Vol 15, No 6 (2013)

Articles
Quality of life of women as the criterion of effectiveness of premenstrual syndrome therapy
Ledina A.V.
Abstract
Quality of life is one of the criteria for therapy effectiveness assessment. The study’s aim was to assess the indicators of quality of life of patients with premenstrual syndrome (PMS) of moderate and severe gravity before and after combined therapy via micro dosed contraceptives containing 20 mcg of ethinyl estradiol and 3 mg drospirenone in a 24/4 regimen. 122 patients aged 16–45 years were observed. To assess the quality of life and the impact of PMS on different aspects of life, patients in the late luteal phase of the menstrual cycle have filled twice – before and after treatment, a Medical Outcomes Study – Short Form (MOS-SF-36) questionnaire. After treatment a statistically significant reduction in the deformation parameters, both physical and psyhological components of health were shown.
Gynecology. 2013;15(6):4-7
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Modern view on the pathogenesis and treatment principles of premenstrual syndrome
Balan V.E., Ilyina L.M.
Abstract
The article presents the current data on etiology, pathogenesis, risk factors of premenstrual syndrome, and the basic principles of diagnosis and treatment of this pathological condition.
Gynecology. 2013;15(6):7-10
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Gestogen intrauterine hormonal contraception in women of senior reproductive age
Kuznetsova I.V.
Abstract
Hormonal contraception, because of the numerous beneficial effects is always used not only for protection against unwanted pregnancy, but also as means of treating a variety of gynecological diseases. Enthusiasm for curative aspects of hormonal contraceptives has led to a shift in emphasis on therapeutic practice and underuse of preventive potential of contraceptive hormones. This particularly refers to the management of women of seniorreproductive group repositories in premenopausal and perimenopausal age. In this group the leading role is left to the questions of treating disorders associated with the extinction of ovarian functions including abnormal uterine bleeding, and substitution of estrogen deficiency, while the problem of birth control tends to be overshadowed. Reduced fertility in this age period should not be an argument for abandoning contraception, especially taking into consideration the fact that timely administration of contraceptive will not heal, but prevent the development of similar violations, which subsequently become an indication for therapeutic purpose of contraceptive hormones. Dual prevention, including the prevention of unwanted pregnancies and prevention of gynecological diseases associated with aging of the reproductive system is the basis for the selection of effective, timely and safe contraception with additional healing properties for women entering into physiological premenopausal period.
Gynecology. 2013;15(6):11-15
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Conservative obesity treatment: opportunities and achievements
Mkrtumian A.M.
Abstract
Statistics show that 20–25% of the world's population is obese, while 30–50% is just overweight. In order to reduce the risk of cardiovascular disease or its complications it is sufficient to reduce the total body weight by 5–10%. Different substances have high efficiency in limiting the absorption of dietary fat. Clinical studies have shown that the patented complex of natural fibers (litramin IQP G-002AS), obtained from Indian Opuntia (Opuntia ficus-indica) and standardized in point of lipophilic activity reduces absorption of fat contained in food, by binding fat in the gastrointestinal intestinal tract, effectively boosting weight loss.
Gynecology. 2013;15(6):15-20
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Ulipristal acetate in uterine fibroids treatment
Korennaya V.V., Podzolkova N.M.
Abstract
Ulipristal acetate is a selective progesterone receptor modulator, characterized by partial tissue-specific antiprogesteron effect, which is used in order to prepare uterine cancer patients for surgery. In the uterus it exerts an antiproliferative, anti-fibrotic and pro-apoptotic effects in relation to the uterine cells, which leads to downsizing of the nodes. Interaction of ulipristal with endometrium causes amenorrhea or bleeding decrease by the 10th day and reduces pain, which is important in symptomatic myoma. Its prescription at a dosage of 5 mg/day for 3 months reduces the volume of large fibroids, in average, by 45–50%. These results are comparable with the effect of agonists of gonadotropin-releasing hormone, but unlike them it’s more easily transferred due to the lower likelihood of developing hypoestrogenism symptoms
Gynecology. 2013;15(6):20-24
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Effectiveness of the human placenta hydrolyzate in the treatment of menopausal symptoms in women in the menopausal transition
Kuznetsova I.V., Gilels A.V., Uspenskaya Y.B., Suleymanova N.S.
