Method for prediction of embryopathy in pregnant women suffering hypotheriosis and obesity
SUBSTANCE: pregnant woman suffering hypotheriosis and obesity on their 2-12 weeks of gestation are examined for a fT4 level. If the fT4 values are less than 10 pmol/l, macrosomic delivery is predicted.
EFFECT: use of the method enables high-accuracy prediction of macrosomic delivery.
The invention relates to medicine, namely to obstetrics and gynecology, and allows to predict the development of fetopathy the child in early pregnancy in women with hypothyroidism, and obesity.
The urgency of the invention is defined by the relatively high frequency of occurrence (up to 1.86%) hypothyroidism among pregnant women. These women are significantly more likely to develop such pregnancy complications like hypertension, pre-eclampsia, placental abruption, intrauterine death, fetal defects, postpartum hemorrhage, which affects the health of not only women but also children (Fadeev V.V., Perminova YEAR, Nazarenko, T.A. Diseases of the thyroid and reproductive function in women: a manual for physicians. - M: IIA-PRINT. - 2009. - p.52).
One of these complications gestational process is the development of fetopathy often found in endocrine pathology in pregnant women.
The proposed method for predicting the development of fetopathy in pregnant women with obesity and hypothyroidism is based on the determination of free thyroxine (fT4) in serum for up to 12 weeks of gestation. Previously free thyroxine was used to diagnose hypothyroidism outside and during pregnancy.
A known method for predicting the birth of large fruit, characterized in that in order to increase the accuracy of the forecast zdorovyh women in the serum in the first stage of labor was determined by the number of total lipids and cholesterol in their content of 9.5 g/l or more and 9.0 mmol/l and above, respectively predict childbirth large fruit (patent No. 1415190. Stepankowsky G.K., Karpenko A.N., Pushkareva TI a Method for predicting the birth of large fruit. // The Bulletin " Discoveries. The invention". - 1988. No. 29. - s).
The above authors conduct the study in the first stage of labor in women that is not sufficiently timely for the early prevention of fetopathy type of large fruit, as has already happened pathogenetic changes leading to this disease, do not indicate the accuracy of the method and the possibility of using this method for the early prediction of childbirth large fruit, conduct lab tests on 2 indicators: the number of total lipids and cholesterol, this method is not specific, as these rates vary for many diseases.
The technical result of the proposed method lies in the fact that in peripheral blood serum of pregnant women diagnosed with hypothyroidism and obesity varying severity in 2-12 weeks of gestation to determine the level of fT4 and when the values of this index less than 10 pmol/l, predicted the birth of large fruit with an accuracy of 75%.
The method is as follows: in peripheral blood serum of pregnant women diagnosed with hypothyroidism and obesity varying severity in 2-12 weeks of gestation to determine the level of fT4 by the standard method.p> First level fT4 defined in the first trimester of pregnancy used to predict the birth of a large fetus in women with obesity and hypothyroidism.
Established prognostic parameter content fT4 in serum of pregnant women in 2-12 weeks of gestation diagnosed with hypothyroidism and obesity, a value which is less than 10 pmol/l predicted the birth of large fruit.
Clinical example 1.
Pregnant N., 30. This second pregnancy. The body mass index of 41.5 kg/m2. The thickness of the placenta in 12 weeks was 11 mm, the Volume of the thyroid gland was 25.4 cm3. During the period of pregnancy arrived in weight 9 kg In the study of fT4 at 34 weeks of pregnancy it was 0.7 pmol/L. the Initial dose of L-thyroxine was 100 mg, for every 2 weeks dose of L-thyroxine was increased by 25 mg Outcome: the birth of a healthy child weight 3,9 kg
Conclusion: low fT4 and the presence of obesity - the birth of large fruit. The forecast for the claimed method was confirmed.
Clinical example 2.
Pregnant Meters, 29 years. This first pregnancy. The body mass index 32,8 kg/m2. During pregnancy noted palpitations, edema of the lower extremities. In the study of fT4 in 2 weeks he was 4 pmol/l, and the level of thyroid stimulating hormone (TSH) - 47,6 mIU/L. Pregnancy replayable, treatment in the form of L-thyroxine was not received. The volume of the thyroid gland was 23 cm3. Outcome: produced medical abortion on the grounds.
