*<IP_ADDRESS>.1 Organic inhibitors*

Organic compound containing oxygen, nitrogen, sulfur with multiple bonds have been reported as good corrosion inhibitors. Many organic inhibitors such as amines, aldehydes, alkaloids, nitro and nitroso compounds have been studied and tried as corrosion inhibitors [39]. Organic inhibitors can be anodic, cathodic and mixed type based on its reaction at the metal surface and potential. These are effective depending upon its size, carbon chain length, aromaticity, conjugation and nature of bonding atoms [40].

#### *<IP_ADDRESS> Alkaline inhibitors*

Metals, which form amphoteric oxides, are prone to corrosion in alkaline solutions. Many organic compounds are often used as inhibitors for metals in basic solutions [41]. Compounds such as thiourea, substituted phenols, naphthol, β-diketone, etc., have been used as effective inhibitors in basic solutions due to the formation of metal complexes.

#### *<IP_ADDRESS> Neutral inhibitors*

Inhibitors which are effective in acidic solutions do not function effectively in neutral solutions, since the mechanism is different in the two solutions [42–44]. In neutral solutions, the interaction of inhibitors with oxide covered metal surface and prevention of oxygen reduction reaction at the cathodic sites takes place. Such inhibitors protect the surface layers from aggressiveness. Some surface active chelating inhibitors have been found to be efficient inhibitors in near-neutral solutions [45].

#### *11.5.4 Based on mode of protection*

## *<IP_ADDRESS> Chemical passivators*

Substances which usually have a sufficiently high equilibrium potential (redox or electrode potential) and sufficiently low over potential decrease corrosion rate on attainment of passivity and are called chemical passivators [46].

Example, nitrites are used as inhibitors for antifreeze cooling waters. Chromates are mostly used as inhibitors for recirculating cooling waters. Zinc molybdate is used as an inhibiting pigment for paints.

#### *<IP_ADDRESS> Adsorption inhibitors*

These represent the most widely used class of inhibitors. In general, they are organic compounds which get adsorbed on the metal surface and provide a blanketing effect over the entire surface, that is, both in cathodic and anodic cases. Generally they effect both cathodic and anodic reactions equally, but in many cases the effect may not be equal. These are commonly used in the acid pickling of hot rolled products in order to remove the black mill scale and are thus known as pickling inhibitors [47–49].

Examples: Compounds containing lone pairs of electrons such as nitrogen atoms in amines, quinolines, sulfur atoms in thio compounds and oxygen atoms in aldehydes.

#### *<IP_ADDRESS> Film forming inhibitors*

In contrast to the adsorption inhibitors which form the straight forward adsorbed film of the inhibiting species, many substances called film forming inhibitors, appear to stop corrosion by forming a blocking or a barrier film of a material other than the actual inhibiting species itself. Such materials tend to be specific either to the cathode or to the anode. Zinc and calcium salts are the most common examples of cathodic film forming inhibitors. Benzoate is the common example of anodic film forming inhibitors, which inhibit corrosion during voyages [50].

**19**

**Figure 14.**

*Corrosion Inhibitors*

Examples,

*<IP_ADDRESS> Synergistic inhibitors*

*<IP_ADDRESS> Precipitation inhibitors*

silicate, zinc-tannins, and zinc-phosphates.

*Schematic representation of vapor phase inhibitors.*

water softeners to prevent the occurrence of rust [57, 58].

*DOI: http://dx.doi.org/10.5772/intechopen.80542*

the schematic representation vapor phase inhibitors.

*<IP_ADDRESS> Volatile inhibitors or vapor phase inhibitors*

Atmospheric corrosion of metals in closed spaces as in parcels during storage and shipment can be prevented by the use of certain substances called vapor phase inhibitors also called as volatile inhibitors [51–56]. These are substances of low but significant vapor pressure. The vapor comes in contact with the surface of the metal and the adsorption of the inhibitor takes place. The moisture then hydrolyses it and releases protective ions which have corrosion inhibiting properties. **Figure 14** shows

Dicyclohexylamine chromate and benzotriazole for protecting copper.

environment to the site of corrosion by volatilization from a source **(Figure 15).** If the corrosion product is volatile, it volatilizes as soon as it is formed, thereby leaving the underlying metal surface exposed for further attack. This causes rapid and continuous corrosion leading to excessive corrosion. Example, Molybdenum oxide (MoO3), the oxidation corrosion product of molybdenum is volatile. In closed vapor process (shipping containers), volatile solids such as salts of dicyclohexylamine, cyclohexylamine and hexamethylene amine are used as volatile corrosion inhibitors [52].

Volatile corrosion inhibitors (VCIs) are compounds which transferred in a closed

These are single inhibitor which is used in cooling water systems. More often, a combination of inhibitors (anodic and cathodic) is used to obtain better corrosion protection properties [56]. Examples include chromate-phosphates, polyphosphate-

These are compounds that forms precipitates on the metal surface, thereby providing a protective film. The most common inhibitors of this category are the silicates and the phosphates. For example, Sodium silicate, is used in many domestic

Phenyl thiourea and cyclohexylamine chromate for brass. Dicyclohexylamine nitrite for ferrous and nonferrous part.

*<IP_ADDRESS> Vapor phase inhibitors*


**5. Risk factors**

#### **5.1. Non-modifiable risk factors**

Coronary atherosclerosis is an important site of atherosclerosis. There are various types of results due to coronary atherosclerosis. Especially, the size of the plaque and the type of the complicated plaque are important for this. Whatever the beginning of the atheromatous plaque, the result can be a fatal heart attack. In developed countries atherosclerosis causes more than half of total mortality. Coronary artery disease (CAD) is responsible for a major

Focus on Coronary Atherosclerosis

9

http://dx.doi.org/10.5772/intechopen.77301

Onset of the atherosclerotic plaque and speed of the growth and complications, there are several signs and symptoms. Atherosclerosis can be seen in every artery, but for the coronary atherosclerosis, the result of the disease is coronary artery disease, and the symptoms and the signs are due to this. Because of the impaired blood flow, there is a sort of symptoms. Some of them are in the side of the chest, and some of them are systemic because of the impaired

• Tachycardia: common in persons with acute coronary syndrome (ACS) and acute myocar-

proportion of these deaths [12].

**6. Signs and symptoms**

circulation.

• Chest pain

• Leg swelling

• Weight gain

• Diaphoresis

• Heart murmurs

• Tachypnea

• Syncope

• Rales

• Leg edema

• Xanthelasmas

• Livedo reticularis

• S4

• S3

• Shortness of breath

• Dizziness, palpitations

dial infarction (AMI)

• High or low blood pressure

gallop: a common early finding

gallop: an indication of reduced left ventricular function

• Weakness, tiredness, reduced exertional capacity

#### **5.2. Modifiable risk factors**

#### **5.3. Atheroprotective factors**

Coronary atherosclerosis is an important site of atherosclerosis. There are various types of results due to coronary atherosclerosis. Especially, the size of the plaque and the type of the complicated plaque are important for this. Whatever the beginning of the atheromatous plaque, the result can be a fatal heart attack. In developed countries atherosclerosis causes more than half of total mortality. Coronary artery disease (CAD) is responsible for a major proportion of these deaths [12].


**2. Materials and methods**

#### **2.1 Sample**

The sample consisted of 100 mother-child dyads. There were 48 girls, 52 boys and 100 mothers. Among children, there were 50 children aged under 1-year-old (27 boys and 23 girls) and 50 children at the age of 1–2 years old (25 boys and 25 girls).

The experimental sample was selected by means of randomization, that is, by the random selection strategy or subjects distribution when all the subjects had an equal chance to enter the group. It provided internal validity and controlled the blending effect. The present study was carried out in an urban polyclinic for children in a little town of the European part of Russia.

#### **2.2 Measures**

The complex assessment of the children's health status was based on the individual medical records. The mothers filled the questionnaire evaluating the mother's relation to her child during the first 2 years of life [42] and the questionnaire aimed at assessing the emotional intelligence level [43]. The questionnaire evaluating the mother's relation to her child includes four scales: sensitivity-insensitivity; attachmentrejection; support-ignoring and efficiency-intervention. The questionnaire assessing emotional intelligence level includes three scales: interpersonal emotional intelligence (EI), intrapersonal EI, emotions understanding, emotion management, some

**5**

malformation.

criteria.

of health were distinguished:

(ontogeny peculiarities).

them) and frequent illnesses.

without any disorders of health.

the stage of subcompensation.

**2.3 Research techniques**

*The Interrelation of the Mother's Health Status with the State of Health…*

subscales and aggregate indicator of EI. It was showed earlier that both questionnaires

The complex assessment of the children's state of health was based on six main indicators (criteria) of health [16]. These indicators are used by all doctors in the state clinics in Russia for child health assessment. We used the results of the doctor's assessments from the individual records of the children. The first criterion: peculiarities of ontogeny (individual development) described according to the genealogical, biological and social anamnesis. The second criterion: a degree of physical development and its harmoniousness. The physical development of the child was assessed by means of the comparison of individual indicators (body length and weight, chest circumference, etc.) and age standards. At that, body length was the most informative and leading feature in the evaluation of physical development. It was important not only to solve the question of correspondence of the physical development indicators of the child to his/her age but also to assess the harmoniousness of his/her development. The third criterion: a level of nervous and mental development of the child depends upon both central nervous system state of the child, musculoskeletal

The fourth criterion: a level of organism resistance assessed by the quantity of acute diseases during the year preceding the examination. According to this criterion, the children were divided into two groups: with good resistance of organism (having had no diseases during a year, or having had diseases from one to three times); with a lower resistance of organism (having had diseases more than four times a year). The fifth criterion: a level of the functional state of organism based on the aggregate of results of laboratory and instrumental examinations of the child (pulse rate, breath, hemoglobin content in the blood and so on), analysis of his or her behavior and adaptive capabilities. The mother accumulated knowledge about the child's behavior during everyday contact with him or her. The following parameters were assessed during the observation of the child: emotional state, mood, sleep, wake, appetite and the nature of relationships with children and adults, at an older age—the ability to concentrate, attention and fatigability. It was important to

The sixth criterion: the presence or absence of chronic diseases or congenital

Based on the complex assessment of the above-mentioned criteria, five groups

Group II-A: children having abnormalities according to the first criterion only

Group II-B: children having some functional disorders (including behavior), physical and/or nervous and mental developmental disturbances (or without any of

Group III: children having chronic diseases at the stage of compensation, that is,

Group IV: children having chronic diseases exacerbating 2–4 times per year, at

Group V: children having chronic diseases at the stage of decompensation.