Abstract
Contraindications to hormone therapy in peri - and postmenopausal periods, as well as giving up hormones determine the relevance of the search for alternative methods of relief of menopausal disorders. Thus we conducted a comparative study of the effectiveness of the hydrolyzate of human placenta and phytoestrogens in women of peri- and postmenopausal period with the presence of symptoms caused by estrogen deficiency. Evaluation of initial severity of menopausal disorders and the effectiveness of therapy was carried out by the Cupperman index. The study had a positive effect, in response to a human placenta hydrolyzate therapy and using phytoestrogens. But the decline of Cupperman index in the group of women treated with hydrolyzate of human placenta was significantly greater, and continued to grow in the period after treatment , whereas the decrease in the Cupperman index while taking phytoestrogens was observed during the first two months of receiving stabilizing for subsequent treatment. Application of human placenta hydrolyzate had a positive effect on blood pressure in patients with hypertension and improved blood lipid. Thus, the use of the hydrolyzate of human placenta can serve as an alternative hormonal therapy in women of peri - and post-menopausal age.
Gynecology. 2013;15(6):24-27
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Correction of estrogen deficiency states in women with endometriosison the background of therapygonadtropin-releasing hormone
Tatarova N.A., Marzhevskaya A.M., Gavrilova N.P., Savina L.V.
Abstract
Research objective. Development of a program of correction of neurovegetative symptoms of climacteric syndrome in patients with estrogen deficiency, to prove the effectiveness of b-alanine in acute attacks of hot flashes and heat in patients of reproductive age, who use therapy agonist of gonadotropin-releasing hormone and the low level of estrogen.The study involved women 2 groups: group 1 – patients with adenomyosis and external genital endometriosis 3 – grade 4, a total of 78 patients; 2nd group – control (30 people with the same diagnosis).Patients in groups 1 and 2 were treated for 6 months triptorelininjection of 3,75 mg (1 injection per month), for 2–3 months of treatment were seen estrogen deficiency symptoms: hot flashes, sweating, tachycardia. At 3 months, all patients of group 1 was assigned to b-alanine at a dose 800 mg/day, the duration of receiving b-alanine 3 months. The control group is the patients refused the correction of b-alanine symptoms of menopausal syndrome. To assess the severity of symptoms of menopausal syndrome was used modified menopausal index (MMI).Control estrogen deficiency implemented by measuring the serum estradiol level (pg/L).Results. After 6 months of treatment was obtained by statistically significant (p<0,05) decrease with MMI 45,78±0,99 (before treatment) to 24,23±0,6 points (after treatment).When comparing the research and control groups (after treatment), there was a significant (p<0,05) difference in rates of two groups: lower scores MMI, which indicates a positive trend climacteric symptoms in patients treated with b-alanine. Changes in serum estradiol were statistically nonsignificant difference.Conclusion. b-Alaninbe called the drug of choice in the treatment of neurovegetative symptoms of menopausal syndrome, caused by the use of triptorelininjection of 3,75 mg, while it does not affect the blood levels of estrogen.
Gynecology. 2013;15(6):28-31
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Adenomyosis: clinic, risk factors and problems of diagnosis and treatment
Zotova O.A., Artymuk N.V.
Abstract
Design: A retrospective case-control study. The study included 804 women, 268 were patients with histologically verified adenomyosis, 536 – women without proliferative diseases of the pelvic organs. It was found that one third of gynecologic patients undergoing hysterectomy, has adenomyosis. There are significant problems in the diagnosis of the disease, because, despite the existence of relevant complaint, the diagnosis of adenomyosis and treatmenthas been given only to 10% of women. The main complaint appearing in adenomyosis patients at an average age of 38, 5 years is heavy and painful menstruation. The average duration from the onset to the first visit to the doctor was 5 years, and prior to surgery – 12,5 years. Women with adenomyosis had certain characteristics. Medical history of these patients was characterized by a high frequency of gynecological and extragenital diseases, intrauterine intervention, family history of the cancer. A history of uterine curettage and induced abortion were the most significant risk factors for adenomyosis.
Gynecology. 2013;15(6):31-34
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Evaluation of the hereditary trombophilia forms frequency in infertility patients joining the ART program
Pestrikova T.Y., Porubova Y.P.
