at the facility. Mean Provider and Facility Integration Index scores were 6.46 (SD = 0.21) and 7.27 (SD = 0.18), respectively. Provider and Facility Integration Index scores were not significantly associated with postpartum contraceptive use. Facility Integration Index scores were negatively associated with receipt of family planning information. Provider Integration Index scores were positively associated with correct identification of family planning service availability. Our results challenge the position that integration provides a clear path to improved outcomes. The presence of facility and provider attributes that support integration may not result in the delivery of integrated care.

Wang Zhi, Suting Li, Yuting Wan et al.

Abstract Background Short-term starvation (STS) has gradually been confirmed as a treatment method that synergistically enhances the effect of chemotherapy on malignant tumours. In clinical applications, there are still some limitations of poly (ADP-ribose) polymerase inhibitors (PARPi), including understanding their effectiveness and side effects. Here, we sought to investigate the effect and mechanism of the combined use of STS and niraparib in the treatment of ovarian cancer. Methods In in vitro experiments, SKOV3 and A2780 ovarian cancer cells were treated with STS and niraparib alone or in combination. Cell viability was assessed with CCK-8, and cell cycle, apoptosis, DNA damage repair and autophagy were examined to explore the molecular mechanisms. Akt and mTOR inhibitors were used to examine any changes in DNA damage repair levels. Xenograft animal models were treated with STS and niraparib, and HE staining and immunohistochemistry were performed to examine the effects. Results The combined use of STS and niraparib inhibited cell proliferation and increased apoptosis more than niraparib application alone. In addition, compared with the niraparib group, the STS + niraparib group had increased G2/M arrest, DNA damage and autophagy, which indicated that STS pretreatment enhanced the cytotoxicity of niraparib. In animal experiments, STS did not affect the growth of transplanted tumours, but the combined treatment synergistically enhanced the cytotoxicity of niraparib. In in vivo experiments, STS did not affect the growth of transplanted tumours, but the combined treatment synergistically enhanced the cytotoxicity of niraparib and reduced the small intestinal side effects caused by niraparib chemotherapy. Conclusion STS pretreatment can synergistically enhance the cytotoxicity of niraparib. STS + niraparib is a potentially effective strategy in the maintenance therapy of ovarian cancer.

Yongbing Guo, Yuchun Zhu, Yu Sun et al.

Abstract Background Preeclampsia (PE) is one of the leading causes of maternal and perinatal mortality and morbidity. Low-dose aspirin (LDA) is the most widely used drug to prevent PE, but the recommended dose of LDA varies according to different guidelines. Peroxisome proliferator-activated receptor (PPAR)-γ is involved in the formation of the placenta during pregnancy and is expressed in women with severe PE. In the present study, Our purpose was to investigate whether aspirin intervention in preeclampsia was related to PPAR-γ. Methods We administered pregnant mice with PPAR-γ-specific antagonist(T0070907) 2 mg/kg/d at 8.5–12.5 days of pregnancy. Mice treated with T0070907 developed key features of preeclampsia. Two doses of LDA (10 mg/kg/d and 20 mg/kg/d) were administered to the mice with a PE phenotype for intervention. Results LDA effectively decreased the increase in blood pressure in mice caused by T0070907 and decreased urinary protein levels and the urinary protein/creatinine ratio. LDA also inhibited the overexpression of endoglin and IL-β treated by T0070907. In addition, LDA evidently increased the placental weight and alleviates the degree of placental lesions of placenta and kidney. LDA alleviated the inhibition of PPAR-γ mRNA expression. The beneficial effect of 20 mg LDA was significantly better than that of 10 mg. Conclusions (1) LDA has a preventive effect against PE treated by PPAR-γ antagonist. (2) The preventive effect of LDA against PE is dose-dependent.

Roman V. Kapustin, Elizaveta M. Tcybuk, Andrew V. Korenevsky et al.

Background: The effective approach to preventing preeclampsia (PE) is administering acetylsalicylic acid (ASA) to high-risk patients. However, there are not enough data analyzing the effectiveness of ASA intake by pregnant women with diabetes mellitus (DM). This study aims to evaluate the effect of ASA on perinatal outcomes in pregnant women with different types of pregestational DM. Methods: This retrospective study included 735 pregnant women with DM (types 1 and 2). At 12–14 weeks of gestation, some patients were prescribed daily ASA at a 100–150 mg dose continuously for up to 36 weeks. The effect of ASA on the development of PE and other outcomes of pregnancy was assessed. The times of delivery and the onset of PE were evaluated as well. Results: When taking ASA, PE developed significantly less frequently in pregnant women with DM. This was significantly more evident in patients with type 2 DM (OR 0.65; 95% CI: 0.52–0.79). In patients with type 1 DM, the mean period of development of PE was 1.5 weeks later relative to those pregnant women who did not take the drug and was 35.5 weeks of gestation. The OR for the development of preterm birth was reduced by 3 times (OR 0.33; 95% CI: 0.15–0.62). In women with DM who took ASA during pregnancy, babies were born with greater body weight, and the frequency of small for gestational age births decreased. Conclusions: ASA administration is associated with a reduction of the incidence of PE, a delay in its manifestations, and a mitigating the risk of other adverse perinatal outcomes typical for pregnant women with DM.

