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The aim of this work is to draw attention to the peculiarities of long-lived patient functioning and to assess the state of health in a 100-year-old patient, her cognitive functions and life factors contributing to active longevity. Materials and methods. We have described and analyzed a case of the 100-year-old female patient’s health, the influence of factors for active aging prolongation (nutrition, physical activity, labor, psychological state, hobbies) on a specific example, conducted a review of the scientific literature regarding the reasons for longevity and people’s lifestyles. Results. According to projections for demographic prospects, by 2050, the number of elderly people in the world will increase to 16 %, and every sixth person will be older than 65 years. Thus, in the EU countries, the expected life expectancy for men is 74–77 years, women ‒ 80–82 years. Based on forecasts, the number of people aged 80 and over will triple: from 143 million in 2019 to 426 million in 2050. Therefore, the relevance of maintaining active longevity is beyond doubt. Examples of long-lived people on the planet have been analyzed and given. The presented clinical case is the 100-year-old woman who underwent a full clinical examination. Her physical and mental state as well as cognitive functions have been evaluated. The life and occupational trajectories, her hobby (singing), social activity, eating habits have been analyzed. Biological age has also been assessed. The biological age of our patient has been determined by metabolic laboratory parameters: complete blood count, creatinine, bilirubin, lipid levels, blood glucose, urea, AST, ALT, albumin, electrolytes. Conclusions. According to the conducted study, the biological age of the patient is 93 years, that is 7 years younger than the chronologic age. Our patient is not overweight, has daily walks lasting up to 1-2 hours, lives alone, but enjoys communicating with friendly people, has been adhering to a balanced diet over the past 40 years. The following are of great importance to the patient: a normal mental state, work after retirement, especially creative work, a positive attitude to life, communication with positive people, music and singing. Thus, a person can live up to 100 years without significant health problems.

Nucleotide-binding oligomerization domain-like receptors (NOD-like receptors) are cytosolic signaling receptors of innate immune cells recognizing ligands derived from bacteria, viruses, fungi and protozoa. They can initiate apoptosis and pro-inflammatory cytokines production. Meanwhile, the role of decidual NOD-like receptors in pathogenesis of early miscarriages remains unknown. Aim: to study NOD-like receptor (NOD1, NOD2, NLRP1, NLRP3, NLRC4) messenger ribonucleic acid (mRNA) expression in decidual tissue from patients with missedand spontaneous abortions compared to progressive pregnancy.Materials and Methods. NOD1, NOD2, NLRP1, NLRP3, NLRC4 and pathway protein receptorinteracting-serine/threonine-protein kinase 2 (RIP-2) mRNA expression in decidua from 34 patients with missed abortions (group I), 34 patients with spontaneous abortions (group II) and 57 women with progressive pregnancy admitted for artificial abortion (group III, control group) were analyzed by reverse transcription quantitative polymerase chain reaction (PCR) at gestational age of 6–10 weeks. Exclusion criteria were as follows: endocrine disorders, severe extragenital diseases, antiphospholipid syndrome, inherited thrombophilia, uterine malformations and fetal chromosomal abnormalities. Samples were collected by uterine abrasion. Results. It was found that mRNA expression of NOD2 was significantly higher in decidua from patients with missed and spontaneous abortions, whereas for RIP-2 (related to relevant signaling pathway) – in women with missed abortions. A moderate positive correlation between gestational age and mRNA expression for NOD2 (R = 0.48; p = 0.01) and RIP-2 (R = 0.41; p = 0.007) was observed in subjects with progressive pregnancy. In contrast, women with missed abortions showed a moderate negative correlation between body weight and mRNA expression for NOD2 (R = –0.46; p = 0.03) and RIP-2 (R = –0.51; p = 0.02) whereas spontaneous abortions was associated with moderate negative correlation between RIP-2 mRNA expression and body weight (R= –0.47; p=0.04) as well as body mass index (R= –0.48; p = 0.04) along with moderate positive correlation with age of menarche (R = 0.46; p = 0.04). However, compared with progressive pregnancy no significant differences were found in expression level form NOD1, NLRP1, NLRP3 and NLRC4 mRNA in decidua from patients with missed and spontaneous abortions. Conclusion. Elevated NOD2 mRNA expression was observed in decidua from patients with missed and spontaneous abortions compared to progressive pregnancy paralleled with upregulated RIP-2 mRNA expression in missed abortions. Finally, it was found that NOD1, NLRP1, NLRP3 and NLRC4 were not involved in pathogenesis of miscarriages.