Abstract
The analysis of the frequency of detection of polymorphisms of genes associated with the risk of multifactorial disease in patients with infertility who applied to the clinic for the implementation of pregravid preparation before assisted reproductive technologies. We studied gene polymorphisms of platelet fibrinogen receptor, collagen, coagulation factors, F2, 5, 7, 13. The study of the individual parameters of hemostasis deviations from normal variants have been identified. Significantly were significant indicators that reflect gene polymorphism inherited thrombophilia factors 2,7 and platelet fibrinogen receptor. The definition of these parameters would eliminate the risk of thrombosis during hormonal stimulation in patients with infertility.
Gynecology. 2013;15(6):35-38
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Embryo aneuploidy and ivf outcomes in patients with different spermatozoa aneuploidy rates
Sokur S.A., Dolgushina N.V., Glinkina Z.I., Gorshkova A.G., Kalinina E.A.
Abstract
Our goal was to study the 13, 18, 21, X, Y chromosomes aneuploidy rate in the embryos of the couples with different spermatozoa aneuploidy rate.In prospective cohort study 56 infertile couples were divided into 3 groups by the spermatozoa aneuploidy rate and preimplantation genetic diagnosis (PGD) by fluorescence in situ hybridization performance.There was a statistically significant correlation between the spermatozoa aneuploidy rate and the number of aneuploid embryos (r=0,19; p=0,0248). The most common types of chromosomal aberrations were 21 and X chromosome monosomy, and sex chromosomes polysomy. In the PGD group with spermatozoa aneuploidy level >0,7% the pregnancy rate was 50% as compared with no-PGD group with pregnancy rate of 8,6% (Kaplan–Meier; p=0,0135).Patients with high rate of spermatozoa aneuploidy are at risk of chromosomal aberrations in the embryos.
Gynecology. 2013;15(6):38-41
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Treatment options for obstetric and gynecological diseases of viral etiology
Ledina A.V., Korotkova N.A.
Abstract
The article presents data on the safety, tolerability and therapeutic efficacy of Panavir in cases of CMV infection exacerbation in pregnant women, collected in an open randomized comparative multicenter controlled clinical trial. Recommendations on its use can also be found there.
Gynecology. 2013;15(6):42-45
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Management of patients with inflammatory diseases of the pelvic organsThe International Union against Sexually Transmitted Infections (IUSTI) overview
Gomberg M.A.
Abstract
В 2012 г. было опубликовано Европейское руководство IUSTI/WHO по ведению пациенток с воспалительными заболеваниями органов малого таза (ВЗОМТ), которое подготовлено известными специалистами по мочеполовым инфекциям из Великобритании (профессором J.Ross) и Франции (профессором P.Judlin). Возглавил группу по разработке руководства J.Jensen из Дании, который на сегодня является одним из ведущих в мире специалистов по инфекциям, вызванным Mycoplasma genitalium . Излишне специально это отмечать, но важнейшим принципом, которым руководствуется редакционный совет Европейских руководств IUSTI, является соответствие приведенных в нем положений принципам доказательной медицины.Нам представляется важным ознакомить российских специалистов с основными положениями, изложенными в этом руководстве, чтобы была возможность сравнить практику ведения таких пациентов в нашей стране с той, что сегодня используется в европейских странах.
Gynecology. 2013;15(6):46-49
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Intravaginal treatment features of vulvovaginal candidiasis in women
Mirzabalaeva K.K., Dolgo-Saburova Y.V.
Abstract
This article describes the features of the various forms of intravaginal treatment of vulvovaginal candidiasis (VVC). Effectiveness of topical treatment of acute VVC is about 90% and is not significantly different from the effectiveness of systemic antifungal agents. Use of a single dose of fungicidal imidazoles, such as 2 % butoconazole nitrate cream ensures maximum adherence and high efficiency of treatment as well as relief of acute exacerbation of recurrent VVC. Weekly use of 5 g of 2% butoconazole nitrate cream for preventing recurrent VVC can be an alternative to the use of systemic antifungal drugs.
Gynecology. 2013;15(6):49-53
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Atrophic vulvovaginitis: new trends in pharmacotherapy
Prilepskaya V.N., Ledina A.V.
Abstract
The article presents the current data on the etiopathogenesis of atrophic vulvovaginitis, diagnostic criteria, clinical manifestations and modern drugs used to treat the pathological condition.
Gynecology. 2013;15(6):54-56
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Aktual'nye problemy reproduktivnogo zdorov'ya zhenshchin
- -.
