Vol 15, No 4 (2013)

Articles
Vulvovaginitis and vaginosis treatment: clinical and laboratory efficiency
Prilepskaya V.N., Mezhevitinova E.A., Abakarova P.R., Brovkina T.V., Pogosyan S.M.
Abstract
A study to assess the clinical and laboratory efficacy of Terzhinan in patients with different vulvovaginal etiologies was held. The study included 230 women of reproductive age diagnosed with vulvovaginitis, selected by random sampling. For the diagnosis specification all women were put through a thorough general medical examination by a single algorithm no later than 2–4 days before the start of treatment (runtime microbiology). All patients were divided into 4 general groups and the control group. The first group consisted of 45 (19,6%) women with a diagnosis of «nonspecific vaginitis» (NV), the second – of 43 (18,8%) women with a «bacterial vaginosis» diagnosis (BV), a third – of 41 (17,8%) women with a diagnosis of «vulvovaginal candidiasis» (VVC), and in 47 (20,3%) of the women in group 4 mixed infection was found and 54 (23,5%) of women were united into the control group. Terzhinan was prescribed as therapy to all groups, following the scheme of 1 tablet vaginally 1 time a day at bedtime for 10 days. A total of 176 women from four first groups were treated. After the treatment some complaints about genital discharge remained the same in only 28 (15,9%) women, of itching and burning – in 1 (0,6%) woman, 6 (3,4%) women complained of dyspareunia, and 2 (1,1%) women complained of vulvar discomfort. Three months after the end of therapy of all 176 women surveyed, 1 woman was diagnosed with NV, 1 other woman was diagnosed with BV, 1 – with VVC, and none contracted mixed infection. All 3 patients with recurrences were re-assigned to a course of treatment. 6 months after the end of treatment, 2 cases of recurrent VVC, 1 case – BT and 1 mixed infection were noted. Patients in all groups, where Terzhinan was used, noted a health improvement and a significant reduction in symptoms on the third day of treatment, which demonstrates the effectiveness of the local comprehensive anti-inflammatory therapy. Conclusions. Terzhinan is an effective treatment of nonspecific vaginitis, bacterial vaginosis and vulvovaginal candidiasis. Its application showed a high percentage of curability and the minimum number of relapses was noted. No complications or allergic reactions were registered after treatment.
Gynecology. 2013;15(4):4-9
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Vaginal dysbiosis in women undergoing in vitro fertilisation
Khachaturyan D.A., Okhrimenko M.A., Smolnikova V.Y., Donnikov A.E.
Abstract
The influence of dysbioticvaginal disturbanses on the results of treatment by IVF is stillremainsunclear. Thebacterial vaginosis takes the leading position in the structure of female genital tract infection diseases. Despite of numerous studies which were conducted in this area of investigation, the influence of bacterial vaginosis on treatment in IVF program and ET and also on the subsequent carrying of pregnancy is bad understood till now.
Gynecology. 2013;15(4):9-11
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Correction bacterial vaginosis before small gynecological surgery
Egorova A.T., Kiseleva E.Y., Golovkina N.V.
Abstract
This paper describes the present views on the problem of dysbiosis vagina, and the results of the study of the effectiveness of topical antimicrobial chemotherapy in the preparation of gynecological patients with bacterial vaginosis to small surgical intervention.
Gynecology. 2013;15(4):12-15
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The effectiveness of chronic pelvic pain treatment in patients with endometriosis depending on the estrogen metabolite levels
Manukhin I.B., Prohorova M.V., Gevorkyan M.A., Manukhina E.I., Smirnova S.O.
Abstract
This article presents the results of studies 58 patients, mean age 29±1,7 years with chronic pelvic pain and laparoscopically confirmed diagnosis of external genital endometriosis. Based on the research results of estrogen metabolites has been allocated two groups studied patients. Group I – 26 patients (44,8%) with a predominance of carcinogenic fractions of estrogen in the urine of 2-ONE1/16-ONE1 least 2 (average 0,8±0,2), II group – 54 patients (55,2%) with normal estrоgen metabolism (average 2,3±0,3). Against the background of suppressive therapy with dienogest 2 mg after surgery in 12 months was significant (p<0,05) reduction in pelvic pain VAS.