We received permits from the children's parents to use the information from

their individual medical records. Mothers with children went to the doctor

Group I: healthy children having no abnormalities according to all the six

*DOI: http://dx.doi.org/10.5772/intechopen.80754*

were valid and reliable [42, 43].

system and the environment effect.

take into account individual peculiarities of behavior.

#### *The Interrelation of the Mother's Health Status with the State of Health… DOI: http://dx.doi.org/10.5772/intechopen.80754*

*Maternal and Child Health Matters Around the World*

attachment to the child.

**2.  The ability to realize and ponder over one's own and others' emotions, of course, implies numerous consequences, first of all, in a person's behavior. Due to that, the interrelation between emotional intelligence and attachment degree is of absolute interest [29, 33, 39, 40]. This is especially significant, since attachment involves the phenomena, which in the real life a person verbalizes seldom. It is difficult to imagine the mother who says by herself: "I accept my child", or "I support and I do not ignore my child". Attachment to the child is an intimate feeling being close to the instinct [31], and a person does not speak to himself or herself about its details. We assume that one of the most important parameters influencing the child's health is a level of the emotional maturity of the mother. It manifests in the high emotional intelligence and emotional attachment to the child. We set the task to evaluate the state of health of the mother and child at birth, and the probability of the diagnosis cancelation in the child at the end of the second year of life. It depends upon two characteristics of the mother: emotional intelligence and the degree of

In Russia, quality examination of the child is fulfilled after birth in the maternity hospital, and a major part of children gets one or the other diagnosis. Another attending doctor may cancel the diagnosis of the child, if the child's status has been normalized. At that, by the end of the first and, quite often, second year of life, medical specialists cancel children's diagnoses made earlier [27]. To a considerable extent, the child's status change is determined by efficient actions of caring persons, mainly, the mother [41]. It is the mother who in the majority of families takes the child to a doctor and carries out all the necessary directions for the rehabilitation. In that situation, her involvement in the process of the child's health recovery impacts substantially on the positive prediction of his/her recovery provided that the disease is not genetic but

The sample consisted of 100 mother-child dyads. There were 48 girls, 52 boys and 100 mothers. Among children, there were 50 children aged under 1-year-old (27 boys and 23 girls) and 50 children at the age of 1–2 years old (25 boys and 25 girls). The experimental sample was selected by means of randomization, that is, by the random selection strategy or subjects distribution when all the subjects had an equal chance to enter the group. It provided internal validity and controlled the blending effect. The present study was carried out in an urban polyclinic for

The complex assessment of the children's health status was based on the individual medical records. The mothers filled the questionnaire evaluating the mother's relation to her child during the first 2 years of life [42] and the questionnaire aimed at assessing the emotional intelligence level [43]. The questionnaire evaluating the mother's relation to her child includes four scales: sensitivity-insensitivity; attachmentrejection; support-ignoring and efficiency-intervention. The questionnaire assessing emotional intelligence level includes three scales: interpersonal emotional intelligence

(EI), intrapersonal EI, emotions understanding, emotion management, some

determined by the peculiarities of intrauterine development and birth.

children in a little town of the European part of Russia.

**4**

subscales and aggregate indicator of EI. It was showed earlier that both questionnaires were valid and reliable [42, 43].

The complex assessment of the children's state of health was based on six main indicators (criteria) of health [16]. These indicators are used by all doctors in the state clinics in Russia for child health assessment. We used the results of the doctor's assessments from the individual records of the children. The first criterion: peculiarities of ontogeny (individual development) described according to the genealogical, biological and social anamnesis. The second criterion: a degree of physical development and its harmoniousness. The physical development of the child was assessed by means of the comparison of individual indicators (body length and weight, chest circumference, etc.) and age standards. At that, body length was the most informative and leading feature in the evaluation of physical development. It was important not only to solve the question of correspondence of the physical development indicators of the child to his/her age but also to assess the harmoniousness of his/her development.

The third criterion: a level of nervous and mental development of the child depends upon both central nervous system state of the child, musculoskeletal system and the environment effect.

The fourth criterion: a level of organism resistance assessed by the quantity of acute diseases during the year preceding the examination. According to this criterion, the children were divided into two groups: with good resistance of organism (having had no diseases during a year, or having had diseases from one to three times); with a lower resistance of organism (having had diseases more than four times a year). The fifth criterion: a level of the functional state of organism based on the aggregate of results of laboratory and instrumental examinations of the child (pulse rate, breath, hemoglobin content in the blood and so on), analysis of his or her behavior and adaptive capabilities. The mother accumulated knowledge about the child's behavior during everyday contact with him or her. The following parameters were assessed during the observation of the child: emotional state, mood, sleep, wake, appetite and the nature of relationships with children and adults, at an older age—the ability to concentrate, attention and fatigability. It was important to take into account individual peculiarities of behavior.

The sixth criterion: the presence or absence of chronic diseases or congenital malformation.

Based on the complex assessment of the above-mentioned criteria, five groups of health were distinguished:

Group I: healthy children having no abnormalities according to all the six criteria.

Group II-A: children having abnormalities according to the first criterion only (ontogeny peculiarities).

Group II-B: children having some functional disorders (including behavior), physical and/or nervous and mental developmental disturbances (or without any of them) and frequent illnesses.

Group III: children having chronic diseases at the stage of compensation, that is, without any disorders of health.

Group IV: children having chronic diseases exacerbating 2–4 times per year, at the stage of subcompensation.

Group V: children having chronic diseases at the stage of decompensation.

#### **2.3 Research techniques**

We received permits from the children's parents to use the information from their individual medical records. Mothers with children went to the doctor

(in Russia mothers of the first-year-old children show their children to the doctors each months) and filled in the questionnaires when the doctor analyzed the health of the child. Then they showed the doctor's records for the researchers. They received the psychological consultations if they participate in the investigation.

For the statistical analysis, the program SPSS-22 was used.

### **3. Results and discussion**

The analysis of the data about the pregnancy of the mothers having first- and second-year-old children showed the following results. About 62% of the mothers of first-year-old children and 66% of the mothers of second-year-old children had a first pregnancy. About 26% of the women had a second one. A total of 6% of the mothers of children aged under one-year-old and 2% of the mothers of children at the age of 1–2 years old had a third pregnancy; 4 and 2% correspondingly—a fourth and fifth one, and as little as 1% of the mothers of second-year-old children had a sixth pregnancy.

Interpreting the data about planned and unintended pregnancy, it was noteworthy that the child was "planned and desired" for 72% of the mothers of first-year-old children and 62% of the mothers of second-year-old children. The baby was "unexpected but desired" for 28 and 38% of the women correspondingly. At that, the majority of the mothers (72%), having children aged less than 2 years old, experienced joy, having learned about their pregnancy. Thus, the total sample consisted of 200 subjects under test; there were 50 dyads of "the motherthe first-year-old child" (mean age of the mothers is 24.5 ± 5.6 years old) and 50 dyads of "the mother-the second-year-old child" (mean age of the mothers is 25.5 ± 4.9 years old).

#### **3.1 Description of health peculiarities in the children during the first 2 years of life**

Based on **Table 1**, in the maternity hospital, the first-year-old children at the moment of examination get approximately the same number of diagnoses: two ones per child on the average. During the first year of living, the number of diagnoses diminishes; and there is one diagnosis per two second-year-old children. That fall of incidence is statistically significant. There are no significant differences in these parameters for the boys and girls.

In spite of the incidence fall, valid differences in the number of the children in the different groups of health at the first and second years of life are not found. This is accounted for that many second-year-old children are identified as group 2A. It includes the children who have no diseases and are almost healthy except these or other peculiarities of the anamnesis at the present moment. As described further, almost all of them have abnormalities owing exactly to the biological anamnesis of the mother.

The obtained results required a more in-depth consideration of morbidity (**Table 2**). The data (in %), obtained and presented in **Table 2**, show that the most widespread diseases are intrauterine hypoxia and physiological jaundice diagnosed in the children during their stay in the maternity ward. Almost all the children have one or the other disease at birth (90% of the first-year-old children, 96% of the secondyear-old children). By the end of the first year of life, the diagnoses are canceled in 40% of the children, and in 60% of the children during the second year of life.

**7**

Russia [12, 41].

The number of diagnoses made in the maternity hospital

The number of diagnosis made by a local doctor

*\*\**р *= 0.99 (there and late* Т*-criterion).*

*\**

**Table 1.**

boys and girls.

flexible period of the child's life.

**of the first- and second-year-old children**

*The Interrelation of the Mother's Health Status with the State of Health…*

**Parameters The number of diagnosis**

The data, obtained and presented in **Table 2**, show that the most widespread diseases are intrauterine hypoxia and physiological jaundice diagnosed in the children during their stay in the maternity ward. Almost all the children have one or the other disease at birth (90% of the first-year-old children, 96% of the second-year-old children). By the end of the first year of life, the diagnoses are canceled in 40% of the children, and in 60% of the children during the second year of life. These disorders are the typical one during pregnancy in many countries [3, 15, 21, 24, 44, 45]. This is a typical distribution of neonatal morbidity in

*The number of diagnosis of the children made in the maternity hospital and by local doctors.*

**The first-year-old children The second-year-old children**

2.0 ± 1.1 2.0 ± 1.1 2.2 ± 1.0 2.4 ± 1.5 2.6 ± 1.7 2.2 ± 1.3

1.2 ± 1.1 1.2 ± 1.1 1.2 ± 1.2 0.6 ± 0.9\*\* 0.8 ± 0.9 0.7 ± 1.0

**children**

**Girls Boys**

**Girls Boys All**

In **Table 3**, there are data about the number of canceled and non-canceled diagnoses for each of the diseases made by a local doctor earlier during the first 2 years. It is evident that during the second year of life already, a major part of the children come to the healthy group (retaining health group II-A because of the burdened anamnesis). There are no differences in this parameter between the

Thus, after the analysis of the medical histories of the children, one can say that the percentage of the healthy children at birth is very small. But the situation changes substantially during the first 2 years of living: a major part of the children's diagnoses are canceled by a local doctor. That is why it is highly important to explore the reasons, which enhance the probability of recovery during the most

**3.2 The interrelation of the biological anamnesis of the mother with the health**

By the end of the first 2 years of life, a major part of the children passes to the group of healthy children. There appears a question of particular peculiarities of the psychological state of the mother that might be predictors of positive changes in the child's health at that time. Since morbidity at birth is often accounted for anomalies during gestation and childbirth, then the comparison of biological anamnesis of the mother and peculiarities of the child's health during the first years of living is of interest. Of course, not only the mother's health and diseases predetermine that change but they make their contribution to it. According to our

*DOI: http://dx.doi.org/10.5772/intechopen.80754*

**All children**

*Differences between of the first and second old children* р *= 0.95.*

*The Interrelation of the Mother's Health Status with the State of Health… DOI: http://dx.doi.org/10.5772/intechopen.80754*

#### **Table 1.**

*Maternal and Child Health Matters Around the World*

**3. Results and discussion**

sixth pregnancy.