Abstract
Проблема ранних потерь беременности в течение мноих лет остается актуальной, это наиболее частое гестационное осложнение, причем согласно современным представлениям до 80% всех потерь беременности приходится на первые 12 нед.В рамках XI Всемирного Конгресса по Перинатальной медицине, проходившего под лозунгом: «Глобальные изменения в заботе о здоровье матери и ребенка: применение на практике достижений доказательной медицины для улучшения качества оказываемой помощи», состоялся симпозиум «Ранние осложнения беременности» с участием ведущих международных и российских ученых.
Gynecology. 2013;15(6):57-61
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Immunohistochemical examination of placenta in women with thrombophilia and pregnancy loss summary
Kornyushina E.A., Zaynulina M.S., Kostyuchek I.N., Kleschev M.A.
Abstract
The immunohistochemical study of angiogenesis, anticoagulative protection, cell death and proliferation in placental tissue in pregnant women with thrombophilia and pregnancy loss was carried out in the following research. The study included 142 pregnant women.The study group included 56 pregnant women, who were, from the first trimester prescribed Curantyl® (dipyridamole) and Fraxiparine® (nadroparine) in order to correct the hemostatic disorders. As for the comparison group (consisting of 50 pregnant women), standard therapy aimed at the continuation of the pregnancy was carried out; the control group consisted of 36 pregnant women. A significantly lower incidence of pregnancy loss in the primary (3,57%) and the control group (0%) compared with the comparison group (18%; p<0,05) was revealed.After correction of violations in blood coagulation system the annexin V expression area in syncytiotrophoblast and expression of vascular endothelial factor in the stroma and vascular endothelium of the villi were much higher than in the comparison group (28,80±2,76% and 22,06±1,93%, p<0,05; 17,38±4,87% and 1,08±0,46% respectively, p<0,01). These immunohistochemical studies have demonstrated the positive effects of the therapy on the angiogenesis process, proliferation and anticoagulant protection in placentic tissue. It enables us to justify the feasibility of dipyridamole and nadroparine in pregnant women with thrombophilia and pregnancy loss.
Gynecology. 2013;15(6):61-67
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Didrogesteron influence on the pregnancy course and outcomes in patients with habitual miscarriage
Nikolaeva M.G.
Abstract
To determine the effect of dydrogesterone on the course and outcome of pregnancy in patients with recurrent pregnancy loss a prospective cohort study was conducted. It involved 702 women, divided into three groups according to their anamneses and I trimester therapy. The research showed that dydogesterone use in the first pregnancy trimester in habitual miscarriage patients minimizes the risk of miscarriage to 51,9% (RR 0,48; 95% CR 0,18–0,47; p=0,002), preeclampsia development risk 36,7% (RR 0,63; 95% CR 0,25–0,35; p=0,048).
Gynecology. 2013;15(6):68-70
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Nerve growth factor level in urine: opportunitiesa new diagnostic test in women with overactive bladder (findings)
Mahmedjanova F.N., Apolikhina I.A.
Abstract
The reasons that cause the symptoms of overactive bladder, it is extremely diverse, so it is very important the correct diagnosis. Can the definition of nerve growth factor in the urine samples to be objective method of diagnosis of overactive bladder? In this article published by the original values of nerve growth factor in the urine samples of patients with overactive bladder and the control group.
Gynecology. 2013;15(6):71-73
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Endocrine risk factors of anxiety and depressive conditions in women in the postpartum period
Tatarova N.A., Shamanina M.V., Sokhadze H.S., Savina L.V.
Abstract
76 women suffering from postpartum depression were included in the survey. In 36 cases the concomitant endocrine pathology (hypothyroidism and Hashimoto's thyroiditis, hyperthyroidism and hyperprolactinemia) was found. Used for the diagnosis were the scales specifically designed to detect depressive symptoms in the postpartum period (BPDS, EPDS, PDSS). These scales are estimated as the most sensitive and specific.It was estimated that endocrine diseases, hypothyroidism and more AIT, are risk factors for anxiety and depression in postpartum women, hyperprolactinemia seldom being the cause of postpartum depression. Monitoring of hormonal parameters in the period of pregnancy and the identification of other known risk factors (transferred affective disorders in the past, in the previous depression postpartum period, negative socioeconomic factors) would allow to determine women tending to developing postpartum depression which in its turn would let to run timely prophylaxis. During pregravidal training Hypothyroidism and AIT should be corrected by thyroid hormones, in hyperprolactinemic states in the event of severe anxiety – depression in postpartum period lactation suppression by dopamine receptor agonists and cabergoline is recommended.
Gynecology. 2013;15(6):74-78
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