Gynecology. 2013;15(4):16-18
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Endometriosis therapy features (clinical lecture)
Kovaleva L.A.
Abstract
The following article focuses on endometriosis pathogenesis features as well as on treatment of its clinical manifestations. Endometriosis is defined as the presence of functional endometrial tissue outside the uterus, causing diverse progressive symptoms such as infertility, pelvic pain, and dysmenorrhea.Тhe etiopathogenesis and treatment of endometriosis still remains unknown. Тhe disease can be effectively cured by definitive surgery. However, prolonged medical therapy may be needed in most of the cases since conservative surgery is usually performed especially in young women.
Gynecology. 2013;15(4):19-22
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Hyperandrogenism syndrome: basic principles of diagnosis and treatment (review)
Kuznetsova I.V., Nabiyeva P.A.
Abstract
The hyperandrogenism syndrome (HAS) brings together a number of diseases/conditions associated with excessive production of androgens in the female body, or increased sensitivity to them in hormone- dependent organs. Nosological SGA forms range from isolated lesions of the skin and its appendages to systemic diseases associated with a high risk of metabolic disorders, cardiovascular disease, infertility, hyperplastic processes of the reproductive system and cancer. Algorithms for management of these patients are processed in endocrinology, gynecology and dermatology, but in actual practice, a multidisciplinary approach to the management of patients is rare. In most cases, clinicians cannot avoid polypharmacy in treatment planning, and the number of medications that can have a multi-dimensional effect is small. This determines the need of continuing the search for drugs, including hormonal treatment strategies for patients with HAS, depending on the endocrinopathy primary display.
Gynecology. 2013;15(4):23-27
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Herbal medicine in the treatment of hyperprolactinemia patients
Yavorskaya S.D.
Abstract
A comparative analysis of the Cyclodynon (Bionorica SE. Germany) and Bromocriptine (Gedeon Richter) effectiveness in 80 hyperprolactinemia patients has shown that in patients with prolactin levels up to 1000 mIU/L the Cyclodynon clinical efficacy is comparable to that of Bromocriptine, with better tolerance and no adverse effects whatsoever.
Gynecology. 2013;15(4):28-30
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COC compliance – accessible improvement in the quality of life
Tikhomirov A.L.
Abstract
This is a article of the modern progestine in COC, and its effects. The compliance of the hormonal contraceptive Midiana containing drospirenone is described. The use of this medicine enhances the use of hormonal contraception. It is considered the distinctive features of the medicine; reduction in the severity of side effects, benefit effects.
Gynecology. 2013;15(4):32-34
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Female sexual function and hormonal contraception (review)
Stenyaeva N.N., Kuzemin A.A.
Abstract
The article is devoted to one of the most controversial issues in gynecology, namely the influence of hormonal contraception on female sexuality. We conducted the analysis of the literature data that characterized the features of the female sexual function against the use of various hormonal contraceptives. The article shows that the level of sex hormones, hormone content in the hormone means not define sexual activity, intensity of the sexual desire and the women's sexually satisfaction.
Gynecology. 2013;15(4):35-38
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Ugly cervix. What to do? (Colposcopic pattern with no signs of HPV-associated lesions)
Firichenko S.V., Manoukhin I.B., Minkina G.N., Studyonaya L.B., Kazenashev V.V.
Abstract
Most abnormalities of the cervix may not be associated with cervical intraepithelial neoplasia and cancer risk. Management and appropriateness of treatment for these conditions is often controversial. A few useful suggestions on the optimal clinical management of these patients is presented in the article.
Gynecology. 2013;15(4):39-44
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Surgical treatment of adnexal masses during pregnancy
Martynov S.A., Adamyan L.V., Zhordania K.I., Danilov A.U.
Abstract
The issue presents the possibilities of new surgical technologies in treatment of adnexal masses during pregnancy and delivery. Surgical treatment provides an option for preservation of pregnancy and reproductive function. Laparoscopic approach allows to eliminate a disease requiring surgery no negative impact on pregnancy course and fetus health.
Gynecology. 2013;15(4):45-47
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Current recommendations and standards governing the use of potassium iodide for pregnant and lactating women (clinical lecture)
Troshina E.A.