25.5 ± 4.9 years old).

parameters for the boys and girls.

**of life**

the mother.

(in Russia mothers of the first-year-old children show their children to the doctors each months) and filled in the questionnaires when the doctor analyzed the health of the child. Then they showed the doctor's records for the researchers. They received the psychological consultations if they participate in the investigation.

The analysis of the data about the pregnancy of the mothers having first- and second-year-old children showed the following results. About 62% of the mothers of first-year-old children and 66% of the mothers of second-year-old children had a first pregnancy. About 26% of the women had a second one. A total of 6% of the mothers of children aged under one-year-old and 2% of the mothers of children at the age of 1–2 years old had a third pregnancy; 4 and 2% correspondingly—a fourth and fifth one, and as little as 1% of the mothers of second-year-old children had a

Interpreting the data about planned and unintended pregnancy, it was noteworthy that the child was "planned and desired" for 72% of the mothers of first-year-old children and 62% of the mothers of second-year-old children. The baby was "unexpected but desired" for 28 and 38% of the women correspondingly. At that, the majority of the mothers (72%), having children aged less than 2 years old, experienced joy, having learned about their pregnancy. Thus, the total sample consisted of 200 subjects under test; there were 50 dyads of "the motherthe first-year-old child" (mean age of the mothers is 24.5 ± 5.6 years old) and 50 dyads of "the mother-the second-year-old child" (mean age of the mothers is

**3.1 Description of health peculiarities in the children during the first 2 years**

Based on **Table 1**, in the maternity hospital, the first-year-old children at the moment of examination get approximately the same number of diagnoses: two ones per child on the average. During the first year of living, the number of diagnoses diminishes; and there is one diagnosis per two second-year-old children. That fall of incidence is statistically significant. There are no significant differences in these

In spite of the incidence fall, valid differences in the number of the children in the different groups of health at the first and second years of life are not found. This is accounted for that many second-year-old children are identified as group 2A. It includes the children who have no diseases and are almost healthy except these or other peculiarities of the anamnesis at the present moment. As described further, almost all of them have abnormalities owing exactly to the biological anamnesis of

The obtained results required a more in-depth consideration of morbidity (**Table 2**). The data (in %), obtained and presented in **Table 2**, show that the most widespread diseases are intrauterine hypoxia and physiological jaundice diagnosed in the children during their stay in the maternity ward. Almost all the children have one or the other disease at birth (90% of the first-year-old children, 96% of the secondyear-old children). By the end of the first year of life, the diagnoses are canceled in 40% of the children, and in 60% of the children during the second year of life.

For the statistical analysis, the program SPSS-22 was used.

**6**

*The number of diagnosis of the children made in the maternity hospital and by local doctors.*

The data, obtained and presented in **Table 2**, show that the most widespread diseases are intrauterine hypoxia and physiological jaundice diagnosed in the children during their stay in the maternity ward. Almost all the children have one or the other disease at birth (90% of the first-year-old children, 96% of the second-year-old children). By the end of the first year of life, the diagnoses are canceled in 40% of the children, and in 60% of the children during the second year of life. These disorders are the typical one during pregnancy in many countries [3, 15, 21, 24, 44, 45]. This is a typical distribution of neonatal morbidity in Russia [12, 41].

In **Table 3**, there are data about the number of canceled and non-canceled diagnoses for each of the diseases made by a local doctor earlier during the first 2 years. It is evident that during the second year of life already, a major part of the children come to the healthy group (retaining health group II-A because of the burdened anamnesis). There are no differences in this parameter between the boys and girls.

Thus, after the analysis of the medical histories of the children, one can say that the percentage of the healthy children at birth is very small. But the situation changes substantially during the first 2 years of living: a major part of the children's diagnoses are canceled by a local doctor. That is why it is highly important to explore the reasons, which enhance the probability of recovery during the most flexible period of the child's life.

#### **3.2 The interrelation of the biological anamnesis of the mother with the health of the first- and second-year-old children**

By the end of the first 2 years of life, a major part of the children passes to the group of healthy children. There appears a question of particular peculiarities of the psychological state of the mother that might be predictors of positive changes in the child's health at that time. Since morbidity at birth is often accounted for anomalies during gestation and childbirth, then the comparison of biological anamnesis of the mother and peculiarities of the child's health during the first years of living is of interest. Of course, not only the mother's health and diseases predetermine that change but they make their contribution to it. According to our

**9**

*The Interrelation of the Mother's Health Status with the State of Health…*

41. Ankyloglossia 2 0 42. The right clavicle fracture 2 0 43. Polycythemia 2 0 44. Intrauterine hypotrophy 2 0

**Canceled Non-**

Anemia 2 0 2 4 0 4

Flat valgus foot 2 0 2 0 0 0 Pyelectasis 2 0 2 0 0 0

Inguinal hernia 0 0 0 4 0 4 Paratrophy 2 2 0 2 0 2 Cardiopathy 2 0 2 0 0 0

**canceled**

**The first-year-old children**

**The ratio of the canceled and non-canceled diagnoses of children The first-year-old The second-year-old**

86 24 62 80 64 16

54 20 34 48 36 12

6 2 4 8 4 4

4 2 2 4 0 4

2 0 2 0 0 0

0 0 0 6 6 0

0 0 0 2 0 2

**Number of diagnoses** **The second-year-old children**

**Cancelled Non-**

**canceled**

data, the mothers of the first- and second-year-old children do not differ between

*The ratio of the canceled and non-canceled diagnoses for each of the diseases made by a local doctor.*

Further, we have fulfilled correlation analysis (the Spearman's coefficient) aiming to identify relations between the children's health parameters and parameters of biological anamnesis of the mothers. There is a positive connection between the number of the diagnoses in the first- and second-year-old children during their stay in the maternity ward and perinatal pathology factors of the mother (r = 0.336, p ≤ 0.001 for the first-year-old children; r = 0.226, p ≤ 0.05 for the second-year-old children). Besides, the interrelation between the number of perinatal pathology

one another in the parameters of biological anamnesis.

*DOI: http://dx.doi.org/10.5772/intechopen.80754*

**maternity ward**

**The name of the diagnosis of the child made by local doctor**

Perinatal encephalopathy

Moving disorders

Excitation syndrome

Atopic dermatitis

Dysplasia of the hip joints

Hypotrophy of the 1,2,3 degrees

Little anomaly of heart development

**Table 3.**

**Table 2.**

**The name of the diagnosis of the child made in the**

*The children's diagnoses made in the maternity hospital (%).*

**Number of diagnoses** *The Interrelation of the Mother's Health Status with the State of Health… DOI: http://dx.doi.org/10.5772/intechopen.80754*

**Table 2.**

*Maternal and Child Health Matters Around the World*

**The name of the diagnosis of the child made in the**

**The first-year-old children**

1. Intrauterine hypoxia 64 52 2. Physiological jaundice 42 60 3. Conjugation jaundice 4 6 4. Risk group due to perinatal encephalopathy 15 8 5. Perinatal damage of central nervous system (CNS) 4 6 6. Excitation syndrome 2 2 7. Toxic erythema 12 6 8. Hemorrhage in the skin 12 20 9. Prematurity 0 2 10. Morphofunctional immaturity 2 2 11. Edema syndrome 2 2 12. Low birth weight 2 6 13. Large child 8 6 14. Asphyxia of low level 4 4 15. Asphyxia of mean level 4 0 16. Asphyxia of high level 2 0 17. Intrauterine growth restriction by hypotrophic type 4 2 18. Cardiopathy 4 2 19. Pathological loss of body weight 2 8 20. Umbilical hernia 0 2 21. Chin tremor 0 2 22. Low muscle tones 0 2 23. Muscle hypertonus 0 2 24. Respiratory distress syndrome of type 1 0 2 25. Hypoxic damage of CNS 0 2 26. The syndrome of CNS depression 0 2 27. Oxygen-dependent child 0 2 28. Depressed reflexes 0 2 29. Mammary glands engorgement 0 4 30. Right parietal cephalohematoma 0 4 31. Perinatal contact with chronic hepatitis C virus 2 2 32. Umbilical cord entanglement around the neck 2 2 33. Nappy rash 0 2 34. Hyperbilirubinemia 0 2 35. The right-side dacryocystitis 0 2 36. The left-side dacryocystitis 0 2 37. The left-side flat valgus foot 2 2 38. Reduced film of the tear duct 0 4 39. Papilloma of the left areola 2 0 40. Urinary tract infection 2 0

**The second-year-old children**

**maternity ward**

**8**

*The children's diagnoses made in the maternity hospital (%).*

**Table 3.**

*The ratio of the canceled and non-canceled diagnoses for each of the diseases made by a local doctor.*

data, the mothers of the first- and second-year-old children do not differ between one another in the parameters of biological anamnesis.

Further, we have fulfilled correlation analysis (the Spearman's coefficient) aiming to identify relations between the children's health parameters and parameters of biological anamnesis of the mothers. There is a positive connection between the number of the diagnoses in the first- and second-year-old children during their stay in the maternity ward and perinatal pathology factors of the mother (r = 0.336, p ≤ 0.001 for the first-year-old children; r = 0.226, p ≤ 0.05 for the second-year-old children). Besides, the interrelation between the number of perinatal pathology

factors and health group of the first- and second-year-old children is observed (r = 0.243, p ≤ 0.02 for the first-year-old children; r = 0.281, p ≤ 0.01 for the second-year-old children). There is no significant interrelation between the number of the diagnoses in the second-year-old children and perinatal pathology factors of their mothers. That is connected with that a part of diagnoses has been canceled by the moment of the examination of the child. However, the number of the diagnoses in the first-year-old children made by a local doctor is validly connected (r = 0.478, p ≤ 0.001) with the quantity of perinatal pathology factors identified during their mothers' pregnancy.

