Vol 16, No 1 (2014)

Articles
K yubileyu Very Nikolaevny Prilepskoy - doktora meditsinskikh nauk, professora, zasluzhennogo deyatelya nauki Rossiyskoy Federatsii
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Abstract
Доктор медицинских наук, профессор В.Н.Прилепская абсолютно заслуженно считается основателем отечественной научной школы по амбулаторно-поликлинической помощи в акушерстве и гинекологии. Под руководством Веры Николаевны были защищены 45 кандидатских и докторских диссертаций, а ее многочисленные ученики сегодня - ведущие специалисты департаментов здравоохранения, заведующие кафедрами акушерства и гинекологии, руководители отделений, научные сотрудники и преподаватели высших учебных заведений.Направления научно-практической деятельности Веры Николаевны всегда сосредоточены на самых актуальных проблемах акушерства и гинекологии.
Gynecology. 2014;16(1):4-6
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Medical eligibility criteria for using various methods of contraception
Prilepskaya V.N., Mezhevitinova E.A., Sheshko E.L.
Abstract
Prevention of abortions and their complications - is priority task in the preservation of female reproductive health. Invaluable role here is played by rational contraception. The analysis of medical eligibility criteria for contraceptive methods is shown in this article.
Gynecology. 2014;16(1):13-21
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Profilakticheskie strategii XXI veka: ot gormonofobii k razumnoy gormonoterapii
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Abstract
В рамках XIV Всероссийского научного форума «Мать и дитя» состоялся круглый стол с участием ведущих международных и российских экспертов. Темой для обсуждения стала проблема рациональной гормонотерапии.
Gynecology. 2014;16(1):22-29
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Efficacy and safety of gestogens in women with metabolic syndrome
Borovkova E.I.
Abstract
The paper presents a study of the safety and effectiveness of gestogen support of pregnancy in patients with metabolic syndrome. Efficacy of dydrogesterone in the development of the threat of termination in the first trimester has been demonstrated in 91% of patients with metabolic syndrome. Dydrogesterone use safety has been proven on the basis of no change in terms of the hemostatic system and components of lipid and carbohydrate metabolism.
Gynecology. 2014;16(1):30-34
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Hormones, phytohormones and the liver: uses and risks
Uspenskaya Y.B., Kuznetzova I.V.
Abstract
This article provides an overview of contemporary literature data on the problem of the influence of drugs female hormones and phytoestrogens on the liver.
Gynecology. 2014;16(1):35-40
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The role of oxidative stress in the formation of postmenopausal osteoporosis
Zakharov I.S., Kolpinskiy G.I., Ushakova G.A., Wavin G.V.
Abstract
In the present review discusses the impact of oxidative stress on bone metabolism. Shows the importance of pro-oxidants in the physiology and pathology of bone remodelling. Key role oxidative stress begins to play in post-menopausal. This is due to a decrease in estrogen levels and the formation of involutional changes in the body, including bone metabolism. Furthermore, the article addresses the issues of antioxidant protection involved in maintaining bone homeostasis.
Gynecology. 2014;16(1):41-43
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Hyperplastic syndrome reproductive system in perimenopausal women: the tactics of conservative therapy and reabilitation
Zvychayny M.A., Vorontsova A.V., Chilova A.A., Fedotovskykh I.V.
Abstract
The article presents the results of the survey and observation for 3 years 93 women 44-49 years old with hyperplastic processes of the reproductive system: a combination of uterine fibroids (1 to 6 knots, the average size of myoma catch 3,4±1,46 cm) with adenomyosis 1-2nd degree (47 surveyed) and (or) with cystic mastopathy fibozno (84 patients) and 4 -stage receiving complex treatment and rehabilitation, including the use of progestogens on the zero point for the purpose of determining the response of fibroids to therapy, and further x depending on the response to the reception antigestagens.
Gynecology. 2014;16(1):44-48
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Benefits of using combined oral contraceptive with drospirenone in 24+4 overweight adolescents
Kuznetsova I.V., Nabiyeva P.A.
Abstract
Combined oral contraception is known as a reliable method of birth control that can provide additional benefits to health and quality of life . Reliability and the main characteristics of combined oral contraceptives do not differ significantly. At the same time, there is a group of women with special medical needs who have questions when choosing hormonal medications, safety and additional benefits issues should be treated with special care. Among these potential users with special needs, no doubt, are teenagers , and among the various problems that reduce the commitment of contraception - the likely problem of weight gain stands out. Given the propensity for uncontrolled weight gain , due to inherent physiological insulin resistance of puberty period , it is necessary to use drugs with optimal metabolic profile for the girls who are prone to being overweight or already are overweight . Among these medications the combinations containing drospirenone and ethinyl estradiol microdozes can be found.
