Vol 15, No 2 (2013)

Objective. Determination of the mRNA expression genes of cell proliferation and tumor suppressor gene PTEN tumor growth in different types of endometrial hyperplasia and estimate the possibility of their use in clinical practice. Materials and methods. A clinical and laboratory examination and sampling of endometrial tissue in 150 women were obtained. The study group included 103 patients – with endometrial hyperplasia (70 – with a simple, 18 – with a complex, 15 – with atypical), control group – 47 women with morphologically normal endometrium proliferative (n=26) and secretory (n=21) phase. Expression of mRNA of proliferation genes: MKI-67, CCNB1, BIRC5 and PTEN, was performed using RT-PCR. Additionally the expression of Ki-67 and PTEN was determined by immunohistochemistry. Results. The study revealed a reduction mRNA expression of genes MKI67, CCNB1 and BIRC5 in endometrial hyperplasia in comparison with the endometrium of proliferative phase (p<0,05) and increased in relation to the of secretory phase. The use of RT-PCR revealed no significant differences in the expression of proliferation markers between simple, complex and atypical endometrial hyperplasia. The results of immunohistochemical studies have shown an increasing level of Ki-67 expression and decreasing PTEN in atypical endometrial hyperplasia in relation to simple and complex endometrial hyperplasia. Conclusion. Endometrial hyperplasia is formed on the background of cell proliferation, decreased in relation to the cell proliferative phase and increased in relation to the phase of secretion. This changes the concept of endometrial hyperplasia, as a condition caused by the increased proliferative activity. It can be assumed that other molecular genetics mechanisms are involved in the formation of endometrial hyperplasia.

ART progress was tremendous in the last decade with the growth of total quantity and availability of procedures. However current clinical purpose remains an improvement of efficiency and safety of reproductive technologies. The health condition of endometrium and optimal receptivity in time of implantation are well known as crucial factor of ART success. Clinical application of trophic factors can be used in pregnancy preparation management in patients with thin endometrium and any pathology to improve tissue receptivity.

The article presents dates about progestagen hormonal contraceptives in the early post partum period by Lactinet. It is shown methods of treatment and negative reactions. There are no negative effects of Lactinet on lactation and child health.

All women with postmenopausal bleeding should be referred urgently. Еndometrial cancer is mostly diagnosed after menopause and often becomes apparent with atypical uterine bleeding.

Iodine deficiency remains the most common global problem and the most common preventable cause of mental retardation and a threat to social and economic development of the country. The most vulnerable groups include pregnant women, nursing mothers and children. At present, in most countries of the world the prevention of natural iodine deficiency is carried through salt iodization of certain foods (salt, bread, etc.), but according to some research it is still not fully resolved. The studies, on the basis of which the recommended dose for certain groups of the population are held as well. However in dieting terms, such products are not able to meet the daily requirement of all population groups and that fact necessitates the use of potassium iodide drugs.

Chlamydia infection (CI) continues to be one of the most common sexually transmitted infections in the gynecological practice. The analytical data indicates an increase in the incidence of CI despite the availability of diagnostic tests and screenings. Fundamental studies in recent years have allowed to clarify the problems of susceptibility to CI, as well as to establish the role of gene mutations in long term complications emergence in women. Nucleic acid amplification methods (SIA) improvement of has led to the possibility of collecting the material by patients themselves which, in the coming years can completely change the current system of screening. Russian IASC by remaining inexpensive are still able to match the commercial demands of the foreign test system in terms of sensitivity and specificity. Mutations in the loci of plasmid DNA of Chlamydia can lead to false-negative results of the IASC. Azithromycin, due to its unique pharmacodynamic properties, is most commonly used in the treatment of CI in Russia and abroad. The drug proved to be safe and effective in pregnancy. The results of post-therapeutic screenings indicate the need of increasing the drug dose. Clinical studies have confirmed its efficacy in the PID.

In the article, different problems of treatment of infections associated with Mycoplasma genitalium are discussed.

Chronic vulvovaginitis and cervicitis are common pathological conditions in obstetrician-gynecologist practice. The main infectious agents, leading to their development are microorganisms and viruses. Causative treatment is carried out by means of the microscopic, microbiological or molecular biological survey methods. Due to changes in local immunity at chronic inflammation of the lower genital tract the use of immuno drugs (interferon and its inducers) is a necessary part of the pathogenetic therapy and is especially effective in treatment of vulvovaginitis associated with viral infection. Here, the data on the positive effect of glycyrrhizin acid complex treatment of chronic cervicitis and benign lesions cervix is presented.

In the article review of the literature is presented about problem of vegetative nervous system functional condition during pregnancy and labor. It is shown that vegetative status changes depending on period of pregnancy. So feature of vegetative nervous system condition can be used as objective criterion of pregnant woman adaptation mechanism condition.

The active folates and omega-3 polyunsaturated fatty acids (omega-3 PUFAs) effects are often considered separately. At the same time, a pharmacodynamic interaction exists between those essential micronutrients in order to support the full development of the pregnancy and the fetus. Various synergistic interactions of omega-3 fatty acids and folates analysis results, as well as those of fundamental and clinical studies are presented in this paper. The prospects for the combined active folate and omega-3 fatty acids drugs use in pregnancy’s nutritional support and malformations prevention are indicated also.

Causes of overactive bladder is extremely diverse, so the correct diagnosis is very important. Can the definition of m-NGF be objective method of diagnosis and evaluation of the therapeutic effect of the GMF, unrelated to invasive urodynamic study? The article describes a literature review of a new method for diagnosis of overactive bladder – definition of nerve growth factor in the urine

Introduction. This article confirms that the use of the fractional carbon dioxide laser in combination with topical application of plasma with a high content of platelets (PRP) on the vaginal mucosa with minimal or mild symptoms of atrophy, as well as in combination with strengthening exercises for the pelvic floor muscles via perineometer improves the condition of all three vaginal layers, including sizeable reduction of discomfort during sexual intercourse. Materials and methods. The study was conducted on two groups: observation group and control group with the main complaints about vaginal dryness, and dyspareunia. The first group went through such PRP methods as therapy, carbon dioxide laser, and exercises to strengthen the pelvic floor muscles, whereas for patients in the control group only PRP and exercises to strengthen the pelvic floor muscles were implemented. For the survey, we used a special vaginal scanner with laser light scattering, which was specially adapted for vaginal examinations. The results in both groups were analyzed using sexological questionnaire and vaginal biopsy tissues. Results. In the observation group compared with the control group, the majority of patients showed a significant improvement in histology of the vaginal mucosa and reduced discomfort during sexual intercourse. Conclusion. The topical vaginal fractional carbon laser use, together with PRP and strengthening exercises for the pelvic floor in women with vaginal tissues atrophy symptoms, the positive effects on all three vagina layers were observed, whereas the estrogen guarantees only the epithelium condition improvements. Also a significant reduction of discomfort during sexual intercourse was observed. However, more detailed information may be required in order to clarify the procedure implementation.