There is a positive interrelation between the health group type of the secondyear-old children and the presence of abortions made before by their mothers (r = 0.213, p ≤ 0.05). One should point out that no similar relation is found in the first-year-old children. The obtained data evidence a negative effect of abortions on the children's health. It manifests and is detected after some time only. The results obtained in correlation analysis correspond to the results of single-factor analysis of variance. It has shown that exactly the number of the perinatal pathology factors of the mother influences the number of the children's diagnoses made in the maternity hospital (where F = 9.565, p = 0.003 for the first-year-old children; F = 5.014, p = 0.030 for the second-year-old children).

We have analyzed 28 parameters indicating the presence of pathology in the mother. Based on them, the control of the state of health and prevention of abnormalities are performed in the children who have risks of getting central nervous system disorders at the maternity house. The analysis reveals that only 8% of the mothers of first-year-old children and 14% of the second-year-old children are almost healthy. About 74 and 62% of the mothers have different extragenital diseases. The obstetric anamneses of 24% of the mothers, having first-year-old children, are burdened with abortions, 22% of the mothers—having secondyear-old children. The anamneses of 8 and 10% of the women correspondingly are burden with miscarriage. The current pregnancy of 34% of the mothers of first-year-old children and 22% of the mothers of second-year-old children is complicated by the threat of abortion. In 18 and 10% of the mothers of children aged under 2 years old, it is accompanied by placental insufficiency. In 14% of the women, there is an immunological incompatibility of blood of the mother and the fetus. Besides, 6% of the women having first-year-old children and 2% of the women having second-year-old children have got the symptoms of fetal hypoxia. About 14% of the mothers of first-year-old children and 10% of the mothers of second-year-old children are characterized by weakness of labor. The dominant factors in the structure of extragenital anomalies of the mothers of first- and secondyear-old children (as in some other investigations) are iron deficiency anemia (26%), kidney diseases (28 and 30%) and vegetovascular dystonia (24 and 20%).

In our further analysis, all the factors are divided into three groups according to the period of impact:

1.Detrimental factors during the progenesis.

2.Adverse factors during the antenatal period.

3.Adverse factors during the birth period (the intranatal period).

We cannot detect any role of factors in progenesis, since we have observed the women regarding the gestation responsibly and regularly consulting with a gynecologist during their pregnancy. Only 4% of the mothers of first-year-old children smoke; and among the mothers of second-year-old children, there are no women

**11**

**Table 4.**

*The Interrelation of the Mother's Health Status with the State of Health…*

with bad habits. About 4% of the mothers of children aged under one-year-old and 12% of the mothers of second-year-old children have gynecological diseases in the

in the mother during the antenatal period on the future health of the child. The most significant factors of risk of the child's morbidity are the following: the threat of abortion (34% of the first-year-old children's mothers and 22% of the secondyear-old children's mothers), anemia (26%), vegetovascular dystonia (24 and 20%), kidney diseases (28 and 30%) and chronic fetoplacental insufficiency (18 and 10%). During the intranatal period, the significant risk factors of perinatal pathology of the mothers, exerting influence upon the health of the first- and secondyear-old children, are episiotomy (20 and 26%), cesarean (26 and 16%), premature rupture of membranes (20 and 18%) and weakness of labor activity (14 and 10%). We have not found any substantial differences in the pathology of the mothers of two groups. But this distribution shows the typical situation for pregnant women in

But we have been able to show the influence of the factors of perinatal pathology

Correlation analysis of the results about the interrelation of the number of diagnoses in the first-year-old children, made by a local doctor, with perinatal anomaly factors during the antenatal period is in **Table 4**. We have found the significant relation of the children's morbidity with fetoplacental insufficiency during pregnancy (r = 0.444, p < 0.001) as well as with threat of abortion (r = 0.379, p < 0.01) and gestosis in the mother during pregnancy (r = 0.353, p < 0.01). We have revealed the close positive relation between the first-year-old children's health deterioration and iron deficiency anemia (r = 0.330, p < 0.02) and kidney diseases (r = 0.276, p < 0.05) through the mother. That is, the more diseases the mother has, the higher

There is no significant correlation relationship between the number of diseases

of the second-year-old children and perinatal pathology factors of the mother during the antenatal period. However, significant interconnection is found between the number of diseases of the second-year-old children and iron efficiency anemia (r = 0.382, p < 0.01), varicosity (r = 0.332, p < 0.02), and the mother's kidney diseases (r = 0.281, p < 0.05). The analysis of the results about the interrelation of the number of diagnoses in the first-year-old children (by a local doctor) with the perinatal pathology factors of the mother during the intranatal period is in **Table 5**. It has revealed the significance of that dependence with weakness of birth activity (r = 0.354, p < 0.001).

Russia [25].

children.

*The Interrelation of the Mother's Health Status with the State of Health… DOI: http://dx.doi.org/10.5772/intechopen.80754*

*Maternal and Child Health Matters Around the World*

p = 0.030 for the second-year-old children).

mothers' pregnancy.

factors and health group of the first- and second-year-old children is observed (r = 0.243, p ≤ 0.02 for the first-year-old children; r = 0.281, p ≤ 0.01 for the second-year-old children). There is no significant interrelation between the number of the diagnoses in the second-year-old children and perinatal pathology factors of their mothers. That is connected with that a part of diagnoses has been canceled by the moment of the examination of the child. However, the number of the diagnoses in the first-year-old children made by a local doctor is validly connected (r = 0.478, p ≤ 0.001) with the quantity of perinatal pathology factors identified during their

There is a positive interrelation between the health group type of the secondyear-old children and the presence of abortions made before by their mothers (r = 0.213, p ≤ 0.05). One should point out that no similar relation is found in the first-year-old children. The obtained data evidence a negative effect of abortions on the children's health. It manifests and is detected after some time only. The results obtained in correlation analysis correspond to the results of single-factor analysis of variance. It has shown that exactly the number of the perinatal pathology factors of the mother influences the number of the children's diagnoses made in the maternity hospital (where F = 9.565, p = 0.003 for the first-year-old children; F = 5.014,

We have analyzed 28 parameters indicating the presence of pathology in the mother. Based on them, the control of the state of health and prevention of abnormalities are performed in the children who have risks of getting central nervous system disorders at the maternity house. The analysis reveals that only 8% of the mothers of first-year-old children and 14% of the second-year-old children are almost healthy. About 74 and 62% of the mothers have different extragenital diseases. The obstetric anamneses of 24% of the mothers, having first-year-old children, are burdened with abortions, 22% of the mothers—having secondyear-old children. The anamneses of 8 and 10% of the women correspondingly are burden with miscarriage. The current pregnancy of 34% of the mothers of first-year-old children and 22% of the mothers of second-year-old children is complicated by the threat of abortion. In 18 and 10% of the mothers of children aged under 2 years old, it is accompanied by placental insufficiency. In 14% of the women, there is an immunological incompatibility of blood of the mother and the fetus. Besides, 6% of the women having first-year-old children and 2% of the women having second-year-old children have got the symptoms of fetal hypoxia. About 14% of the mothers of first-year-old children and 10% of the mothers of second-year-old children are characterized by weakness of labor. The dominant factors in the structure of extragenital anomalies of the mothers of first- and secondyear-old children (as in some other investigations) are iron deficiency anemia (26%), kidney diseases (28 and 30%) and vegetovascular dystonia (24 and 20%). In our further analysis, all the factors are divided into three groups according to

**10**

the period of impact:

1.Detrimental factors during the progenesis.

2.Adverse factors during the antenatal period.

3.Adverse factors during the birth period (the intranatal period).

We cannot detect any role of factors in progenesis, since we have observed the women regarding the gestation responsibly and regularly consulting with a gynecologist during their pregnancy. Only 4% of the mothers of first-year-old children smoke; and among the mothers of second-year-old children, there are no women

with bad habits. About 4% of the mothers of children aged under one-year-old and 12% of the mothers of second-year-old children have gynecological diseases in the anamnesis.

But we have been able to show the influence of the factors of perinatal pathology in the mother during the antenatal period on the future health of the child. The most significant factors of risk of the child's morbidity are the following: the threat of abortion (34% of the first-year-old children's mothers and 22% of the secondyear-old children's mothers), anemia (26%), vegetovascular dystonia (24 and 20%), kidney diseases (28 and 30%) and chronic fetoplacental insufficiency (18 and 10%). During the intranatal period, the significant risk factors of perinatal pathology of the mothers, exerting influence upon the health of the first- and secondyear-old children, are episiotomy (20 and 26%), cesarean (26 and 16%), premature rupture of membranes (20 and 18%) and weakness of labor activity (14 and 10%). We have not found any substantial differences in the pathology of the mothers of two groups. But this distribution shows the typical situation for pregnant women in Russia [25].

Correlation analysis of the results about the interrelation of the number of diagnoses in the first-year-old children, made by a local doctor, with perinatal anomaly factors during the antenatal period is in **Table 4**. We have found the significant relation of the children's morbidity with fetoplacental insufficiency during pregnancy (r = 0.444, p < 0.001) as well as with threat of abortion (r = 0.379, p < 0.01) and gestosis in the mother during pregnancy (r = 0.353, p < 0.01). We have revealed the close positive relation between the first-year-old children's health deterioration and iron deficiency anemia (r = 0.330, p < 0.02) and kidney diseases (r = 0.276, p < 0.05) through the mother. That is, the more diseases the mother has, the higher number of diseases the first-year-old children have.

There is no significant correlation relationship between the number of diseases of the second-year-old children and perinatal pathology factors of the mother during the antenatal period. However, significant interconnection is found between the number of diseases of the second-year-old children and iron efficiency anemia (r = 0.382, p < 0.01), varicosity (r = 0.332, p < 0.02), and the mother's kidney diseases (r = 0.281, p < 0.05). The analysis of the results about the interrelation of the number of diagnoses in the first-year-old children (by a local doctor) with the perinatal pathology factors of the mother during the intranatal period is in **Table 5**. It has revealed the significance of that dependence with weakness of birth activity (r = 0.354, p < 0.001). There is no similar association in the second-year-old children.

