Vol 15, No 2 (2013)


The characteristics of expression proliferation markers in endometrial hyperplasia

Dumanovskaya M.R., Chernukha G.E., Burmenskaya O.V., Nepsha O.S., Pavlovich S.V., Kogan E.A., Trofimov D.Y.


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.
Gynecology. 2013;15(2):4-8
pages 4-8 views

Hyperplastic processes of the endometrium in premenopausal women: modern opportunities of hormonal correction and prevention

Tkachenko L.V., Sviridova N.I.


Hormonal therapy prescribed for endometrium hyperplastic processes is essentially for preventive treatment aimed at correcting the menstrual cycle, reducing apparent estrogenic effects and preventing the formation of endometrial hyperplasia. Currently, the arsenal of physicians have a wide range of products for the treatment of endometrial hyperplastic processes. These include progestins, combined oral contraceptives (COC), antigonadotropic drugs and gonadoliberin agonists. We carried out a clinico-morphological evaluation of the effectiveness of COCs Mediana for the prevention of recurrent endometrial hyperplastic processes in patients with associated cardiovascular disease in premenopausal women.
Gynecology. 2013;15(2):8-12
pages 8-12 views

Pregravidal preparation of the endometrium and secondary nreproductive technologies

Shurshalina A.V.


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.
Gynecology. 2013;15(2):12-14
pages 12-14 views

Medical aspects of oral contraceptives containing chlormadinone acetate in women with reproductive disorders

Unanyan A.L., Kossovich Y.M.


Сontraceptives containing chlormadinone acetate as the progestin component other than a contraceptive effect, ensure the stability of the menstrual cycle when giperpolimenoree and dysmenorrhea, and also have a pronounced therapeutic effect in androgen-dependent dermatopatiyah and manifestations of premenstrual syndrome.
Gynecology. 2013;15(2):15-18
pages 15-18 views

Topical issues of postpartum contraception

Ovsyannikova T.V., Makarov I.O., Kulikov I.A.


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.
Gynecology. 2013;15(2):18-21
pages 18-21 views

Endocrine aspects of menstrual disorders and their correction in overweight women of reproductive age

Apetov S.S., Kalinchenko S.Y.


Insulin resistance in patients with obesity leads to indirect menstrual cycle disruption through hyperinsulinemia and hyperleptinemy. In order to correct menstrual disorders, the metabolic characteristics of the optimal progestin should be considered, so that the already existing disorders of fat and carbohydrate metabolism may not be aggravated even more.
Gynecology. 2013;15(2):22-25
pages 22-25 views

Uterine bleeding in menopause, cancer risks

Kovalyova L.A.


All women with postmenopausal bleeding should be referred urgently. Еndometrial cancer is mostly diagnosed after menopause and often becomes apparent with atypical uterine bleeding.
Gynecology. 2013;15(2):26-29
pages 26-29 views

The effectiveness of vitamin-vegetative complex in the treatment of menstrual disorders in young women

Kuznetsova I.V., Sheveleva T.V., Yusupov M.I.


The emergence of functional disorders of the menstrual cycle is associated with the stress factors impact and is often combined with psycho disorders in women. Approach to the treatment of functional disorders involves not only the correction of hormonal disorders, but also intervention in terms of the neuroendocrine stress response components. The results for the Time Factor vitamin-vegetative complex for correction of functional disorders of the cycle research are presented in this article. The overall health improvement, as well as the menstruation rhythm normalization, ovulation recovery and the significant improvement in the results of the endometrial M-echo parameters was noted on therapy. The use of Time Factor as the means of gravidity preparation contributed to pregnancy in women with anovulatory infertility.
Gynecology. 2013;15(2):29-32
pages 29-32 views

The role of iodine deficiency in women's reproductive health

Yesayan R.M., Sekinaeva A.V., Runikhina N.K., Ushkalova E.A.


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.
Gynecology. 2013;15(2):33-36
pages 33-36 views

A cross-comparative pharmacokinetic study of Klimalanin (ingestion or sublingual intake)

Yurghel I.S., Limanova O.A., Siling T.B., Torshin I.Y., Gromov A.N., Volkov A.Y., Egorova E.Y., Gromova O.A.


Beta-alanine (Klimalanin) is generally used for the treatment and prevention of vasomotor disturbances (hot flushes) in menopausal period. This paper presents the results of a comparative analysis of the beta-alanine pharmacokinetics with a single ingestion and sublingual intake in the group of 12 volunteers. The comparison showed that sublingual administration was characterized by a faster and more intense pharmacokinetics, and higher concentrations of active beta-alanine in the blood plasma.
Gynecology. 2013;15(2):37-41
pages 37-41 views

Chlamydial infection in gynecology: the modern trends of the pathogenesis of diagnosis and treatment

Kovalyk V.P.


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.
Gynecology. 2013;15(2):42-47
pages 42-47 views

Genital herpes: treatment options

Abakarova P.R.


Herpes is one of the most common human viral infections and is a serious medical and social problem. About 22% of the United States population suffer from it, and European incidence is about 35%. In the Russian Federation, the incidence of genital herpes in 2011 amounted to 18,4 per 100 000 population. Article highlights clinical issues, diagnostic and treatment options of the disease.
Gynecology. 2013;15(2):47-50
pages 47-50 views

Treatment of infections associated with Mycoplasma genitalium

Savicheva A.M., Shipitsina E.V.