Conclusion: high levels of TSH produced medical abortion.
In this way were examined 28 women, of whom a positive result by the present method were obtained in 21 patients, which amounts to 75%.
The effect of the proposed method is to determine the level of fT4 in serum of pregnant women in 2-12 weeks of pregnancy, which allows early prediction of major birth of the fetus, fetal development, subsequently implementing a set of preventive measures to reduce the risk of birth disorders; the possibility of screening pregnant women in the first trimester for the prediction of the birth of large fruit; and is simple and easy to perform techniques.
A method for predicting fetopathy in pregnant women with hypothyroidism and obesity by examining pregnant, characterized in that in the peripheral blood serum of pregnant women diagnosed with hypothyroidism and obesity varying severity in 2-12 weeks of gestation to determine the level of fT4 and values less than 10 pmol/l predicted the birth of large fruit.
SUBSTANCE: tissue samples are incubated at 37°C for 4 hours with estradiol in the concentration 2.21x10-6 M, precipitated with dihitonine for one night at 4°C, and a homogenate of a check sample and a sample cultivated with estrogen is analysed for thyroid peroxidase (TPO) activity by spectrophotometry. If the enzymatic activity after co-incubation with estradiol is increased in the tumour tissue sample by at least 50 % in comparison with the reference, such growth is considered to be sensitive to estrogen action. Such conclusion is made regardless of the content of cytoplasmic receptors of steroid hormones in the analysed tissue.
EFFECT: use of the method allows evaluating estrogen-dependence of thyroid cancer in prescribing a conservative therapy of the disease.
2 tbl, 2 ex
SUBSTANCE: in order to realise the method before starting complex treatment content of general triiodthyronine in patients' blood is determined, and if its concentration is within 1.35-1.70 nmole/l reduction of tumour size on 25-50% and more after performing chemoradiotherapy is predicted, if concentration of triiodthyronine is within 0.52-1.10 nmole/l progression of disease after performing chemoradiotherapy is predicted.
EFFECT: obtained results of triiodthyronine content in case of chemoradiotherapy are a prognostic factor of treatment efficiency and can be used in treatment of patients with disseminated skin melanoma for timely selection of patients and application of proper treatment tactics.
1 tbl, 2 ex
SUBSTANCE: invention relates to medicine, namely to psychiatry. In patients' blood serum content of cortisol, dehydroepiandrosterone sulphate (DHEAS), general triiodothyronine (T3), free thyroxine (fT4) is determined. If values of cortisol level are higher than 500 nmole/l at the background of reduction of DHEAS concentration relative to its level in healthy people, with ratio DHEAS/cortisol lower than 0.3 and normal level of T3 and T4, patients' passing into adaptation disorder with predominance of depressive reactions is prognosed. If fT4 concentration increases to 20 pmole/l and higher with physiological concentrations of cortisol, dehydroepiandrosterone sulphate and ratio DHEAS/cortisol, passing into dissociative (conversion hysterical) disorder is prognosed.
EFFECT: obtaining possibility to prognose further course of neurotic disorders at early stages, to take rehabilitative psychotherapeutic and pharmacologic measures purposefully.
2 ex, 1 tbl
FIELD: medicine; gynaecology.
SUBSTANCE: in girls with suspected functional hyperprolactinaemia determined are level of prolactin two hours after falling asleep, concentration of general triiodtrionin, cortisol, and ultra-sound examination of small pelvis organs is carried out in order to determine volume of right ovary. On the basis of obtained data canonical value (K) is calculated by formula, and if K is greater than (-2.28) and lower than 1.27 functional hyperprolactinaemia is determined.
EFFECT: increase of accuracy of diagnosing functional hyperprolactinaemia in girls using minimal number of most informative tests.
SUBSTANCE: invention concerns medicine, namely obstetrics and gynecology and is intended for diagnostics by microprolactinum of a pituitary body at girls. At girls with suspicion on a microprolactinum of a pituitary body Prolactinum levels are defined in two hours after a backfilling and in 6 o'clock in the morning, in addition concentration of the general triiodothyronine is defined and out an eyeground research is carried out. Initial size and after comparison with constants the patient is carried to group of patients or to group of the healthy.
EFFECT: augmentation of accuracy of diagnostics, reduction of quantity of diagnostic manipulations, depression of labour input of diagnostic researches and reduction of terms of their carrying out.