Gynecology. 2014;16(1):49-53
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Local endometrial injuryas a contributing factor to implantation
Okhrimenko M.A., Smolnikova V.Y.
Abstract
In the review the last data showing the relationship between the outcomes of the IVF program and the presence of a local inflammatory reaction in the endometrium is presented. Special attention is given to the justification of endometrial biopsy as one of the possible mechanisms for the advancement of its receptor activity by increasing the expression of key molecules
Gynecology. 2014;16(1):54-57
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Myo-inositol pregravidal training use prospects in women with polycystic ovary syndrome and insulin resistance
Gromova O.A., Goncharova E.A., Torshin I.Y., Limanova O.A., Kerimkulova N.V.
Abstract
Polycystic Ovarian Syndrome (PCOS) is the main infertility cause due to metabolic and hormonal dysfunctions of the ovaries. This syndrome is comorbid with insulin resistance and substantially increases the risk of endometrial hyperplasia, obesity, breast cancer, myocardial infarction and stroke. Women with PCOS have an increased risk of anovulatory cycles, infertility and miscarriage.One of the promising nutricial directions in the complex treatment of PCOS is the use of myo-inositol. A systematic analysis presented in this paper, showed that oral administration of myo-inositol at a dose of 2-4 g/day helps to reduce insulin resistance, excessive androgen secretion, the risk of hirsutism and acne, normalization of lipid profile and blood pressure. Its reception improves functioning of the reproductive axis in patients with PCOS, normalizes ovulation and formation of mature oocytes. Inclusion of myo-inositol in the process of preparing for the procedure of in vitro fertilization (IVF) can significantly improve the results in patients with PCOS and other disorders associated with infertility.
Gynecology. 2014;16(1):58-65
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Progesterone in implantation and early pregnancy
Tatarova N.A., Airapetyan M.S.
Abstract
The article highlights the issues concerning implantation and endometrial decidualization. Mechanism of spontaneous abortion. Assessed is the need for progestogens in the treatment and prevention of recurrent miscarriage and threatened abortion. The article provides an overview of progesterone drugs used in routine practice by obstetricians.
Gynecology. 2014;16(1):66-68
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The role of magnetic resonance imaging in differential diagnosis of adnexal masses during pregnancy
Martynov S.A., Adamyan L.V., Kulabukhova E.A., Uchevatkina P.V., Danilov A.Y.
Abstract
The issue presents the possibilities of MRT in evaluation of adnexal masses during pregnancy. Magnetic resonance imaging seems to be useful when the diagnosis is not clear on sonography, especially in cases of teratoma and endometriotic cysts.
Gynecology. 2014;16(1):69-72
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Minimally invasive access as a way to reduce surgical complications in the surgical treatment of benign diseases of the uterus
Plekhanov A.N., Tatarova N.A., Ryabinin G.B., Shishkina Y.S., Gamolin V.I.
Abstract
The results of 153 hysterectomies performed using minimally invasive approaches (laparoscopically assisted vaginal and vaginal), and 110 hysterectomies, of traditional laparotomy access were analyzed. Using a differentiated approach to the choice of the method of radical surgical treatment of uterine fibroids and applying advanced techniques of minimally invasive hysterectomy separate stages, we managed to reduce the number of complications in laparoscopically assisted vaginal hysterectomy compared with conventional hysterectomy (1,04% for laparoscopically assisted vaginal hysterectomy versus 3,64% for abdominal hysterectomy) by three, though they were not noted in vaginal hysterectomy. The reduction of the number of postoperative complications: from 4,5% for abdominal hysterectomy to 1,75% for vaginal hysterectomy was noted as well; as for the reduction of the number of postoperative complications, it dropped from 4,5% for abdominal hysterectomy to 1,75% for vaginal hysterectomy.
Gynecology. 2014;16(1):73-76
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Cervical intraepithelial neoplasia: pathogenesis and diagnosis (a literature review)
Sheshukova N.A., Makarov I.O., Chulkova E.A., Averchenko R.R., Chulkova O.V.
Abstract
This article reflects the current views on the etiology and pathogenesis of cervical intraepithelial neoplasia, as well as the fundamental questions concerning the diagnosis of pathological processes of the cervix, that are covered in detail.
