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study of immune parameters was carried out by direct rosette method of erythrocytes coated with monoclonal antibodies. Descriptive statistics are given as median and interquartile range. Comparison of parameters was performed by Mann-Whitney test (U-Test). To understand the nature and the coupling between the studied parameters we used Spearman rank correlation coefficient.
Results. There was an essential, statistically significant (U = 24.00, Z = 3.09, p = 0.002) difference between the level of 25(OH)D in children with the recurrent respiratory infections (32,70 [23,03—39,81] r|g/ml) and in occasionally ill children (46,36 [40,21—52,51] |g/ml).
Among children who were predisposed to recurrent respiratory disease course, children with subclini-cal deficiency of vitamin D dominated — 50 %, 6 % had an extreme shortage of vitamin D, and in 44 % of cases the level of vitamin D was sufficient. In the control group — twice as many children have an adequate vitamin D level (88 %), 12 % had subclinical vitamin D deficiency (according to a scale of Cianferotti and Marcoc-ci (2012) [1]. Analysis of the level of vitamin D in children predisposed to recurrent respiratory disease course according to the months of the year found that 25(OH) D3 did not reach sufficient levels (above 30 ng/ml) in March, April, and in autumn. Optimal levels (above
60 ng/ml) on average were not recorded, even in the summer months.
A moderate direct correlation was discovered between levels of 25(OH)D3 and the relative and absolute number of CD25+ and the relative number of CD8+, CD95+ (p < 0.05; weak direct relationship was detected between the level of 25(OH)D3 and the following parameters: number of lymphocytes, relative and absolute number of CD4+, CD16+, absolute number of CD8 + , CD95+, phagocytosis completeness index, index NBT-test.
Conclusion. In infants with recurrent respiratory infections with n o signs of rachitis level of 25(OH)D3 was almost two times lower than in their occasional ill peers, which may indicate extraosseal action of vitamin D, including the immune response influence. This necessitates determining the level of vitamin D in children with recurrent infections and its correction.
References
1. Maidannik V.G. Clinical recommendations in diagnostic, treatment and prophylaxis of vitamin-D deficient rickets in children. — K., 2014. — 58 p.
2. Vitamin D in the healthy European Pediatric population / C. Braegger, C. Campoy, V. Colomb et al. // JPGN. — 2013. — Vol. 56, № 6. — P. 692-700.
3. Camargo C.A. Jr, Ganmaa D., Frazier A.L. et al. Randomized trial of vitamin D supplementation and risk of acute respiratory infection in Mongolia // Pediatrics. — 2012. — 130. — e561-7.
BOYCHUKA., BUDNIK T., BOYARCHUKO. Ternopil State Medical University named after I.Ya. Horbacevsky, Ternopil, Ukraine
Supply of Vitamin D in Pregnant Women
Introduction. The role of vitamin D is well researched in the processes of mineral metabolism. However, in recent years, new sides of the importance of its deficiency in development of many diseases are discovered. Nowadays the question of the impact of vitamin D deficiency on the development of a number of pathologies in infants, in general its impact on the pregnant women health and newborn child is discussed. The use of vitamin D and its optimal doses during pregnancy is remained open (Luz Maria De-Regil et al., 2012).
The aim of our study was to determine the availability of vitamin D in pregnant for determining the need of further correction.
Materials and methods. The survey of 30 women recently confined who were in the obstetrics and physiological department of Ternopil city Hospital № 2 was done. The survey included a questionnaire containing the social block of questions (age, education, financial position), a block of questions related to the supply of vitamin D (using products containing vitamin D, sun stay, suntan cream use, etc.), as well as questions about the awareness of women recently confined about the role of the vitamin D. In addition a standard questionnaire was used to define the daily intake of vitamin D and calcium from food.
Results. The average age of women was 26.97 ± 4.89 years. Half of the women had higher education, 20 % —
incomplete higher education, others — secondary education. Majority of women (63.3 %) evaluated their social status as satisfactory, the rest of them — good. It was found that the average daily intake of vitamin D from food during pregnancy was 311.40 ± 56.85 IU: during the first pregnancy — 391.7 ± 71.9 IU, during the next pregnancy — 231.0 ± 42.2 IU. Average daily calcium intake was 1,318.7 ± 240.7 mg: during the first pregnancy — 1,110.1 ± 202.7 mg, the next pregnancy — 1,527.7 ± 278.9 mg.
12 women (40 %) received vitamin D additionally. Most of them (10—33 %) received vitamin D at a dose of 500 IU daily in the form of complex vitamin and microelements, ranging from 12 weeks of pregnancy. One woman took them from 8 to 16 week, as she read that just at that period enhanced bone formation was gone and the need of calcium and vitamin D increased. The other woman took 500 IU Ergocalciferol from 28 to 34 week on the advice of the doctor, as during this period she did not go out because of fear to catch disease (January — February).
In addition, 20 (66.7 %) women took fish oil on prescription of the doctor, whom they were registered, as they were suffering from the signs of preeclampsia. Among the women recently confined who took fish oil were dominated pregnant women not for the first time.
19 (63.3 %) of pregnant were outdoor more than 2 hours, 9 (30 %) were outdoor less than 2 hours, 2 (6.7 %) did not walk every day. 11 (36.7 %) of pregnant used sun-protection cream with the effect of SPF.