Abstract
A critical consequence of chronic iodine deficiency during fetal development and early childhood is a violation of intellectual development. The need and the order of iodine prophylaxis in pregnant and lactating women identified the World Health Organization (WHO) and the International Council for Control of iodine deficiency disorders (IDD – ICCIDD). Pregnant and lactating women are referred to the absolute risk of developing IDD. WHO and ICCIDD recommend prescribe potassium iodide for women during pregnancy and breast-feeding, living in areas of iodine deficiency. Order № 50 of the Ministry of Health and Social Development of the Russian Federation from 2007 identified essential drugs for women during pregnancy and the postpartum period, which also made the preparations of potassium iodide. Russia's recommendations on the level of iodine intake by pregnant and nursing women conform to WHO recommendations. Federal standards of care for pregnant women include prescription drugs, potassium iodide.
Gynecology. 2013;15(4):48-52
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Pharmacoepidemiology and pharmacovigilance in pregnancy: experience of the regional service of clinical pharmacology
Eliseeva E.V., Feoktistova Y.V., Poddubnyi E.A., Shmykova I.I., Goncharova R.K.
Abstract
One of the priority healthcare tasks is the prevention of congenital malformations at all stages – pregravidal, prenatal and postnatal. The analysis of 1306 pregnant women’ pharmacotherapy was carried out. 27,93% of the prescribed drugs were relatively safe for the fetus (category A, B). The most commonly used (36,12%) drugs were the ones with undetermined safety level (N FDA– Food and Drug Administration). In 35,93% of cases drugs with the risk of teratogenicity or embryotoxicity effects to the fetus (category C, D, X) were used.
Gynecology. 2013;15(4):52-55
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The role of magnesium drugs in the treatment of women with recurrent pregnancy loss when threatened with pregnancy termination
Zainulina M.S., Eremeeva D.R., Kornyushina E.A.
Abstract
The effects of combination therapy, including drugs, such as those of magnesium lactate and pyridoxine (Magnelis B6) on hemostasis rates and efficacy of the treatment of threatened abortion were evaluated by means of a retrospective analysis. The results indicate a reduction of spontaneous abortion risk in all patients, including women with a compromised obstetric-gynecologic and somatic history.
Gynecology. 2013;15(4):56-58
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Vitamin and mineral status correction in pregnant women with a high risk of macrosomia
Shikh E.V., Grebenschikova L.Y.
Abstract
Purpose. Optimizing the correction of vitamin and mineral status in pregnant women with a high risk of macrosomia. Patients. 1308 female patients were examined at 23–24 weeks of pregnancy. Increased risk of macrosomia was diagnosed in 527 pregnant women. Two groups were formed: first group, consisting of 280 women who were not taking any vitamin-mineral complexes (VMC) at the diagnosis time, and the 2nd group, consisting of 247 women receiving VMCs since the establishment of pregnancy. Methods. Quantitative determination of zinc (Zn) was performed by mass spectrometry, whereas vitamins such as A, E – by means of the high performance liquid chromatography (HPLC), and vitamin C – using the Farmer-Abt method. For early macrosomia prediction the «method of predicting birth of a large fetus» was used (patent number 2,428,118 as of 18.01.2010). Results. In the first group at 23–24 weeks' gestation revealed the following changes in element reduction: in Zn provision in 72,5% of the cases, in B12 vitamin in 70,3%, in B1 vitamin in 65,8%, in B9 vitamin – in 63,9%, and vitamin C – in 54,6%. Upon VMC prescription to the group of pregnant women from 24 weeks of pregnancy up to the delivery the normal physiological levels of Zn, at the lower boundary level of vitamins B1, B12, B6, B9 are not restored. In pregnant women who received the VMC Alphabet Mommy's health a statistically significantly higher provision of Zn and vitamin B9, compared to a group of pregnant women who received single-pill VMC was noted. Conclusion. In the event of receiving VMC at 23–24 weeks of pregnancy the VMC produced with interactions should be preferred in order to increase the vitamin B9 and Zn provision.
Gynecology. 2013;15(4):59-64
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Pelvic inflammatory diseases in women (review)
Zarotchentseva N.V., Arshakyan A.K., Menshikova N.S.
Abstract
The timely, high-quality diagnosis and adequate treatment of inflammatory diseases of the pelvic organs are the foundation of female reproductive health.
Gynecology. 2013;15(4):65-69
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