**Table 4.**

*Correlations between the number of diagnosis and factors of the mother's perinatal pathology.*

We have revealed (**Table 5**) close interrelation between the number of diagnoses, made by a local doctor, and premature childbirth of the mother (r = 0.663, p < 0.001) for the second-year-old children.

One might suppose that the degree of influence of those factors upon children of different sex would be different (**Table 6**). We have found close positive interconnection between the number of the first-year-old girls' diagnoses and their mothers' diseases of the cardiovascular system (r = 0.581, p < 0.01), iron deficiency anemia and kidney diseases (r = 0.529, p < 0.02; r = 0.463, p < 0.05) as well as fetoplacental insufficiency (r = 0.489, p < 0.05). As for the boys, there is a positive relationship between the number of diagnoses and gestosis in the mother during pregnancy (r = 0.400, p < 0.001), the threat of premature childbirth (r = 0.374, p < 0.05), immunological incompatibility of blood of the mother and the fetus (r = 0.457, p < 0.01) and kidney diseases (r = 0.391, p < 0.01).

The analysis of the results about the relationship of the number of diagnoses in the second-year-old girls with the perinatal pathology factors during the antenatal period reveals significant dependence between the child's morbidity and iron deficiency anemia and edema in the mother during pregnancy (r = 0.509, p < 0.02; r = 0.780, p < 0.001 correspondingly). It is noteworthy that close relationship is found between the number of diseases in the second-year-old boys and kidney diseases in the mother (r = 0.484, p < 0.01). Besides, significant positive relation is identified between the number of diseases in the second-year-old boys and negative Rh factor of the mother (r = 0,508, p < 0.001), and iron deficiency anemia (r = 0.494, p < 0.01).

The result of correlation analysis between the antenatal pathology factors of the mother and the number of diagnoses, made by a local doctor separately for the boys and girls, are in **Table 6**.

Further, we carry out correlation analysis aimed at identifying the interrelation of the number of diagnoses in the boys and girls, made by a local doctor, with the perinatal anomaly factors during the intranatal period (**Table 7**).

Close positive connection reveals between the number of diagnoses in the first-year-old girls, made by a local doctor, and episiotomy (r = 0.552, p < 0.01), and premature rupture of membranes in the mother (r = 0.586, p < 0.01). There is association between the number of diagnoses of the first-year-old boys and weakness of labor activity of the mother (r = 0.457, p < 0.01).

The analysis of the results about the interconnection between the number of diagnoses in the second-year-old girls and the perinatal pathology factors during delivery reveals significant dependence, the defect of the placenta (r = 0.780, p < 0.001) and manual control of the uterine cavity at childbirth (r = 0.453, p < 0.05). There is no significance of the same associations in the second-year-old boys. Subsequently, the health of children aged under 2 years old changes significantly during the first 2 years of life. The less factors of perinatal anomalies the

**Table 5.**

*The interrelation of the number of diagnoses of children (by a local doctor) with the perinatal pathology factors of the mother during the intranatal period.*

**13**

different in the boys and girls.

 The most widespread diagnoses of the child at birth are encephalopathy and syndrome of motor disorders. The leading groups of the factors of perinatal pathology of the mother are extragenital diseases and birth activity complications. The change of the relationship between the number of diagnoses of the children at the age of the first 2 years old and the perinatal pathology factors of the mother is

*The interrelation of the number of diagnoses of boys and girls (by a local doctor) with the perinatal pathology*

*DOI: http://dx.doi.org/10.5772/intechopen.80754*

Fetoplacental insufficiency r = 0.489,

Iron deficiency anemia r = 0.529,

Kidney diseases r = 0.463,

*factors of the mother during the antenatal period.*

Episiotomy r = 0.552,

**The intranatal pathology factors of the mother**

premature rupture of membranes

manual control of the uterine

*factors of the mother during the intranatal period.*

cavity

**Table 7.**

**The antenatal pathology factors of the mother**

The threat of premature

childbirth

Diseases of the cardiovascular system

Immunological incompatibility of blood

**Table 6.**

Number of diagnoses of boys and girls (by a local doctor)

*The Interrelation of the Mother's Health Status with the State of Health… DOI: http://dx.doi.org/10.5772/intechopen.80754*

#### **Table 6.**

*Maternal and Child Health Matters Around the World*

p < 0.001) for the second-year-old children.

(r = 0.494, p < 0.01).

and girls, are in **Table 6**.

(r = 0.457, p < 0.01) and kidney diseases (r = 0.391, p < 0.01).

perinatal anomaly factors during the intranatal period (**Table 7**).

ness of labor activity of the mother (r = 0.457, p < 0.01).

**Pathology factors of the mother during the**

*factors of the mother during the intranatal period.*

**intranatal period**

We have revealed (**Table 5**) close interrelation between the number of diagnoses, made by a local doctor, and premature childbirth of the mother (r = 0.663,

One might suppose that the degree of influence of those factors upon children of different sex would be different (**Table 6**). We have found close positive interconnection between the number of the first-year-old girls' diagnoses and their mothers' diseases of the cardiovascular system (r = 0.581, p < 0.01), iron deficiency anemia and kidney diseases (r = 0.529, p < 0.02; r = 0.463, p < 0.05) as well as fetoplacental insufficiency (r = 0.489, p < 0.05). As for the boys, there is a positive relationship between the number of diagnoses and gestosis in the mother during pregnancy (r = 0.400, p < 0.001), the threat of premature childbirth (r = 0.374, p < 0.05), immunological incompatibility of blood of the mother and the fetus

The analysis of the results about the relationship of the number of diagnoses in the second-year-old girls with the perinatal pathology factors during the antenatal period reveals significant dependence between the child's morbidity and iron deficiency anemia and edema in the mother during pregnancy (r = 0.509, p < 0.02; r = 0.780, p < 0.001 correspondingly). It is noteworthy that close relationship is found between the number of diseases in the second-year-old boys and kidney diseases in the mother (r = 0.484, p < 0.01). Besides, significant positive relation is identified between the number of diseases in the second-year-old boys and negative Rh factor of the mother (r = 0,508, p < 0.001), and iron deficiency anemia

The result of correlation analysis between the antenatal pathology factors of the mother and the number of diagnoses, made by a local doctor separately for the boys

Further, we carry out correlation analysis aimed at identifying the interrelation of the number of diagnoses in the boys and girls, made by a local doctor, with the

The analysis of the results about the interconnection between the number of diagnoses in the second-year-old girls and the perinatal pathology factors during delivery reveals significant dependence, the defect of the placenta (r = 0.780, p < 0.001) and manual control of the uterine cavity at childbirth (r = 0.453, p < 0.05). There is no significance of the same associations in the second-year-old boys. Subsequently, the health of children aged under 2 years old changes significantly during the first 2 years of life. The less factors of perinatal anomalies the

weakness of birth activity r = 0.354, p < 0.01 p > 0.05 premature childbirth p > 0.05 r = 0.633, p < 0.001

*The interrelation of the number of diagnoses of children (by a local doctor) with the perinatal pathology*

**The number of diagnoses of children**

**The second-year-old children**

**The first-year-old children**

Close positive connection reveals between the number of diagnoses in the first-year-old girls, made by a local doctor, and episiotomy (r = 0.552, p < 0.01), and premature rupture of membranes in the mother (r = 0.586, p < 0.01). There is association between the number of diagnoses of the first-year-old boys and weak-

**12**

**Table 5.**

*The interrelation of the number of diagnoses of boys and girls (by a local doctor) with the perinatal pathology factors of the mother during the antenatal period.*

#### **Table 7.**

*The interrelation of the number of diagnoses of boys and girls (by a local doctor) with the perinatal pathology factors of the mother during the intranatal period.*

mother has got, the more positive prognosis with regard to the child's health is. The most widespread diagnoses of the child at birth are encephalopathy and syndrome of motor disorders. The leading groups of the factors of perinatal pathology of the mother are extragenital diseases and birth activity complications. The change of the relationship between the number of diagnoses of the children at the age of the first 2 years old and the perinatal pathology factors of the mother is different in the boys and girls.

Maternal pathology leads to low level of oxygen during pregnancy and followed the different child disorders [46].

### **3.3 The influence of psychological features of the mother on the child's health**

It is obvious that not only perinatal pathology contributes to the health of the child at an early age [46]. Moreover, the success of child care during the first years of life is determined by psychological features of the mother. And that is why we will address the assessment of the influence of emotional reaction of the mother to the child's health status. Univariate analysis of variance is carried out to evaluate the influence of independent variable "the degree of the mother's attachment to the child" [47, 48] on the future possible cancelation of the child's diagnosis by a local doctor. The significant influence is obtained for one scale of the questionnaire only. Based on the results of the research, the degree of acceptance of the child (the acceptance-rejection scale) by the mothers of first-year-old children exerts influence on the probability of cancelation of the child's diagnosis made by a local pediatrician (F = 6.829, p < 0.003) during the first 2 years.

There are no differences between the mothers of first- and second-year-old children according to the degrees of attachment. About 54% of the mothers of each group are characterized by low degree of attachment; 44 and 42% correspondingly are characterized by mean degree. Only 2 and 4% of the mothers of first- and second-year-old children have high degree of attachment. No mothers with maternal deprivation are identified. Positive prognosis in terms of health of the first-yearold children depends upon the degree of acceptance of the child by the mother: the higher the value on the acceptance-rejection scale is, the better the child's health is. Our data point to the absence of differences in the features of emotional intelligence of the mothers of the first- and second-year-old children. The similarity of emotional intelligence of the mothers is explained by that they represent the same social environment.

The research results show that the majority of the mothers are characterized by low level of the capability to understand and control their own and other emotions as well as of interpersonal, intrapersonal and general emotional intelligence. There are no mothers with high level of emotional intelligence. Probably, that is why we do not find any association between emotional intelligence of the mother and the probability of cancelation of the child's diagnosis either in variance or correlation analysis. At the same time, in a sample of the mothers of second-year-old children, univariate analysis of variance reveals the influence of independent variables "understanding of other emotions" and "general emotional intelligence" on dependent variable "degree of attachment" (F = 2.115, p = 0.051; F = 2.618, p = 0.029). The better the understanding of other emotions and general emotional intelligence are, the higher the degree of attachment is. We have detected the influence of independent variables "understanding of other emotions", "control of expression" and "control of one's own and other emotions" on dependent variable "sensitivityinsensitivity" (correspondingly, F = 3.741, p = 0.002; F = 3.714, p = 0.003; F = 2.747, p = 0.015). The higher the values of the structural components of emotional intelligence are, the more efficient the mother is. That is, she respects for the child's independency to a greater extent.