SUBSTANCE: method is implemented as follows. Blood is tested for concentration of TSH, hormones T3, T4 with radioimmunoassay. Received data are processed. Graphical circadian rhythm curve is plotted for each hormone and used to evaluate time of individual acrophase and bathyphase. Acrophase indicators (confidence interval) of TSH development biorhythm 9 h 55 min (confidence interval within 5 h 20 min to 14 h 29 min), T3 development biorhythm 15 h 19 min (confidence interval within 8 h 14 min to 22 h 23 min), T4 development biorhythm 17 h 22 min (confidence interval within 9 h 20 min to 25 (01) h 23 min), and bathyphase indicators of TSH secretion circadian rhythm within 21 h to 22 h, T3 secretion circadian rhythm within 2 h to 4 h, T4 secretion circadian rhythm within 5 h to 6 h show diagnosed stable desynchronosis of pituitary thyroid system.
EFFECT: prescription of individual chronotherapy regimen.
9 dwg, 2 ex
SUBSTANCE: invention concerns medicine, namely to therapy and can be used for diagnostics of desynchronosis of hypophysial-thyroidal system functions at sick of a bronchial asthma of moderate severity level. For realisation of the method define concentration of hormones TTG, T3, T4 in blood using radio immunologic method, process the obtained data and build a graphic curve of a circadian rhythm on each hormone on which basis define time of individual acrophase and bathyphase. At indicators of acrophase biorhythm development TTG 2 hours and 12 minutes (confidence interval from 1 hour 11 min till 3 hours 13 min), T3 - 4 hour of 32 min (confidence interval from 2 hours 26 min till 6 hours 38 min), T4 - 9 hours 00 min (confidence interval 4 hours 50 min till 13 hours 09 min) and indicators of circadian rhythm bathyphase of secretion TTG from 13 hours till 14 hours, T3 - from 15 hours till 16 hours, T4 - from 20 hours till 21 hour - diagnose easy desynchronosis of hypophysial-thyroidal system.
EFFECT: revealing easy desynchronosis of functions of a thyroid gland at sick of a bronchial asthma of moderate severity level.
9 dwg, 2 ex
SUBSTANCE: invention is referred to medicine, namely to pediatrics. Essence of the method of delay prediction of psychological development at children of preschool age with perinatal lesions of the central nervous system in the anamnesis: determine content of triiodothyronine in serum of peripheric venous blood of the 4 years old child without clinical implications of a hypothyrosis. At its value of 1.26-1.85 ng/ml prognosticate III-IV group of psychological development to the 7th year of life.
EFFECT: possibility of prediction of a delay of psychological development at children of preschool age of seven years.
4 ex, 1 tbl
FIELD: medicine, endocrinology.
SUBSTANCE: in a patient's blood serum it is necessary to detect the content of interleukin-6 (IL-6) due to immunoenzymatic assay, the content of 2-macroglobulin (MG) due to immunoelectrophoresis and thyrotropic hormone (TTH) due to immunoenzymatic assay, calculate the index of antibody-formation (IAb) according to the following formula: IAb=IL6/MG×TTH. At IAb value being above 7 in a patient under testing one should diagnose autoimmune thyroiditis, and at IAb being below 3 one should diagnose diffuse toxic goiter.
EFFECT: higher efficiency and accuracy of diagnostics.
FIELD: medicine, obstetrics.
SUBSTANCE: the present innovation deals with predicting subclinical minimal thyroid dysfunction during pregnancy. One should detect the value of the ratio of free thyroxine and free triiodothyronine estimated in blood serum of pregnant women (FT3/FT4). If the value of FT3/FT4 ratio is above 0.28 one should diagnose minimal thyroid dysfunction in a pregnant woman and carry out preventive therapy due to applying levothyroxine preparations. The innovation suggested enables to control the quality of medicinal therapy.
EFFECT: higher accuracy and efficiency of diagnostics.
SUBSTANCE: multiple urine samples are taken during external exposure on a body for one day. Each sample is examined for the concentrations of thiols and urochrome that is followed by calculation of a thiol-urochrome coefficient (TUC) as a relation of the concentrations of thiols and urochrome. If the TUC value is 1.46±0.2, the body status is stated to be satisfactory. The TUC value more than 1.66 or less than 1.26 enables to state the status beyond the satisfactory limits.