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12 (40 %) women recently confined knew about vitamin D and its benefits during pregnancy (all had higher education). The rest of women were not aware of the importance of vitamin D, they were mostly women with secondary education 15 (50 %).
Conclusion. Thus, researches have shown low supply of vitamin D of pregnant women from food which re-
quires correction of vitamin D in the period of increased body demands. Extra vitamin D during pregnancy is mainly provided by fish oil or common multivitamins, doses and duration of taking them were not always adequate. Educational work among pregnant women about the role of vitamin D and its effect on the foetus is required.
DUPLIJ D.R., SKIDANOVA.G., KOTULSKYJ I.V., RADCHENKO V.A.
Institute of Spine and Joints Pathology named after M.I. Sytenko, Ukrainian Academy of Medical Sciences (SISJP UAMS), Kharkiv, Ukraine
Comparative Estimation of Electromyografic and Imaging Study Indicators of Sarcopenic-Related Alterations of Paravertebral Muscles
Introduction. The advancing age and degenerative lumbar spine diseases are accompanied by a pronounced decreased muscle mass and quality, but investigators lack of available and informative markers of such kind impairments. Electromyography (EMG) has some advantages being not as invasive as biopsy and cheaper than computer tomography (CT). The muscles bioelectrical activity generation is based on the strong relationships between muscle fiber diameter and its conduction velocity. The spectral analysis of complicated interference muscle signal permits to distinguish and recognize the prevailing frequency and amplitude components. The aim of the study is to find out age-related EMG spectral components and to interconnect age-related EMG spectral components with CT results.
Participants. A group of healthy students-volunteers has been recruited from Kharkov higher schools and employees of SISJP UAMS. A group of degenerative diseases of the lumbar spine inpatient patients has been recruited from a vertebral clinic of SISJP UAMS. The participants were divided by age as follows: adolescence (10—15 yrs), youth (16—20 yrs), mature age (21—34 yrs), adulthood (35—54 yrs), advanced age (55—75 yrs), old age (> 75 yrs).
Testing procedure and equipment. The EMG test was performed in the prone position on a horizontal couch. During the test each subject was suggested to fulfill a body isometric back extension and to keep their arms and legs unsupported, and to sustain that position for 60 sec. The electromyography m. erector spinae at lumbar level (L5) was examined on the four-channel electromyo-graph Neuro-MEP, carried out the registration. There 95 records of 48 healthy volunteers (one record was rejected) and 152 myograms of 76 patients were obtained. The spectral analysis of the records was performed using the software modules developed by the authors posed the problem by department of biomedical engineering of Kharkiv National University of Radio Electronics [1]. The total power (TotalP), mean power (MP), median frequency (MedF), mean frequency (MF), peak frequency (PF), start median frequency (startMedF), end
median frequency (endMedF) and MedF rate were calculated. Statistical processing of data was fulfilled by Mann Whitney U-test and Kruskal-Wallis analysis. Furthermore, 663 axial CT images of 129 mature patients (21—75 years) and 93 youth (under 21 years) were studied. Some areas of paravertebral muscles were selected on axial slices of CTs of 7—10 mm diameter and were selected 3,978 samples of muscle tissue. The minimum and maximum values of X-ray density, its average value, standard deviation, and two peak values (in Hounsfield units) were analyzed [2].
Results. From EMG analysis we found out a significant difference between the healthy group and degenerative disease patient group in terms of TotalP, MedF, startMedF, MedF rate (p < 0.001). Neither in the healthy, no patients groups, sex was not the influencing factor for those indicators. Also, we found out a significant difference between the youth, mature age and adulthood groups of healthy in terms of MedF rate and sMedF (Kw = 0.328, p > 0.05). We found out a significant difference between groups of mature age, adulthood, advanced age of patients in terms of TotalP (Kw = 0.083, p > 0.05) sMedF (Kw = 0.113, p > 0.05). From analysis of CT and MRI images we established that age-related changes in the youth group occur slightly differently than adults one. At the age of 21 years, the content of muscle tissue with age does not change significantly, but percentage of connective tissue in all muscles is growing, mainly in m.multifidus and in m.erector spinae. In mature age and adulthood, we can observed the decrease in the muscle tissue percentage in the m. erector spine, most pronounced in adulthood after 48 years [2].
Conclusion. The spectral indicators of TotalP, MedF, startMedF of m.erector spinae myograms have significant dependence on age. The findings are in agreement with the values of X-ray density reflecting sarco-penic muscle tissue percentage. EMG can be suggested to measure age-related and degeneration-related changes in paravertebral muscles and it needs further investigation.
References
1. Gubanov A.V., Zhemchuzhkina T.V., Nosova T.V., Noso-va Y.V. Electromyographic data processing module 5-th International radio electronic forum «Applied electronics. Status and Development Trends», Conference «Problems of Biomed Engineering. Science and Technology», Vol. 3, Kharkiv, 2014, P. 25-27.
2. Paravertebral muscles status and the results of surgical treatment of degenerative lumbar spine diseases / A. Skidanov, V. Rad-chenko, K. Popsuyshapka, A.Popov, I. Fedotova // Proceeding of IV WCMISST. Paris, 2014.
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