Our data refer only to those women who led predominantly healthy lives before pregnancy and actively cared for the child immediately after his (her) birth. It is consistent with a large number of studies showing the dependence of the health level of the child at birth on both the mother's health before pregnancy and her pathology that arose during pregnancy and during childbirth [1, 7, 18, 19]. Our data show that the acceptance of the child is the main psychological factor that

**15**

*The Interrelation of the Mother's Health Status with the State of Health…*

contributes to the recovery of the child by the end of the second year his (her) life. At the same time, there are no significant effects between the parameters of emotional intelligence and the child's recovery. Although the parameters of emotional intelligence affect the sensitivity of the mother to the child needs. Perhaps in another sample, in which mothers with high level of the emotional intelligence

Almost all the children at birth have one or the other diagnosis (96% of the firstand second-year-old children). But by the end of the first year of life, diagnoses are canceled in 40% of the children by a local doctor, and during the second year of life—in 60% of the children. The most widespread diagnose of the child at birth is

Only 8% of the first-year-old children's mothers and 14% of the second-year-old children's mothers are almost healthy. The less factors of perinatal pathology there are in the mother, the more positive the prognosis with regard to the child's health within the first 2 years of living is. The association of morbidity of the children with the factors of perinatal pathology of the mother is the most pronounced during the first year of living. During the second year of life, the boys' health is less dependent

There are differences between the mothers of first- and second-year-old children according to the degrees of attachment. About 54% of the mothers of each group are characterized by low degree of attachment; 44 and 42% correspondingly are characterized by mean degree. Only 2 and 4% of the mothers of the first- and second-year-old children are characterized by high degree of attachment. No mothers with maternal deprivation have been identified. Positive prognosis with regard to the first-year-old children's health depends upon the acceptance of the child by the mother: the higher the value on the scale of acceptance-nonacceptance is, the

The degree of emotional intelligence of the mother is not associated with the

The work was supported by the grant of the Russian Fund of the Fundamental

*DOI: http://dx.doi.org/10.5772/intechopen.80754*

on those factors than that of the girls.

probability of cancelation of the child's diagnosis.

better the child's health is.

**Acknowledgements**

**Conflict of interest**

Researches# 18-413-480007.

We have no any conflict of interest.

**4. Conclusions**

would participate, such connections will be found.

perinatal encephalopathy and syndrome of motor disorders.

*The Interrelation of the Mother's Health Status with the State of Health… DOI: http://dx.doi.org/10.5772/intechopen.80754*

contributes to the recovery of the child by the end of the second year his (her) life. At the same time, there are no significant effects between the parameters of emotional intelligence and the child's recovery. Although the parameters of emotional intelligence affect the sensitivity of the mother to the child needs. Perhaps in another sample, in which mothers with high level of the emotional intelligence would participate, such connections will be found.


*<IP_ADDRESS> Psychological status and post-donation psychosocial outcomes*

Potential donors' psychological stability has been one of the greatest concerns for living transplant programmes, particularly in the context of unrelated donation. The willingness or desire to donate to a stranger has been historically viewed with suspicion [71, 72]. Studies suggest that most potential donors do not suffer from mental illness [73, 74]. Many donors have reported positive feelings about donation however, a few have observed psychological distress, anxiety and depression. Thus, it becomes critical to identify, and mitigate key risk factors for these poorer outcomes: non-first degree relatives [75, 76], ambivalent donors [76, 77] and "black sheep" donors (persons who donate in order to compensate for past wrong doings or to restore their position in the family) are at higher risk for poorer post-donation psychosocial outcomes [76, 77].


*3.4. Catalytic Reaction*

The catalytic performance of LTL-type zeolites in glucose dehydration was evaluated under batch conditions, by using a glass pressure tube equipped with threaded bushing (15 mL, pressure rated to 10 bars, Ace Glass, Vineland, NJ, USA) under magnetic stirring. In a typical experiment, 0.15 g of glucose, 0.05 g of catalyst, 1.5 mL of deionized water and 3.5 mL of methyl isobutyl ketone (MIBK) were introduced into the reactor. Reactors were always purged with nitrogen, prior to the catalytic

study in order to minimize side reactions of HMF which decrease its yield. The mixture was heated with a thermostatically controlled oil bath. The reaction was quenched by submerging the reactor in a cool water bath, and the liquid phases were separated, filtered and the analysis of products was performed in both phases by high performance liquid chromatography (HPLC). A JASCO (Easton, MD, USA) instrument equipped with quaternary gradient pump (PU-2089), multiwavelength detector (MD-2015), autosampler (AS-2055), column oven (co-2065) using a Luna C18 reversed-phase column (250 mm × 4.6 mm, 5 μm) and a Rezex ROA-Organic Acid H<sup>+</sup> column (8%, 300 mm × 7.8 mm, 5 μm) (both supplied by Phenomenex (Torrance, CA, USA). Both glucose and fructose were monitored using a refractive index detector for aqueous phase, while 5-HMF production was monitored using a UV detector in both phases. The mobile phases consisted of pure methanol (flow rate 0.5 mL min−1) for the Luna C18, and deionized water (flow rate 0.35 mL min−1) for the Rezex ROA column, being the columns at room temperature and 40 ◦C, respectively.

**Author Contributions:** Experiment: M.J.G.M., N.H.A., S.M.M.; Data Curation: C.G.S., S.M.; Writing-Original Draft Preparation: C.G.S., E.-P.N., P.M.T.; Writing-Review & Editing: C.G.S., S.M., E.-P.N., P.M.T.; Supervision: E.-P.N., P.M.T.; Funding Acquisition: E.-P.N., P.M.T.

**Funding:** This research was funded by the Spanish Ministry of Economy and Competitiveness (RTI2018-94918-B-C44), FEDER (European Union) funds and FRGS (203/PKIMIA/6711642).

**Acknowledgments:** The authors thank the Servicios Centrales de Apoyo a la Investigación at University of Málaga for technical support. C.G.S. acknowledges the University of Málaga for a postdoctoral contract.

**Conflicts of Interest:** The authors declare no conflict of interest.


**3. Clinical manifestations**

Generally, patients with nonparasitic hepatic cysts less than 3 cm are asymptomatic [2]. Cysts are classified as "large" when they are greater than 4 cm in the longest diameter. If the diagnosis of hepatic serous cyst is clear, there is no need of treatment, unless it becomes symptomatic, has a diameter more than 5 cm, or if the cyst grows rapidly within a short period of time [19].

Around 15% of patients with liver cysts develop symptoms at some stage in life. When the patients start complaining, the most common symptom is pain in the right upper quadrant. Other encountered symptoms are nausea, vomiting, abdominal meteorism, shoulder or lumbar pain, dyspnea, and/or postprandial fullness. Hepatic cysts become symptomatic when they are large, fast growing, multiple, or complicated.

#### **3.1. Complications**

Complications occur in approximately 10% of patients [20]. Obstructive jaundice, portal hypertension, intracystic hemorrhage, infection, intraperitoneal and/or intrahepatic rupture, torsion, and inflammation represent complications of nonparasitic hepatic cysts [21–24]. The compression exerted by a large hepatic cyst on the adjacent structures can manifest as cardiac arrhythmia or inferior vena cava thrombosis [25, 26]. The vicinity with the cholecyst can cause its functional disturbance with consecutive gallstones.

Hemorrhage into a simple liver cyst is rather uncommon but poses issues regarding differential diagnosis. The differential diagnosis between intracystic hemorrhage, cystadenoma, and cystadenocarcinoma is difficult with the imaging studies currently available. One consequence is to assume a simple cyst with intracystic hemorrhage as being neoplastic lesion and perform an unnecessary hepatectomy. The other consequence is to assume a neoplastic lesion as being benign and perform laparoscopic fenestration with subsequent peritoneal dissemination of malignant cells.

There are situations when an intracystic hemorrhage occurs unrecognized. Even if no acute symptoms supervene, the hemorrhage causes a rapid enlargement of the cyst, raising suspicion of malignant degeneration.

Infection of hepatic cyst can occur through common bile duct or blood stream. The most common encountered microorganisms are *Escherichia coli* and *Klebsiella pneumoniae*. *Proteus*, *Bacteroides*, and *Clostridium* are also incriminated in infection of hepatic cysts. The most likely source of infection for simple liver cysts is the gastrointestinal tract. Diverticulitis of the sigmoid colon and gut manipulation during abdominal operations have been found to be the cause of infectious complications of hepatic cysts [27]. The patients with diabetes mellitus, undergoing chronic hemodialysis or immunosuppressive therapy (e.g., after kidney transplant in patient with polycystic liver and kidney disease), are prone to develop such infections.

The patient with infected liver cyst presents with acute onset of right upper quadrant abdomi‐ nal pain, diarrhea, and/or fever. There are situations when pain is absent, and the only symptoms are fever and malaise that render a complete workup to rule out other causes.

The rupture of serous hepatic cyst is a rare complication that needs emergency intervention. The cyst rupture is generally secondary to trauma, but a spontaneous one is also possible. The cyst fluid can enter the pleural or peritoneal cavity, causing pain in right upper quadrant or even diffuse abdominal pain due to peritoneal irritation.

Granuloma degeneration is a rare complication of the hepatic cysts (Figure 10). In severe form, it can resemble malignant invasion into surrounding tissues. The differential diagnosis is difficult to make even intraoperatively. Extensive excision of involved tissues is sometimes necessary [28]. Eventually histology delineates the diagnosis.

**Figure 10.** Serous cyst with granulomatous transformation, hyaline collagen fibrosis and focal, nonspecific chronic in‐ flammation. Hematoxylin and eosin staining ×100.


**3. Methodology**

## *3.1. Overview*

Given a 3D facial geometry data *G*, 3D facial landmarks' detection is the task to locate *N* pre-defined fiducial points, including eye corners, nose tip, mouth corners and so on. We denote the homogeneous coordinate of 3D facial landmarks as *S*:

$$S = \begin{pmatrix} x\_1 & x\_2 & \dots & x\_N \\ y\_1 & y\_2 & \dots & y\_N \\ z\_1 & z\_2 & \dots & z\_N \end{pmatrix} \\ \tag{1}$$

where *N* is the pre-defined number of landmarks. The function is also equal to the following function:

$$S = \begin{pmatrix} x(u\_1, v\_1), & x(u\_2, v\_2), & \dots & x(u\_N, v\_N) \\ y(u\_1, v\_1), & y(u\_2, v\_2), & \dots & y(u\_N, v\_N) \\ z(u\_1, v\_1), & z(u\_2, v\_2), & \dots & z(u\_N, v\_N) \end{pmatrix},\tag{2}$$

where *x*,*y* and *z* represent the *x*,*y*,*z* coordinate map for each pair (*u*, *v*). Given 3D facial data, our goal is to simultaneously estimate the (*u*, *v*) accurately.