EFFECT: use of the method allows analysing dynamics of the antioxidant body status, response to the external exposure, including to cosmophysical.
3 tbl, 3 ex, 3 dwg
SUBSTANCE: pH of thrombocyte-poor plasma, and a diagnostic coefficient D is calculated by formula: D=const1xPPP-const2, where D is a diagnostically significant coefficient, PPP is a pH value of thrombocyte-poor plasma of an examined patient, const1=18.877, const2=139.381. If D is less than 0.25, thrombocyte hyperaggregation is stated reliably, and the value of D exceeding 0.25 makes to state reliably the absence of thrombocyte hyperaggregation signs.
EFFECT: use of the declared technique allows high-accurate and sensitive evaluation of thrombocyte hyperaggregation.
SUBSTANCE: invention describes a method for determining antibacterial resistance of a human body in diseases caused by a staphylococcus infection, based on blood neutrophil analysis; functional activity of neutrophilic granulocytes of patient's peripheral blood is determined by chemoluminescence with calculating a bacterial activation index (the BAI-index) of neutrophils representing the relation of an area under a curve of neutrophilic granulocyte chemoluminescence induced by Staphylococcus epidermidis bacteria to an area under a curve of spontaneous neutrophilic granulocyte chemoluminescence, and if the derived value is less than 1.47, a high level of antibacterial resistance is stated, while the derived values 1.47 and more shows a low level of antibacterial body resistance.
EFFECT: method is informative, precise, complies with the modern requirements for laboratory diagnostic techniques and allows predicting a nature, a clinical course period and bacterial complications in the patients of various groups.
1 ex, 2 tbl
SUBSTANCE: method for prediction of rate of acute infectious diseases in infants with determining the immune status values on the first and fifth postnatal day: absolute lymphocyte count, differentiation marker carriers CD3, CD4, CD8, CD 19, CD56, CD95, a spontaneous nitroblue tetrazolium test value (NBTsp), a level of a phagocytic coefficient (PC), blood serum immunoglobulin A, M, G (IgA, IgM, IgG) concentrations, and further calculating a forecasting index (Ifor) with using a certain equation of multiple linear regression if Ifor does not exceed 3.2, a probability of no more than one acute infectious disease in an infant is concluded; if Ifor is within 3.2-3.7, 2 to 5 probable acute infectious diseases in an infant is stated; if Ifor exceeds 3.7, probability of more than 5 acute infectious diseases in an infant is concluded.
EFFECT: higher prediction accuracy.
SUBSTANCE: complete blood count is performed, and the leukogram components are used to calculate integral hematological values: Calph-Caliph leucocytic intoxication index - LII1, Ostrovsky leucocytic intoxication index - LII2, stress index - SI, neutrophil-lymphocyte index - NLI, neutrophil-monocyte index - NMI, lymphocyte-monocyte index - LMI. If observing the values LII1≤2.5, LII2≤2.75, SI≤1.0, NLI≤11.0, NMI≤16.0, LMI≤2.0, a mild severity is detected. The values LII1 2.6 to 4.5, LII2 2.76 to 5.0, SI 1.1 to 2.0, NLI 11.1 to 15.0, NMI 16.1 to 24.0, LMI 2.1 to 2.5 enables to predict a moderate severity level. A severe level is ensured by LII1> 4.5, LII2> 5.0, SI> 2.0, NLI> 15.0, NMI> 24.0, LMI> 2.5.
EFFECT: use of the declared method allows higher objectivity of determining severity level of acute pancreatitis.
4 ex, 2 tbl
SUBSTANCE: method of early solid malignant disease staging (at the stage of provisional clinical diagnosis) by cell number with stable ontogenetic disorders detected in patient's peripheral blood lymphocytes by quantitative and qualitative analysis of stable chromosomal and genomic disorders in metaphase plates from patient's peripheral blood lymphocytes.
EFFECT: method enables following disease change shift in response to treatment and determining clinical effectiveness.
