2021, Kotov, Y., Semenova, T., Семенова, Татьяна Алексеевна

© 2021, The Author(s), under exclusive license to Springer Nature Switzerland AG.Complex system exploring at initial stage includes fixation of basic data blocks, problem categories, and other. At this stage, an adequate description uses gestalt-like patterns for the future system, its components and their functioning. In the structure of such system, functional and logical relationships can be found between the components or processes. Such a complex system is a living organism (for example, a patient). A skilled patient-treating physician can discover functional and logical associations between the components or processes in the studied system. In some difficult cases, doctors cannot explain their decisions and actions. They might use it practically, but cannot formulate verbally. For these cases, mathematician I.M. Gelfand has proposed a method of diagnostic games. The game is a cognitive research to reveal the doctor’s intuitive action plan for specific case of the patient’s treatment. Working together, the mathematician and physician can formulate a verbal case description. The objective of this study is to extract strict formalized elements from the doctor’s gestalt perception: the rules of diagnostic decision. In order to analyze the intuitive actions of the specialists, the authors propose a mathematical language and technologies based on non-numerical statistics and three-valued logic. The language helps us detect and solve such cognitive problems. The collaboration with doctors allows us to create clear diagnostic rules based on the latent knowledge of an experienced specialist. The article provides a brief description of the method used for solving the problems of practical medicine.

2021, Guryeva, V. M., Travkina, A. A., Matveev, M. O., Morokhotova, L. S., Semenova, T. A., Семенова, Татьяна Алексеевна

© 2020 Trylyst. All rights reserved.Purpose of this review was to highlight the current and future possibilities of medicine in prevention of preeclampsia (PE) and placenta-associated complications (PAO). PE remains one of the most important causes of maternal and perinatal morbidity and mortality, and is responsible for the mass of premature births. The urgency of PE and PAO problem is primarily due to the lack of effective treatment for extensive clinical symptoms, as well as need to terminate pregnancy regardless of the gestational age and prognosis for fetus. In this regard, PE prevention is of great importance for clinical practice. This review presents the modern concept of PE pathogenesis, highlights the key points of hemostatic system disorders, leading to the clinical symptoms and PE. It was also shown that the imbalance between thromboxane and endothelial prostacyclin as well as between pro- A nd anti-angiogenic factors in pregnant women with PE can be considered as a therapeutic target in PE prevention and treatment; prescription of antiplatelet agents and anticoagulants for PE prevention is justified. Modern systematic reviews and meta-analysis have shown some effectiveness of antiplatelet agents and anticoagulants in PAO prevention. This review highlights the role of some nutrient deficiencies in the development of PAO and folate supplementation for their prevention. Presented data indicate that today there are methods for PAO prevention, which can significantly reduce their probability by 17-30% in pregnant women with a high risk of this obstetric pathology. However, a complete prevention and effective treatment of PAO at the stage of advanced clinical symptoms has not yet been developed, which leads to early termination of pregnancy, perinatal morbidity and mortality. Therefore, the development of new therapies that completely prevent or cure PE would be a major advance for practical obstetrics. This review presents the main scientific developments in this direction, in particular, clinical trials of drugs that can reduce sFlt-1 and soluble endoglin secretion, thus curing endothelial dysfunction in PE.

2021, Guryeva, V. M., Travkina, A. A., Matveev, M. O., Morokhotova, L. S., Semenova, T. A., Семенова, Татьяна Алексеевна

© A group of authors, 2021.The diagnosis of preeclampsia in clinical practice causes certain difficulties due to the non-specificity of symptoms, the polymorphism of the clinical picture, and the discrepancy between the magnitude of clinical symptoms and the severity of multiple organ dysfunction. Therefore, the accurate diagnosis and prediction of preeclampsia is of great importance for practical obstetrics. The paper presents the results of the basic studies devoted to the clinical interpretation of the sFlt-1/PlGF ratio for the diagnosis and prediction of preeclampsia and shows the informative value and significance of the ratio for the objectification of the diagnosis of preeclampsia, as well as the possibility of predicting this obstetric complication according to sFlt-1/PlGF data. It shows the experience of using sFlt-1/ PlGF in the obstetric service in the Moscow Region and formulates indications for the study of sFlt-1/PlGF in clinical practice and approaches to its interpretation. Conclusion. The application of sFlt-1/PlGF allows the differential diagnosis of preeclampsia with an exacerbation or a manifestation of a number of somatic diseases that occur with similar clinical symptoms. The use of sFlt-1/PlGF provides an economic effect, by improving the routing and decreasing the number of severe perinatal and maternal outcomes, as well as reducing unjustified hospitalization. sFlt-1/PlGF is an informative marker for the diagnosis and prediction of preeclampsia and its adverse outcomes and can be recommended for use in clinical practice.