For this purpose, we propose transforming the 3D face landmarks' estimation to detect the landmarks on five types of 2D facial attribute maps, including shape index map, normal maps and original range map that calculated on 3D geometry data. Then, a novel framework as Figure 1 was presented to achieve our goal accurately and efficiently. Based on the coarse-to-fine strategy, the framework comprises two main parts: one is for global estimation and the other is for local refinement. Specifically, the global estimation phase is intended to locate the landmarks roughly by feeding into the fused global feature that extracted from these attribute maps. Then, the local refinement stage is to learn the nonlinear mapping function from the fused local feature that extracted from a local patch around estimated global landmarks to residual distance.

In the global estimation phase, the goal is to locate landmarks roughly, but it is still more robust and accurate than the mean shape. To train this model, instead of applying the handcrafted feature, we use the pre-trained deep network to extract features from each facial attribute map as a global feature and then concatenate them as the fused feature. Feeding into the fused feature, the target of the regression model is to estimate global landmarks directly. According to the trained model, the global landmarks would be obtained roughly but robustly, which can lay the foundation for the local refinement.

After global optimization by inputting the fused global feature, we can get the initialization shape. The initialization shape is more robust and accurate than the mean shape; however, it is still

not satisfied. To refine the global estimation, the refinement stage is designed to refine the results. We extract the local CNN feature from the cropped local patches around the global landmarks and then learn the mapping function from the fused local feature to the residual distance between previous landmarks and ground truth.

#### *3.2. Facial Attribute Maps*

To comprehensively describe the geometric information of 3D data, five types of facial attribute maps were constructed, including three surface normal maps *Nx*, *Ny*, *Nz*, curvature feature *SI*, and range data *R*. Among these maps, surface curvature and normal maps are the most significant feature in 3D object detection, recognition and other 3D tasks. Figure 2 shows the five types of facial attribute maps computed from original 3D facial geometry data.

**Figure 2.** These five facial attribute maps, denoted as three surface normal map *Nx*, *Ny*, *Nz*, curvature feature map *SI* and range map *R*.

#### 3.2.1. Surface Curvature Feature

The surface curvature features have been adopted for 3D face landmarks' estimation in many types of research. Actually, surface curvature is the most significant feature in 3D object detection, recognition and other 3D tasks. Thus, this paper chooses the shape index feature map as the first facial attribute.

The Shape index is a continuous mapping of principal curvature values (*kmax*, *kmin*) of a 3D object point *p*. Once we have two principal curvature (*kmax*, *kmin*), the shape index values, which describe different shapes classed as single numbers ranging from 0 to 1, are calculated as:

$$SI(p) = \frac{1}{2} - \frac{1}{\pi} \arctan(\frac{k\_{\max} + k\_{\min}}{k\_{\max} - k\_{\min}}).\tag{3}$$

#### 3.2.2. Surface Normal Maps

Considering a normalized 3D facial geometry data *G*, denoted as a *m* × *n* × 3 matrix:

$$G = [P\_{uv}(\mathbf{x}, \mathbf{y}, z)]\_{m \times n} = [p\_{uv \mathbf{x}}, p\_{uv \mathbf{y}}, p\_{uv z}]\_{1 \le u \le m, 1 \le v \le n} \tag{4}$$

where [*Puv*(*x*, *y*, *z*)] denotes the corresponding 3D point coordinate of facial geometry data. The corresponding surface normal maps are represented as:

$$N(I\_{\mathcal{g}}) = N[P\_{uv}(x, y, z)]\_{m \times n}$$

$$\mathcal{I} = [N(p\_{uvx}), N(p\_{uvy}), N(p\_{uvz})]\_{1 \le u \le m, 1 \le v \le n}. \tag{5}$$

In this paper, a local plane fitting method is applied to compute *N*(*Ig*), which consists of a three *M* × *n* matrix. In other words, for each point in 3D facial geometry data, the surface normal vector can be computed by the following function:

$$S\_{\rm uv} : N\_{\rm uvx} q\_{\rm uvx} + N\_{\rm uvy} q\_{\rm uvy} + N\_{\rm uvz} q\_{\rm uvz} = d\_{\prime} \tag{6}$$

where (*quvx*, *quvy*, *quvz*) represents any point within the local neighbourhood of point *puv* and *Nuvx*, *Nuvy*, *NuvzT*2 = 1. In this paper, a neighbourhood of 5 × 5 window is adopted and three normal maps would be obtained, denoted as *Nx*, *Ny*, *NZ*.

#### *3.3. Global Estimation*

As the proposed method illustrates, these five types of attribute maps as Figure 2 would be fed into the neural network to estimate landmarks roughly. Considered the calculated feature maps, denoted as shape index *SI*, *Nx*, *Ny*, *Nz* and original range map *R*, *Sg* (*x*) ∈ *R*2*N*×1 represents the ground truth of *N* landmarks. The goal of our global model is to learn the mapping function *F* from our fused feature map to the ground truth coordinate:

$$S\_{\mathcal{K}}\left(\mathbf{x}\right) \leftarrow F\left(SI, \mathcal{N}\_{\mathbf{x}}, \mathcal{N}\_{\mathcal{Y}}, \mathcal{N}\_{\mathbf{z}}, \mathcal{R}\right). \tag{7}$$

Limited to the amount of training data, training a global CNN model directly is always over-fitting. To overcome this limitation, fine-tuning based on a pre-trained deep model was employed to learn *F*. To achieve this goal, the parameters of pre-trained model were fixed except training the last layer. Then, the *SI*, *Nx*, *Ny*, *Nz*, *R* are fed into the pre-trained model (e.g., VGG (Visual Geometry Group)-net in this paper) separately. Generally, the pre-trained deep CNN model can be regarded as a special feature extractor, which can be regarded as *v* = *DNN* (*Map*), where *DNN* represents the fixed part of the pre-trained model, *Map* denotes the resized facial attribute map, and *v* is the extracted feature vector of each attribute map. Consider adopting shape index maps and convolution neural networks to detect a coarse *S*0 as the result of the first step. In particular, the deep models are all comprised of three main parts including convolutional layers, pooling layers and fully connected layers.

#### • Convolutional Layer and ReLU Non-linearity.

Through a set of designed and learnable filters, the convolutional layer transforms the input images or activation maps to another. Specifically, given a set of activation maps from the previous layer *yl*−1 ∈ R*Wl*−1×*Hl*−1×*Dl*−1 , and *Kl* convolutional filters, each with size *Wf* × *Hf* × *Dl*−1, a list of activation maps *yl* ∈ R*Wl*×*Hl*×*Dl* at the layer *L* will be computed and output. Let this stride be *S*; then, the *Wl* = (*Wl*−1 − *Wf* + 2*P*)/*S* + 1 and *Hl* = (*Hl*−1 − *Hf* + 2*P*)/*S* + 1. Then, we add an activation function *ϕ* to adjust the result to a nonlinear function. In this paper, rectified linear units (ReLU), denoted as *ϕ* (*x*) = *max* (0, *x*), is used. Thus, the result of *l* layer is denoted as:

$$\boldsymbol{y}^{l} = \boldsymbol{\varphi}(\boldsymbol{\mathcal{W}}\_{l} \* \boldsymbol{y}^{l-1} + \boldsymbol{b}\_{l}),\tag{8}$$

where *bl*denotes the bias term, and ∗ denotes the convolution operator.

• Fully Connected layers.

This layer is used to reshape these feature maps into a vector feature. The hidden layers are fully connected, which means that each unit in a previous layer is connected with each unit in the next layer. Suppose the global network has *L* convolutional layers in total and so the feature maps in the last convolutional layers are represented as *yl* ∈ R*WL*×*HL*×*DL* . Let the (*L* + 1)-th layer be the fully connected layer, and the output of layer *L* be the input of layer *L* + 1, with size *yL*+1 ∈ R*K*, where *K* = *WL* × *HL* × *DL*. Thus, this layer is equal to:

$$y^{L+1} = r
epsilon p(y^L).\tag{9}$$

Then, the next fully connected layer will be:

$$y^{L+2} = \varphi(w^{L+1} \times y^{L+1} + b^{L+1}),\tag{10}$$

where *WL*+1 is the weight value in the *L* + 1-th layer and *bL*+1 is the bias term value. *ϕ* denotes the tanh activation function. C. Objective function. After feature extraction for each facial attribute map is done separately, the feature vectors are concatenated as *V* = *vSI*, *vNx* , *vNy* , *vNz* , *vR* to train the global model *F*. Specifically, by training a designed neural networks, our target has been formulated as solving the objective function:

$$\arg\min \left\| S\_{\mathcal{J}} - F\left(V\right) \right\|\_{2}^{2} . \tag{11}$$

where *F* is the nonlinear regression function from *V* to the landmarks *Sg*, denoted as *F* = *σ WTV* + *b*, where *σ* represents the nonlinear activation function such as sigmoid, tanh and Relu. In this paper, sigmoid function is employed by the final output layer to learn the parameters [*W*, *b*]. However, the range of final output is [0, 1], while the range of regression is inconsistent. Therefore, *Sg* would be normalized to range [0, 1], so that the objective function can be formulated as minimizing the function:

$$\arg\min \left\| S\_{\mathcal{S}} - F\left(V\right) \right\|\_{2}^{2} + \lambda \left\| \mathcal{W} \right\|\_{F'}^{2} \tag{12}$$

where *W* 2*F* denotes the regularization term, added to prevent the over-fitting. *λ* is the set to 0.00005.

After the optimization with Equation (12), the learned parameters [*W*, *b*] are obtained and *S*0 would be calculated via *S*0 = *F*(*V*).