5 ex, 1 tbl
SUBSTANCE: method of diagnosing rejection of kidney allotransplant includes determination of phase height PH of peripheral blood live lymphocytes by method of phase-interference microscopy, determination of quantity of lymphocytes with phase height PH≤1.5 mcm, 1.5 mcm<PH≤2 mcm, 2 mcm<PH≤2.5 mcm, PH>2.5 mcm, selection of lymphocyte activity coefficients for each limit, said phase heights of lymphocytes equal k3=3, k2=2, k1=1, k0=0 respectively. Obtained data are used to determine functional activity of lymphocytes in sample by formula: FA=(k3n3+k2n2+k1n1+k0n0)/n, where n is number of lymphocytes in sample, n3 is number of lymphocytes with PH≤1.5 mcm, n2 is number of lymphocytes with 1.5 mcm<PH≤2 mcm, n1 is number of lymphocytes with 2 mcm<PH≤2.5 mcm, n0 is number of lymphocytes with PH>2.5 mcm, k3, k2, k1, k0 are coefficients of lymphocyte activity, and if value of lymphocyte functional activity is within FA=1.8-2.0, rejection of kidney transplant is diagnosed.
EFFECT: application of claimed method makes it possible to set diagnosis in due time, which considerably increases efficiency of anti-crisis therapy in post-transplantation period.
2 ex, 1 tbl
SUBSTANCE: claimed is method of diagnosing antioxidant function of membranes of erythrocytes in case of exacerbation of herpes-viral infection. Method lies in determination of superoxide dismutase concentration and titre of antibodies to herpes virus by method of immunosorbent assay (ELISA) of peripheral blood in pregnant women after exacerbation of herpes-virus infection. If superoxide dismutase concentration is 297.63±13.16 Unit/gHb (control - 386.77±13.12 Unit/gHb), titre of antibodies to herpes virus in peripheral blood of pregnant woman constituted 1:3200. If titre of antibodies is 1:6400, superoxide dismutase concentration decreased to 243.85±7.71 Unit/gHb (control - 386.77±13.12 Unit/gHb; p<0.001).
EFFECT: reduction of superoxide dismutase concentration in erythrocytes of peripheral blood in pregnant women during exacerbation of herpes-virus infection predicts reduction of protective reaction of toxic impact of lipid peroxidation on membranes of erythrocytes, increasing risk of their destruction.
SUBSTANCE: essence of method of predicting character of progressing course of chronic kidney disease (CKD) lies in determination of blood coagulation characteristics: activated partial thromboplastin time (aPTT), prothrombin time (PT), thrombin time (TT), antithrombin III (ATIII) level, von Willebrand factor (WF), endothelin-1 (E-1), D-dimer. If aPTT indices are within the range from 28 to 35 seconds, PT is from 12 to 15 seconds, TT is from 9 to 13 seconds, ATIII level is from 29 to 70%, WF level is from 105 to 115%, E-1 does nor exceed 0.32 fmol/ml and D-dimer is from 245 to 520 ng/ml FEU slow progressing of CKD is predicted. If aPTT, PT, TT, ATIII level are the same, and WF is higher than 115%, E-1 is higher than 0.32 fmol/ml, D-dimer is higher than 620 ng/ml FEU, accelerated CKD progressing is predicted.
EFFECT: increase of accuracy and reliability of chronic kidney disease diagnostics.
2 ex, 2 tbl
SUBSTANCE: method includes determination of ceruloplasmin level on blood plasma. If its values are from 202.8 to 266.8 mg/l, thymus weight is higher than 0.2 g and content of lymphoblasts in it is more than 19%, development of re-inoculated lymphoblastic leukemia in line AKR/JY mice is diagnosed.
EFFECT: method makes it possible to diagnose syngenic re-inoculated lymphoblastic leukemia in mice quickly and accurately.
1 tbl, 1 ex
SUBSTANCE: invention relates to laboratory methods for blood analysis. Plasma is dropped in copper sulfate solution with density 1.023 g/cm3, not above, and time for drop falling on bottom of graduated cylinder with column height 243 mm is measured. The blood plasma density value is calculated by the formula:
wherein is the unknown blood plasma density (g/cm3); is copper sulfate solution density measured by areometer (g/cm3); t is average falling time of plasma drop in the copper sulfate solution (as seconds); 0.260130126 and 0.00290695 are correction coefficients. Temperature of plasma and copper sulfate solution is 20oC. Method is simple and suitable and allows carrying out analysis of small volumes of blood plasma and to reduce analysis time.
EFFECT: improved assay method.