[TREATMENT OF SEVERE INTRAPATUM ASPHYXIA.]

THE AIM: Estimate of efficiency of newborns with severe birth asphyxia treatment using systemic therapeutic hypothermia. MATERIALS AND METHODS: a retrospective open-controlled clinical research with a resolution of the Ethics;Committee performed in 33 neonates born in asphyxia and treated at the NICU All newborns due to the presence of indications, overall controlled hypothermia was conducted according to the approved protocol, using the apparatus Allon 2001". RESULTS: The neurological status at admission: Sarnat II was detected in 60.6% (20) children; Sarnat III was detected in 39.4% (13) children. The correlation ofApgar scores with the most severe hypoxic ischemic encephalopathy. Pupillary reflexes admission absent in 48.5% (16) newborns. Convulsions within first hours of lfe were observed in 57.6% (19) newborns. Convulsions within I day of life were observed in 81.8 % (27) newborns. The correlation of the amniotic infection (AI) and meconium aspiration syndrome (MAS) treatment using high-frequency mechanical ventilation (p<0,05) and prolongation of mechanical ventilation for more than 5 days (p<0,01). At the beginning of systemic hypothermia fraction of inspired oxygen (FiO2), mean airway pressure (MAP), respiratory rate (RR) were down to the 12th hour of life and reaches a minimum at the end of the third day. These trends have been observed in children with MAS. The correlation of the use of high-frequency mechanical ventilation using high doses ofcardiotonics and the transition to the infusion of epinephrine or norepinephrine (p <0.01).There were no deaths in the studying group. CONCLUSIONS: 1. Reliable predictor of the clinical outcomes severity of hypoxic-ischemic encephalopathy (HIE) by the end of the first month lf is the presence of convulsions within the first hour of lf (p<0. 03). 2. When comparing the evaluation on Apgar scale with the data of acid-base balance and severity of HIE a significant correlation between the estimation at the first minute is I point and at the fifth minute 3 point and more severe pH shift, base deficiency, hyperlactatacidosis and severe HIE. 3. MAS and AI are the most frequent accompanying diseases that complicates the severity of newborn status causing prolonged artificial ventilation and the infusion ofcardiotonics. 4. There is a decrease in all parameters of artficial lung ventilation to the twelfth hour life in early systemic hypothermia and reached minimum by the end of the third day.

[Evaluation of the reactogenicity and immunogenic potency of combined vaccine "Bubo-Kok" in the immunization of children against diphtheria, tetanus, pertussis and viral hepatitis B]. / Otsenka reaktogennosti i immunogennosti kombinirovannoi vaktsiny "Bubo-Kok" pri immunizatsii detei protiv difterii, stolbniaka, kokliusha i virusnogo gepatita B.

Combined vaccine "Bubo-Kok" is characterized by safety and high immunological activity. The number of postvaccinal reactions in children aged 1 and 2 years, immunized with vaccine "Bubo-Kok", was not statistically different from those in groups of children immunized with adsorbed DPT vaccine, as well with such vaccine in combination with vaccine against hepatitis B. After the completion of the primary course of immunization 100% of children had protective antibody titers against diphtheria, tetanus and hepatitis B. Antibody titers against pertussis, equal to or exceeding protective titers, were found in more than 70% of immunized children. The immunogenic potency of vaccine "Bubo-Kok" with respect to all its components was not inferior to that of adsorbed DPT vaccine and vaccine against hepatitis B, when introduced simultaneously in different areas of the body. Vaccine "Bubo-Kok" successfully passed state trials and was recommended for registration.

[Evaluation of reactogenicity and immunogenicity of Bubo-M, the Russian combined vaccine for immunization of adults against diphtheria, tetanus and viral hepatitis B]. / Otsenka reaktogennosti i immunogennosti otechestvennoi kombinirovannoi vaktsiny Bubo-M pri immunizatsii vzroslykh protiv difterii, stolbniaka i virusnogo gepatita B.

Bubo-M, the first Russian associated vaccine, was found to have low reactogenicity and high immunogenic potency. The frequency of postvaccinal reactions in the group of persons immunized with Bubo-M (20%) appeared to be considerably lower than among persons who received the combined injection of adsorbed DT toxoid with reduced antigen content and vaccine against hepatitis B (47.7%). Following the course of vaccination the level of anti-HBs considerably exceeded the protective level. Immune response to the diphtheria and tetanus components of Bubo-M exceeded that observed after immunization with absorbed DT toxoid with reduced antigen content (p < 0.05).

[Reactions to and immunogenic properties of the combined vaccine Bubo-M for immunization of children against diphtheria, tetanus and viral hepatitis B]. / Reaktogennost' i immunogennost' kombinirovannoi vaktsiny Bubo-M pri immunizatsii detei protiv difterii, stolbniaka i virusnogo gepatita B.

Bubo-M, the first Russian combined vaccine, was found to have low reactogenicity. The difference between the number of postvaccinal reactions in the group of children immunized with Bubo-M (25.9%) and those in the group of children who had been simultaneously injected into different sites of the body with ADS-M toxoid (adsorbed DT toxoid with reduced antigen content) and hepatitis B vaccine (26.7%) was not statistically significant. Following immunization a considerable increase in the level of diphtheria and tetanus antibodies (p < 0.005) was observed in all children (100%), the level of HBs antibodies in the group of children immunized with Bubo-M (the geometric mean titer: 13,721 IU/l) essentially exceeding that observed in the control group injected with ADS-M toxoid and hepatitis B vaccine (the geometric mean of the titer: 2,441 IU/l). Bubo-M was duly registered and allowed for industrial production and medical use.

[Anti-vascular antibodies in women with physiological pregnancy and pregnancy complicated by gestosis]. / Protivososudistye antitela u zhenshchin s fiziologicheskoi i oslozhnennoi gestozom beremennost'iu.

Immunologic manifestations of injury to the vascular wall were studied in 191 pregnant women. Blood serum ++anti-vascular antibodies were analyzed by passive hemagglutination, complement fixation, and precipitation tests. ++Anti-vascular antibodies were found in all the women with a normal pregnancy course. Normal pregnancy was characterized by clear-cut periods in the time course of ++anti-vascular antibody levels; for gestosis preclinical and clinical periods a constant growth of ++anti-vascular antibody titers was characteristics, that was due to effects of various injurious factors on the vascular wall. These data permit regarding gestosis as a vascular syndrome of pregnancy.