Gynecology. 2014;16(1):77-80
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Urogenital disorders in menopause: treatment features
Balan V.E., Kovaleva L.A.
Abstract
The following article describes the common pathogenetic mechanisms of urogenital disorders, and their complex treatment features.
Gynecology. 2014;16(1):81-84
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Polymorphism of the serotonin 5HT1A receptor genes 5HT2A and in the diagnosis of overactive bladder in women (study results)
Makhmejanova F.N., Apolikhina I.A.
Abstract
Search for potential predictors of diagnosis of overactive bladder led to the study of polymorphism of the serotonin 5HT1A receptor genes 5HT2A and women with overactive bladder. The results showed differences in frequencies of alleles HTR1A -1019 (1016) C>G (rs6295) and HTR2A 102 C>T (S34S) (rs6313) between the core group (with OAB) and the control group was found.
Gynecology. 2014;16(1):84-87
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Local anesthesia in surgery of urinary incontinence in women
Gvozdev M.Y., Reva I.A., Tupikina N.V., Pushkar D.Y.
Abstract
Introduction. To date, the methods of surgical treatment of stress urinary incontinence minimally invasive techniques are gaining more and more popularity. Application of mini-loops allows the surgeon to fully control the installation process of loops under the middle part of the urethra, as well as to perform the operation with minimal surgical aggression, under local anesthesia.Goals and objectives. The study was focused on assessing the efficacy and safety of the operation to install Ophira suburethral mini-loop under local anesthesia.Materials and methods. The treatment experience of 28 patients suffering from stress urinary incontinence was analyzed. The average age was55,5 years. Preoperative evaluation included a survey in the gynecological chair with carrying out functional tests («the cough» test, test with straining), urethrocystoscopy, ultrasound and complex urodynamic examination. All patients were induced with Ophira suburethral mini-loops under local anesthesia. Results. Intraoperative and serious early postoperative complications were recorded. Duration of operational benefits was around 18,4 min. In 1 month after surgery no signs of obstructive voiding were shown in patients. The other complications such as wound infection, pain symptom, hinge erosion or dispareunia were absent as well.Conclusions. Ophira mini-loop has proven efficacy in the treatment of urinary incontinence and has several advantages over other synthetic loops. Lo-wer cost of consumables for anesthesia, no need for anesthesia team and expensive equipment, and as a result, less patients staying in hospitals: all those factors can significantly reduce costs.
Gynecology. 2014;16(1):87-90
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The role of antioxidants in high risk pregnancy
Bakhareva I.V.
Abstract
The article describes the current understanding of the oxidative stress and its influence on the development of pregnancy complications: premature labor, preterm premature rupture of the membranes, preeclampsia, placental insufficiency, intrauterine growth restriction, congenital malformations. Particular attention is paid to the role of antioxidants in prophylaxis of pregnancy disorders and of a number of diseases in neonates. Vitamins and micronutrients supplementation may help restore balance to the oxidative pathways. The development of safe and efficient antioxidant strategies to prevent o minimize oxidative damage before and during pregnancy and during lactation are required.
Gynecology. 2014;16(1):90-96
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The role of allergic factor in chronic inflammation of the low part of genitalia in women
Pavlova A.A., Dolgushina N.V., Latysheva E.A., Mezhevitinova E.A.
Abstract
High prevalence of chronic vulvovaginitis and cervicitis, and increased risk of different obstetrical and gynecological complications in these women, contributes to study the etiological and risk factors of this disease. In this review the authors outline the role of allergic factor in the chronic inflammation of the low part of genitalia in women.
Gynecology. 2014;16(1):96-101
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Bacterial vaginosis therapy: modern overview
Pestrikova T.Y., Pikhovskaya V.G., Pivkina O.A.
Abstract
In the structure of vaginal infections bacterial vaginosis firmly holds the leading position. Statistics show that this disease is found in various populations of women with a frequency of 16-87%. The article presents the current data on the etiology of the disease state, principles of diagnosis and the most optimal from the point of view of the practitioner regimen.
Gynecology. 2014;16(1):101-103
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Subclinical inflammatory diseases of the pelvic organs: chronic endometritis
Tapilskaya N.I., Karpeev S.A., Kuznetsova I.V.