Nidhi Goyal, K Jayakrishnan

A 36-year-old female with Mosaic Turner Syndrome presented for oocyte donation program. She developed endometrial collection each time she was started on estradiol valerate for endometrial preparation. All causes of the endometrial collection were ruled out and empirical antibiotics given. Finally, the patient developed a satisfactory endometrium of 5.7 mm with no endometrial collection after being given low dose estradiol-estrogel (Transdermal application) and five doses of subcutaneous injections on granulocyte-colony-stimulating factor. The patient conceived after embryo transfer and is in follow-up.

Thalyta Freitas dos Santos Laguna, Tanandra Hermanns, Ana Claudia Pinto da Silva et al.

Abstract Objectives: to characterize the teaching-learning process of children in early childhood taught by their parents and/or caregivers in remote educational mode, in different social contexts, during the COVID-19 pandemic. Methods: a bibliographic study was carried out through a qualitative research in three VHL, Lilacs and Scielo databases. The descriptors Children, Pandemic, Caregivers, Distance education and Mental health were used. The sample was composed of 35 materials. Results: it was observed that countries presented problems in its educational system and that their situation also aggravated, such as in Brazil. Schools should try to mitigate the impact of the confinement, based on the recommendations that aim to consolidate what has been learned and interrupt the teaching of new content, eliminating the pressure on parents and guardians who assist students at this time. It is known that there is a lack of preparation of these caregivers, since the vast majority do not have materials or available time, because of home office, making remote learning difficult. The psychological impacts of remote learning - stress, fear, decreased performance and frustration are noticeable in everyone who is involved. Thus, the coping strategy focused on the problem can prevent the worsening of symptoms in mental health. Conclusion: it is expected to promote future reflections according to the theme through Psychology.

Elechalawar CK, Hossen MN, Shankarappa P et al.

Chandra Kumar Elechalawar,1 Md Nazir Hossen,1 Priya Shankarappa,2 Cody J Peer,2 William D Figg,2 J David Robertson,3 Resham Bhattacharya,4 Priyabrata Mukherjee1,5 1Department of Pathology, The University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA; 2Clinical Pharmacology Program, National Cancer Institute, Bethesda, MD 20892, USA; 3Department of Chemistry and University of Missouri Research Reactor, University of Missouri, Columbia, MO 65211, USA; 4Department of Obstetrics and Gynecology, The University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA; 5Peggy and Charles Stephenson Cancer Center, The University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USACorrespondence: Priyabrata MukherjeeDepartment of Pathology, The University of Oklahoma Health Sciences Center, 975 NE 10th Street, BRC-1409B, Oklahoma City, OK 73104, USATel +1 405-271-1133Fax +1 405-271-2472Email Priyabrata-Mukherjee@ouhsc.eduIntroduction and Objective: Pancreatic cancer (PC) is characterized by a robust desmoplastic environment, which limits the uptake of the standard first-line chemotherapeutic drug gemcitabine. Enhancing gemcitabine delivery to the complex tumor microenvironment (TME) is a major clinical challenge. Molecular crosstalk between pancreatic cancer cells (PCCs) and pancreatic stellate cells (PSCs) plays a critical role in desmoplastic reaction in PCs. Herein, we report the development of a targeted drug delivery system to inhibit the proliferation of PCCs and PSCs in vitro. Using gold nanoparticles as the delivery vehicle, the anti-EGFR antibody cetuximab (C225/C) as a targeting agent, gemcitabine as drug and polyethylene glycol (PEG) as a stealth molecule, we created a series of targeted drug delivery systems.Methods: Fabricated nanoconjugates were characterized by various physicochemical techniques such as UV-Visible spectroscopy, transmission electron microscopy, HPLC and instrumental neutron activation analysis (INAA).Results and Conclusion: Targeted gemcitabine delivery systems containing mPEG-SH having molecular weights of 550 Da or 1000 Da demonstrated superior efficacy in reducing the viability of both PCCs and PSCs as compared to their non-targeted counterparts. EGFR-targeted pathway was further validated by pre-treating cells with C225 followed by determining cellular viability. Taken together, in our current study we have developed a PEGylated targeted nanoconjugate ACG44P1000 that showed enhanced selectivity towards pancreatic cancer cells and pancreatic stellate cells, among others, for gemcitabine delivery. We will investigate the ability of these optimized conjugates to inhibit desmoplasia and tumor growth in vivo in our future studies.Keywords: pancreatic cancer, gold nanoparticles, PEGylation, drug delivery

Sepideh Mashayekh-Amiri, Fatemeh Bakouei, Sedighe Esmaeilzadeh et al.