In the article, different problems of treatment of infections associated with Mycoplasma genitalium are discussed.
Gynecology. 2013;15(2):51-54
pages 51-54 views

Urinary tract infections in women: main characteristics of prevention and treatment

Kovalyova L.A.


Women experience urinary tract infections (UTIs) with greater frequency during pregnancy and menopausal. Cranberry supplementation may be a valuable therapeutic choice in the treatment and prophylaxis of UTIs.
Gynecology. 2013;15(2):54-57
pages 54-57 views

Glycyrrhizic acid in the chronic vulvovaginitis and cervicitis treatment

Ledina A.V., Prilepskaya V.N.


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.
Gynecology. 2013;15(2):58-60
pages 58-60 views

Features of early pregnancy treatment in women with luteal phase defect

Mikhelson A.F., Lebedenko E.Y., Feoktistova T.E., Kurochka M.P., Kuznetsova N.B., Nastueva S.M.


The purpose of this study was the first pregnancy trimester flow analysis in patients with IDLF receiving pre-gravidity training including dydrogesterone taking. Materials and methods. The drug was prescribed to 60 patients at the pregnancy planning stage. After becoming pregnant patients were divided into two clinical groups: I – with dydrogesterone prolongation taking in trimester one (n = 36), II – dydrogesterone cessation after pregnancy verification (n = 24). The results overview. Significant differences in the incidence of adverse prenatal outcomes, with a predominance of those in clinical group II were obtained. Conclusion. Dydrogesterone discontinuation for up to 8 weeks of pregnancy, when used at the stage of preparation is irrational, as manifested not only as a threat, but the termination of pregnancy in the I trimester.
Gynecology. 2013;15(2):61-62
pages 61-62 views

Importance of the vegetative nervous system condition for course of pregnancy, labor and neonatal period

Alexandrov L.S., Kovalev M.I., Masliankina K.P., Tutter N.V.


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.
Gynecology. 2013;15(2):62-66
pages 62-66 views

Pregravidal preparation for women with hyperhomocysteinemia

Ozolinya L.A., Kashezheva A.Z.


The paper presents the results of a study of pregravidal training efficacy in women with hyperhomocysteinemia (HHC). 136 patients, among them: 30 women with mutations GGC against methylenetetrahydrofolate, 71 patients with GHz without this mutation and 35 women with normal levels of homocysteine (HC) in the blood plasma were constantly monitored. Risk factors for HHC were: anemia, hormonal contraception, diseases of the gastrointestinal tract, the lack of food folate, high coffee consumption (more than 2 cups per day), smoking. To reduce HC following treatment was appointed: folic acid (3 mg/day) and Vitrum Prenatal Forte multivitamin complex (1 tab/day). A significant decrease in the homocysteine concentration in blood plasma was noted on the first month of treatment, however, the level of GC in women who have not had methylenetetrahydrofolate mutation than in patients with this mutation was more reducing more quickly. Thanks to the adequate pregravidal preparation the majority of patients were able to normalize the level of homocysteine in blood and reduce the risk of obstetric complications in the event of pregnancy.
Gynecology. 2013;15(2):67-70
pages 67-70 views

Omega-3 polyunsaturated fatty acids and active folates: the prospects of integrated use for pregnancy's nutritional support and malformations prevention (literature review)

Gromova O.A., Torshin I.Y., Limanova O.A.


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.
Gynecology. 2013;15(2):71-77
pages 71-77 views

Endometriosis – especially surgical pathology?

Tikhomirov A.L.


The application of the combined hormonal contraceptives in the preventive maintenance of disease and the successful fight with the most common clinical manifestations of endometriosis, namely, with the syndrome EAPP (endometriosis associated pelvic pain): chronic pelvic pain, dispareunia and dysmenorrhea, it is promising for the system of public health with respect to braking the progression of disease, reduction of relapses after surgical treatment, an improvement in the quality of the life of patients.
Gynecology. 2013;15(2):78-81
pages 78-81 views

New in the diagnosis of overactive bladder (review)

Mahmedzhanova F.N., Apolikhina I.A., Besnoschenko O.S.


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
Gynecology. 2013;15(2):82-84
pages 82-84 views

Biofeedback in rehabilitation of women with pelvic floor dysfunction: uroginecological and sexological aspects

Stenyaeva N.N., Apolikhina I.A., Khritinin D.F.


Active ageing and operability of the modern women makes actual the problem of effective rehabilitation of patients with pelvic floor dysfunction, to maintain a high level the quality of life. The given review considers the therapeutic possibilities of adding biofeedback to pelvic floor muscle training to treat incontinence and to improve women's sexual functioning. The tactics and the effectiveness of various techniques the treatment and the rehabilitation are discussed, that are used for sexual dysfunction, associated with incontinence. The article describes the prospects using biofeedback in urogynecology and highlight need for more additional knowledge from experts in the field of women's sexual health.
Gynecology. 2013;15(2):85-88
pages 85-88 views

Vaginal fractional carbon laser: minimally invasive means of restoring the vaginal mucosa

Gaspar E., Eddemo G., Brandy H.


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.
Gynecology. 2013;15(2):89-93
pages 89-93 views

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