Introduction. Despite a long history of the disease, genital prolapse still have not been definitively solved. A relevance of pelvic organ prolapse in women has been increasing in recent years largely due to a change in the quality of life and desire to sustain their youth. The number of studies pinpointing the cause of the disease in connective tissue dysplasia (CTD) has been increasing annually.Aim: to conduct a systematic analysis and determine most common signs of CTD in women with genital prolapse.Materials and methods. CTD criteria and the relationship with genital prolapse were analyzed. The study was conducted using questionnaires and including clinical studies examining residents of the Belgorod region (135 women). The main group included 91 patients who had signs of pelvic organ prolapse, and control group consisted of 44 healthy women. CTD intensity score proposed by T.Yu. Smolnova et al. (2003) was used to assess signs of dysplasia in women examined allowing to build up three groups in which each symptom was evaluated as severity score.Results. Asthenic constitution was noted in high percentage of women suffering from genital prolapse (16.70 ± 0.38 %) compared with healthy women (2.30 ± 0.15 %; p = 0.016). Mild bruising, increased tissue bleeding tended to rise in main vs. control group (16.50 ± 0.37 % in main group and 0.0 in control group; p = 0.016). Signs of varicose veins and hemorrhoids requiring no surgical treatment were found in 33.00 ± 0.47 % and 4.50 ± 0.21 % in main vs. control group (p = 0.0002), respectively. Genital prolapse and hernia in first-line relatives were recorded in 9.90 ± 0.30 % in main group (p = 0.031), women without signs of prolapse did not indicate prolapse in close relatives.Conclusion. Asthenic constitution, hernias, varicose veins and hemorrhoids, female pelvic and hernial prolapse in close female relatives, a tendency to mild bruising, skeletal anomalies, elastosis skin were among common CTD signs in women with genital prolapse.

Aim: conduct a systematic analysis of pregnancy development, investigate clinical and laboratory data affecting development of labor abnormalities in women residing in the Belgorod region. Materials and Methods. From 2014 to 2018, 484 women were examined and divided into 2 groups: main group consisted of those who had childbirth complicated with labor abnormalities (n = 344), whereas control group consisted of women lacking complications during delivery (n = 140). The following methods were used in the study: questionnaires, general clinical methods, biochemical blood tests in pregnant and postpartum women, populational statistics as well as methods of standard and multivariate statistics. Results. In the second half of pregnancy in women with labor abnormalities revealed higher rate of moderate preeclampsia (34.30 ± 2.56 % vs. 10.71 ± 2.61%; p < 0.05), polyhydramnios (11.34 ± 1.71 % vs. 5.71 ± 1.96 %; p < 0.05), chronic intrauterine hypoxia (29.6 ± 2.46 % vs. 12.86 ± 2.83 %; p < 0.05), chronic utero-placental insufficiency (60.47 ± 2.64 % vs. 20.00 ± 3.38 %; p < 0.05), sexually transmitted infections (3.78 ± 1.03 % vs. 0.71 ± 0.71 %; p < 0.05), acute respiratory viral infection (8.72 ± 1.52 % vs. 3.57 ± 1.57 %; p < 0.05) as well as a combination of several types of pathology (8.72 ± 1.52 % vs. 13.57 ± 2.89 %; p < 0.05). Laboratory parameters in women with labor abnormalities compared with control antepartum group were noted to have significantly decreased count of red blood cells (3.89 ± 0.38×1012/L vs. 3.99 ± 0.40×1012/L; p = 0.006), eosinophils (0.95 ± 0.69×109/L vs. 1.20 ± 0.67×109/L; p = 0.026) and platelets (226.29 ± 62.71×109/L vs. 245.44 ± 60.32×109/L; p = 0.0003). Blood biochemical parameters in women with labor abnormalities vs. control group were featured with significantly decreased level of bilirubin (6.76 ± 3.16 μmol/L vs. 9.88 ± 3.60 μmol/L; p < 0.05) and alanine aminotransferase (13.94 ± 10.08 U/L vs. 19.41 ± 14.40 U/L; p = 0.004). Analyzing coagulation parameters in the main group showed significantly reduced fibrinogen level (4.30 ± 1.00 g/L) compared with control group (4.71 ± 1.14 g/L; p < 0.05) as well as elevated international normalized ratio (1.07 ± 0.11 vs. 1.03 ± 0.10; p = 0.001). Conclusion. Our study data found that pregnant women with labor abnormalities had altered clinical and laboratory parameters observed as early as in the second half of gestation, which may be used to calculate an individual risk of such labor complication.

У статті наведено результати аналізу ефективності використання онлайн-форм у процесі опанування дисципліни «внутрішні хвороби». Проведено педагогічний експеримент із включенням 46 лікарів-інтернів, які займалися на кафедрі в період 2016-2017 років. Встановлено, що використання онлайн-форм дозволяє підвищити ефективність навчального процесу за рахунок, по-перше, зменшення часу, який витрачається на обробку результатів опитування, і, по-друге, поліпшення рівня засвоєння матеріалу та «виживаності» знань лікарів-інтернів за допомогою наочного представлення результатів вихідного випробування і предметної дискусії з проблемних питань. Онлайн-опитування характеризується більшою об'єктивністю і, як наслідок, більш позитивним стимулюючим впливом на пізнавальну діяльність лікаря-інтерна. У запропонованій методиці перевірка виконання ситуаційних завдань виконується централізовано, за єдиними критеріями, що дозволяє з достатньою підставою судити про загальний ступінь сформо-ваності відповідних знань та навиків, виявляти типові помилки і на цій основі корегувати та надалі вдосконалювати навчальний процес. Поєднання онлайн-опитування як форми перевірки з традиційними засобами контролю, а також із самоконтролем може сприяти виробленню реальної системи об'єктивної оцінки знань і реалізації головного завдання освітнього процесу — формуванню міцних знань і забезпеченню високої якості підготовки майбутніх фахівців.