#### *3.4. Local Refinement*

The global estimation phase describes the mapping function from the fused facial attribute maps to the target landmarks' location. Unlike other methods, the estimated shape is global and more accurate than the mean shape. However, it is still rough and there is room for improvement. To achieve more accurate locations, a coarse-to-fine based approach is proposed to improve the performance. Similar to many cascade regression methods for 2D face alignment, a local model as Figure 3 is employed to estimate the residual distance Δ*S*, representing the distance between global estimated shape *S*0 and ground truth *Sg*.

**Figure 3.** Five different local attribute maps for 22 landmarks. (**a**): depth feature map; (**b**): curvature feature; (**c**): surface normal feature along the *x*-axis; (**d**): surface normal feature along the *y*-axis; (**e**): surface normal feature along the *z*-axis.

Similar to the global estimation, we employed the pre-trained CNN model to extract local features from the local patches around the estimated shape *S*0. Each local patch around *S*0 is cut out within 30 mm, and then transformed to attribute maps. After the calculation of local attribute maps, they would be resized to 224 × 224 and are fed into the pre-trained deep neural network to extract local CNN features. Actually, we once considered concatenating the fused local feature of all landmarks to estimate the Δ*S* jointly. However, limited to the huge number of trained parameters (e.g., 4096 × 5 × 22 × 44 = 19,824,640), we propose refining each local patch around a landmark independently. For this purpose, deep feature fusion is also applied for training local model, denoted as *φi* = [*φiSI*, *φiNx*, *φiNy*, *φiNz*, *φi R*]*i*=1,2,... *N*, where *i* represents the *i*-th landmark and *N* is the number of located landmarks.

Getting the local feature vectors, the local refinement model is to learn a nonlinearity function *Hi* from fused local feature *φi* to the Δ*Si* for each landmark, denoted as Δ*Si* = *Sg*(*i*) − *S*0(*i*). The objective function of each model can be formulated as follows:

$$\arg\min \|\Delta S\_i - H\_i(\phi\_i)\|\_2^2 + \beta \left\|\mathcal{W}\_k\right\|\_{F'}^2 \tag{13}$$

where *Hi* is a regression function the same as *F*, represented as *Hi* = *σ* (*Wiφi* + *bi*). Different from the global estimation, the activation function *σ* is the tanh function, so that all the outputs are in range [−1, 1]. After optimization, we can compute Δ*Si* according to Δ*Si* = *Hi* (*φi*), and then we obtain Δ*S* = [Δ*S*1, Δ*S*2, ..., Δ*SN*]. Therefore, normalized results *Sfinal* can be computed as the following:

$$S\_{final} = \Delta S + S\_0. \tag{14}$$


*Edited by David Mathieu*

Gamma knife radiosurgery is a minimally-invasive treatment alternative for intracranial disorders, including tumors, vascular malformations, facial pain and epilepsy. This book will allow the reader to learn when gamma knife radiosurgery is appropriate and what to expect as treatment results.

ISBN 978-953-307-888-5

Gamma Knife Radiosurgery

Photo by xmee / iStock


**2.9.1 Principle**

The phosphate ion reacts with Molybdate to produce Phosphomolybdate, which is finally reduced to a molybdenum blue, which is photo metrically measured.

### **2.9.2 Technique**

1. Three test tubes were labeled as: Blank –BL

Standard –ST

$$\text{Sample} \quad \text{-SA}$$

Inorganic phosphate (mg/dl) = SA O.D 4 ST O.D

O.D = Optic Density

Normal value of serum phosphate was taken as 2.4- 4.5 mg/dl.

The Prevalence of Renal Osteodystrophy in

in the presence of alkaline oxidizing agents.

**2.11.1 Princile**

**2.11.2 Technique**

**2.12.1 Principle**

bone iso-enzyme.

**2.13.1 Procedure**

acid for 2 days.

**2.13 Bone histology (post mortem)**

Chronic Renal Failure Patients in Urban Niger Delta of Nigeria 53

4- amino antipyrine gives a red purple colour with compounds containing a phenolic group

2mls of buffer substrate was measured into each of the 2 test tubes and placed in water bath at 370C for a few minutes. To one of the test tube (patients' test tube) was added 0.lml of serum and the tubes were incubated for exactly 15 minutes. They were removed from the bath and 0.8ml of 0.5M sodium hydroxide and 1.2ml of 0.5M (the blank) was added to both tubes, 1ml of amino- antipyrine reagent and 1ml of potassium ferricyanide were added. For the standard, 1ml of buffer and 1ml of phenol standard containing 0.01mg of phenol was taken. For the standard blank, 1.1ml of buffer and 1ml of water was taken to both tubes, and then sodium hydroxide, bicarbonate amino-antipyrine and ferricyanide was added as above. It was read with a spectrophotometer set at 520 millimicrons. Serum alkaline

phosphatase (King- Amstrong unit per 100mls) was derived from the formula: Serum alkaline phosphatase = Reading of unknown - Reading of blank x 10

Total serum alkaline phosphatase values of 25-95 IU/L was taken as normal

**2.12 Determination of bone specific alkaline phospatse**

spectrophotometer set at 520 millimicron wavelength.

1. The autopsy specimen biopsy was taken from the pelvic bone.

ascending grades of alcohol. (70%, 90%, 100%) respectively.

Reading of standard - Reading of standard blank

This was done by curve-fitting of inhibition kinetic as popularized by (Statland et al, 1972).

After the determination of the total serum alkaline phosphatase as described above, the serum is heated for 13 minutes at 560c to inactivate the bone- type isoenzyme. The sera are now read as in the determination of the total serum alkaline phosphatase using a

The concentration of serum alkaline phosphatase excluding the bone isoenzyme was determined as was done for total alkaline phosphatase using a spectrophotometer set at 520millimicron wavelength. The bone isoenzyme was determined by subtracting this value from the total alkaline phosphatase. Values of bone specific alkaline phosphatase level greater than 50% of total serum alkaline phosphatase shows significant contribution from

2. Decalcification: The piece of bone biopsied was decalcified by emersion in 10% nitric

3. Dehydration: the decalcified bone was dehydrated by passing the bone through

#### **2.10 Measurement of total serum calcium**

The Cresolphtalein- Complexone method (CPC) was used for the determination of total serum calcium. This is a standard Colorimetric method. This like most calcium assays measures the total serum calcium although it is only the free calcium which constitutes 50- 65% of total calcium that is biologically active.

#### **2.10.1 Principle**

CPC forms a violet colored complex with calcium. The absorbance of the colour produced was measured in a colorimeter using a Spectrophotometer at 575nM wavelength measured in a colorimeter using a spectrophotometer at 575nM wave length. Interference from magnesium was reduced by including 8-hydroxquinoline in the working CPC reagent. The Ethanediol in the reagent suppresses the ionization of the 0- Cresolphtalein and helps to give a clear solution. A correction was made when the patient's serum albumin level was below 40g/l using this formula:

Corrected serum albumin = 2 albumin g /l Ca 40 40


Preface

Vitamin D is one the first hormones, or even the very first hormone that was produced more than 500 million years ago. During evolution, compound D progressively participated in several biological processes. It is now widely accepted that Vitamin D is a steroid (more precisely, a secosteroid) hormone. Many preclinical research and clinical studies demonstrated that hormone D plays several physiological key roles in different areas, and that its essential function is not limited to bone growth and maintenance, as believed in the past. It was demonstrated that its deficiency causes several detrimental effects on our health and these problems can be addressed by means of Vitamin D administration. Thanks to the anti- inflammatory, antiproliferative, and antibacterial activities exerted by hormone D, it is very effective in the treatment of several systemic illnesses in the field of endocrinology, immunology, oncology, hematology, neurology, and reproductive medicine.

This book is organized into four sections: Section 1 "Vitamin D Deficiency in Children and Adults"; Section 2 "Vitamin D Deficiency and Brain Functions"; Section 3 "Vitamin D Deficiency and Metabolic Diseases"; and Section 4 "Vitamin D Deficiency and Chronic Diseases". Chapters in these sections cover the earliest investigations of hypovitaminosis D in children and adults, the consequences of Vitamin D deficiency for the cognitive functions of the brain, and the implication of Vitamin D deficiency in the pathogenesis of cardiovascular, metabolic, immune, and renal disorders.

An important theme developed in Section 1 is Vitamin D status in children, adults, and pregnant women. The different ways to improve the status of Vitamin D deficiency and distinct strategies for it in young and old humans are discussed in several chapters of this section. The exciting role of Vitamin D deficiency in brain disturbances is discussed in the chapters of Section 2. An important future direction for study of Vitamin D deficiency implication in the metabolic processes is a section on the beneficial effects of Vitamin D in obesity and diabetes mellitus. Finally, the last section of this book promotes the understanding of implications of Vitamin D deficiency in the pathology of renal, autoimmune, and cardiovascular diseases that may help to find the best strategy of therapy for the patients with such diseases.

The book summarizes the meaning of Vitamin D deficiency in the development of various chronic diseases in humans. However, many questions still remain and will likely fuel ongoing investigation and debate. These questions will likely keep the story open on pleiotropic effects of Vitamin D for the future.

**II**

**Chapter 8 153**

Vitamin D Deficiency and Metabolic Diseases **175**

**Chapter 9 177**

**Chapter 10 189**

Vitamin D Deficiency and Chronic Diseases **211**

**Chapter 11 213**

**Chapter 12 229**

**Chapter 13 247**

*by Ihor Shymanskyi, Olha Lisakovska, Anna Mazanova and Mykola Veliky*

Vitamin D and Cardiovascular Disease: The Final Chapter?

*by Ifigenia Kostoglou-Athanassiou, Lambros Athanassiou*

Vitamin D3 Modulates NF-kB/p65, 17β-Estradiol, and Vitamin D Receptors

Expression at Estrogen Deficiency

**Section 3**

**Section 4**

Vitamin D and Obesity

*by Alexandra Koshkina, Olga Volkova and Julia Fedotova*

*by Sabrina Ait Gacem and Moyad Jamal Shahwan*

Vitamin D Deficiency and Diabetes Mellitus

*by Jeremy I. Purow and Seth I. Sokol*

Vitamin D and Autoimmune Diseases

Vitamin D Deficiency in Renal Disease

*by Jean Jeanov Filipov and Emil Paskalev Dimitrov*

*and Panagiotis Athanassiou*

**Julia Fedotova, Ph.D. habil.** Professor, Laboratory of Neuroendocrinology, I.P. Pavlov Institute of Physiology, Russian Academy of Sciences, St. Petersburg, Russia

**1**

Section 1

Vitamin D Deficiency in

Children and Adults