Background: The effect of individual sleep hygiene education on sleep quality components remains largely unknown during pregnancy. This study aimed to assess the effect of a short-term sleep hygiene education during prenatal care visits on pregnant women with poor sleep quality. Methods: A quasi-experimental study, designed as a pre- and post-test with a  single group, was conducted on 32 pregnant woman with poor sleep quality. All the participants completed the Beck Depression Inventory (BDI), Perceived Stress Scale (PSS), and Pittsburgh Sleep Quality Index (PSQI). The women with good sleep quality and symptoms of severe depression and high stress were excluded from the study. Sleep hygiene education was presented face to face within 25 minutes. A Persian educational booklet, according to the routines of prenatal care visits during the first trimester of pregnancy, was also provided. PSQI, as the primary outcome, and sleep hygiene index (SHI), as the secondary outcome, were measured at the third trimester (34-36 weeks) of pregnancy. Results: The two components of PSQI (sleep latency and daytime dysfunction) improved, whereas the score for component 3 (sleep duration) worsened. No statistically significant differences were found in the mean global sleep quality scores after the intervention.  The sleep hygiene index significantly improved by sleep hygiene education (P= ≤ 0.0001). Conclusions: A short-term sleep hygiene education program during prenatal care visits cannot effectively improve sleep quality in pregnant women with poor sleep quality. Thus, it is highly imperative that further considerations for the use of sleep hygiene education during pregnancy be seriously taken into account.

K. U. Petry, J. Horn, A. Luyten et al.

Abstract Background The primary objective was to determine human papilloma virus (HPV) clearance rate after cervical biopsy among women with persistent high-risk HPV infection compared with spontaneous HPV clearance rate in the absence of biopsy. Methods We collected data from a dedicated screening program of women aged 30–70 years old. Inclusion criteria for the baseline non-interventional cohort were a positive HPV test (hybrid capture 2, HC2) and normal cytology. In the baseline cohort women were followed with approximately yearly HPV-tests and cytology until HPV regressed (one negative HPV test) or interventions in the form of diagnostic biopsies or therapy. Women who had a diagnostic biopsy were included in the biopsy cohort and followed until HPV regression or therapy. Observed HPV regression rates and time to HPV regression were compared between baseline and biopsy cohorts. For the comparison, we used Fisher’s exact test for the HPV regression rates and interval-censored, accelerated failure time model for time to HPV regression. Results Among the 1079 women included in the baseline cohort, 499 (46.3%) had HPV clearance and 475 were referred for colposcopy with biopsy. The biopsy cohort comprised all women who were not treated and had at least one HC2 test after biopsy (201/475; 42.3%). Of those, 138 (68.7%) experienced HPV regression. In the biopsy cohort, time to clearance of HPV infection was approximately halved (0.46, 95% CI 0.38–0.56) compared with the baseline cohort. This result was robust in a wide range of sensitivity analyses. Conclusions A higher proportion of women cleared their HPV infection, and time to HPV clearance was shorter in the biopsy cohort than in the baseline cohort. It is reassuring for clinicians to know that conservative management of patients with HPV persistency is successful when colposcopy with biopsies excludes high-grade disease.

Y. S. Parashchuk, T. V. Gorbach, E. V. Gancheva et al.

У зв'язку з високим рівнем гестаційних ускладнень під час вагітності у жінок з пієлонефритом актуальним є вивчення особливостей системи мати-плацента-плід. Виявленно, що при хронічному пієлонефриті вагітних, який не супроводжується збільшенням прозапальних інтерлейкінів і порушенням проникності мембран нефроцитів, відсутні прояви ендотеліальної дисфункції як у матері, так і у новонароджених. При хронічному пієлонефриті вагітних, у разі появи в сироватці крові трансамідинази і підвищенні вмісту інтерлейкіну 1β (ІЛ 1β), має місце ендотеліальна дисфункція, з'являється ризик багатоводдя, пошкоджується ендотелій судин у системі мати-плацента-плід. При гестаційному пієлонефриті вагітних є дисфункція ендотелію, підвищений ризик затримки внутрішньоутробного розвитку плоду, порушується функціональний стан ендотелію судин у новонародженого. Отримані результати обгрунтовують необхідність для прогнозування стану плоду та можливих профілактичних заходів, проводити дослідження трансамідинази в сироватці крові вагітних з пієлонефритом.

W. Copeland

S. E. Illanes, J. K. Nien, G. E. Rice