Abstract
The economic costs of treating infertility using assisted reproductive technologies are a burden even for advanced Western countries.In infertility patients with long and unsuccessfully treatment history, where all available methods, including assisted reproductive technology are present, chronic endometritis is diagnosed in 60% of cases. Overview of research on chronic endometritis, suggests that endometrium contaminated by microorganisms with confirmed subclinical inflammation is the cause of the reduction in fertility. Identification of a microbial agent in endometritis in routine outpatient practice is not mandatory, as the international experience, including research with a high level of evidence proves the expediency of empirical therapy, based on the minimum clinical criteria, because, otherwise, the consequences for the reproductive system may be irreparable. Preventive antibiotic therapy in patients with pre-conception infertility and recurrent miscarriage is an effective way of preventing reproductive losses. Josamycin is the drug of choice for these conditions due to broad-spectrum, high efficacy against intracellular agents and anaerobic microbiota, favorable safety profile, as well as additional systemic anti-inflammatory and immunomodulatory effects.
Gynecology. 2014;16(1):104-109
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On the resistant pathogens problem of the recurrent vulvovaginal candidiasis
Dolgo-Saburova Y.V., Mirzabalaeva A.K., Klimko N.N.
Abstract
The article presents the results of a prospective clinical study of susceptibility of recurrent vulvovaginal candidiasis (RVVC) to fluconazole in vitro. During the period from 2003 to 2013 1155 patients were examined. Major causative agent in 88% of cases is Candida albicans. The RVVK cause in 12% of patients were 11 species of C. not-albicans, which are dominated by Candida glabrata (3,6%), Candida krusei (2,0%) and Candida parapsilosis (1,8%). Fluconazole in vitro was susceptible to pathogens RVVK 94%. Among the isolates of C. albicans, susceptibility to fluconazole in vitro was 98,8%. Secretion frequency of C. not-albicans strains, sensitive to fluconazole was 53%.
Gynecology. 2014;16(1):110-114
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Rational therapy of pelvic inflammatory disease
Tikhomirov A.L.
Abstract
Features of the etiology and pathogenesis of the pelvic inflammatory diseases (PID) determine the dire need for antibiotic therapy, while avoiding polypharmacy in order to improve compliance, particularly in the prescription of the empirical treatment of uncomplicated PID. The article presents data on the effectiveness of a new generation fluoroquinolone - drug Avelox® (moxifloxacin) in monotherapy genital mixed infection.
Gynecology. 2014;16(1):115-118
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Clinical and immunological peculiarities of tubal factor infertility associated with genital tuberculosis
Klinyshkova T.V., Yakovleva A.A., Dolgih T.I., Frolova N.B., Plekhanova M.A.
Abstract
For the purpose of an assessment of clinico-endoscopic features of TFI associated with the genital tuberculosis (GT), and a condition of local humoral specific immunity 32 patients with division into 2 groups depending on inspection data at phthisiatrician - gynecologist were surveyed: TFI and GT (active or transferred) (the 1st group), TFI without data for GT (the 2nd group). The following signs in the patients of the 1st group were established: long infertility and the supervision without effect from, 3-fold increase of frequency of operations on uterine tubes; existence of full occlusion of uterine tubes (62,5%) with bilateral defeat in every second case, the high frequency of proximal occlusion (р=0,004), existence of the tubercular appearance on a peritoneum of a pelvic organs (56,2%), in comparison with patients of the 2nd group with the prevalence of distal occlusion of tubes and chlamydial infection in the anamnesis (р<0,05). At TFI level of specific Ig M in peritoneal fluid of patients with revealed GT exceeds IgM values at patients without GT (р=0,007) that can serve as an additional marker of GT at patients with TFI when carrying out a laparoscopy.
Gynecology. 2014;16(1):119-123
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Rational pharmacotherapy of major vaginal diseases
Kedrova A.G.
Abstract
This paper outlines the issues of rational pharmacotherapy for women with various vulvovaginal etiology. Taking into consideration the pathogenesis of major diseases of the vagina, the concept of therapy based on combined drugs. Implementation of safe dosage forms of metronidazole, mikоnazole and lidocaine (Neo-Penotran® Forte L) allowed to quickly relieve symptoms of acute discomfort sensations in patients with symptomatic vulvоvaginitov, relieving pain, usually manifested in the form of burning, itching, edema, hyperemia of the vestibule and perineal tissues, allowed to achieve maximal compliance during treatment and achieve not only clinically but also pathogenic effect.The combination of metronidazole and mikоnazole showed a dose-dependance efficiency that depends on the type and form of the disease pathogens vagina, as this combination of drugs had a positive impact on the recurrent form of the disease.
Gynecology. 2014;16(1):123-126
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