Vol 17, No 1 (2015)

Articles
Anogenital diseases associated with HPV infection
Prilepskaya V.N., Nazarova N.M., Sulamanidze L.A., Burmenskaya O.V., Trofimov D.Y., Pavlovich S.V.
Abstract
The review examined the role of HPV in anogenital diseases. There are presented modern data on the prevalence of anal intraepithelial neoplasia (AIN), HPV infection of the anal region among women at risk (cervical intraepithelial neoplasia - CIN, vulvar - VIN, vaginal - VaIN). There are considered methods of diagnosis of HPV-associated anogenital diseases. Analyzes the literature on the importance of the development of screening AIN in patientswith CIN, VIN, VaIN. There are presented data of the preliminary results of the research of HPV infection of the anal region in patients with genital neo-plasias, the data on different tropism of HPV to cervical epithelium and the epithelium of the anal region.
Gynecology. 2015;17(1):4-7
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Comprehensive treatment of cervical dysplasia from moderate to severe degree on the HPV infection background
Dobrohotova Y.E., Venediktova M.G., Grishin I.I., Sarantsev A.N., Morozova K.V., Lutsenko N.N.
Abstract
The article is devoted to an actual problem of modern health care is the treatment and prevention of cervical dysplasia. In recent years, despite the development of science and medicine has continued to increase the incidence of precancer and cancer of the cervix, which necessitated the creation of newand improvement of existing methods of diagnosis and treatment of precancerous diseases of the cervical epithelium. According to many researchers in a large percentage of cases of this pathology has a viral etiology and due carriage of HPV (human papilloma virus) high-risk types. The currently existing immunomodulators suppress the activity of HPV, thereby reducing the risk of pathological changes in the cervical epithelium. One of these drugs with proven efficacy is Isoprinosine. Given the urgency of this problem, it is necessary to further study and selection of schemes of immunomodulators, evaluation of their effectiveness in terms of clinical outcomes with the aim of reducing the risk of developing dysplasia moderate and severe and cervical cancer, on the background of carrying HPV.
Gynecology. 2015;17(1):8-12
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Efficacy and safety of imiquimod in the treatment of subclinicaland clinical forms of persistent cervical papillomavirus infection in patients of early reproductive age
Tapilskaya N.I., Vorobtsova I.N., Gaidukov S.N., Proshin S.N.
Abstract
Objectives. HPV infection is a major risk factor for cervix cancer. This study evaluated cervical application of imiquimodfortreatment of subclinical (flat condyloma) and clinical (CIN I, LSIL) manifestations of human papillomavirus infection. Methods. An open controlled study (n=28) efficacy and safety of imiquimod (5% cream Aldara) in 1-2 months. Results. All patients treated had complete clinical responses. Clinical efficacy of treatment at 1 month was 96,4%, in 2 months - 100%. Microbiological efficacy (full HPV-clearance) achieved in 60,7% of cases, in other cases there was a decrease in viral load. Elimination of the 16 types of virus was achieved in 80% of cases. Immunocytochemical study showed higher levels of expression of Toll-like receptor 4 and 9 type in the endo - and ectocervix after treatment. Undesirable effects were not grounds for termination of treatment.Conclusions. The trial does support the feasibility and acceptability of the use of imiquimod on the cervix in treatment of manifestations of human papillomavirus infection.
Gynecology. 2015;17(1):14-17
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The sensitivity of the pathogenic microflora of the cervical canal to antibiotics in patients with chronic cervicitis and human papilloma virus
Pestrikova T.Y., Panfilova Y.O.
Abstract
The study of the sensitivity to antibiotics of microbial flora of the cervix in patients with chronic cervicitis, and HPV infection. Patients were divided into 2 groups. The study group included patients with chronic cervicitis, against papillomavirus infection. The comparison group consisted of women with chronic cervicitis without the presence of human papillomavirus infection. Microbial landscape of the cervical canal of patients in both groups was represented by the following microorganisms: Gram-positive cocci (Staphylococcus aureus, S. epidermidis, S. saprophyticus, Enterococcus faecium), Gram - negative bacteria (Escherichia coli, Proteus mirabilis, Klebsiella), class Mollicutes (Ureaplasma urealyticum, Mycoplasma hominis). We have identified the impact of human papillomavirus infection susceptibility to antibiotics of the microbial flora of the cervical canal.
Gynecology. 2015;17(1):18-21
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Contraception: efficacy and safety of levonorgestrel-releasing intrauterine system
Pestrikova T.Y., Danilenko I.A., Bolonyaeva N.A., Gaponenko E.K.
Abstract
The study included 120 women aged 24 to 44 years attending Vivea gynecology department and wanting to use an intrauterine levonorgestrel-releasing system (LNG-BMC) as a contraception method.After a preliminary examination and exclusion of contraindications for this method of contraception LNG-BMC is inserted into the first 7 days of men-strual bleeding.The results indicate a high contraceptive efficacy of the LNG-BMC, a therapeutic effect in dysmenorrhea, premenstrual syndrome, menorrhagia, anemia.
Gynecology. 2015;17(1):22-24
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Drospirenone-containing contraception: curative and preventive aspects of use
Ledina A.V., Prilepskaya V.N.
Abstract
The use of combined hormonal contraceptives is a pathogenetically sound method of treating pathological conditions associated with the menstrual cycle. The study, the purpose of which was to study the effectiveness and acceptability of hormonal microdosed combined oral contraceptive containing 20 mcg ethinylestradiol and 3 mg drospirenone (Yaz®, Bayer HealthCare Pharmaceuticals, Germany), in the treatment of women who suffer from premenstrual syndrome manifestations and of moderate to severe dysmenorrhea. As a result of treatment revealed a statistically significant reduction of the symptoms of premenstrual syndrome, in the absence of serious adverse effects.The study showed high efficacy and acceptability of a microdosed drospirenone-containing combined oral contraceptive in 24/4 mode for the treatmentof women with premenstrual syndrome secondary to severe.
Gynecology. 2015;17(1):25-29
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Symposium materials on «Security issues of long-term use of menopausal hormone therapy: interdisciplinary approaches»
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Abstract
Gynecology. 2015;17(1):30-33
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The efficacy of 17β-estradiol and low dosed drospirenone use in postmenopausal women (literature review)
Andreeva E.N., Grigoryan O.R., Absatarova Y.S.
Abstract
Vasomotor symptoms, including hot flushes (HF), are the most common symptoms of menopause, requiring treatment with estrogen and/or progestogen. Recent international guidelines recognize the need to use the lowest effective dose of hormone replacement therapy. Drospirenone (DR) in combination with 17-estradiol (E) is used as hormone therapy (HT) for relief the symptoms and prevention of postmenopausal osteoporosis.The aim of this review is a meta-analysis of studies examining the efficacy and safety of low-dose DR and E for the treatment of vasomotor symptoms inpostmenopausal women.The review presents data of 2 large randomized controlled studies that evaluated the lowest effective dose combination DR/E, the safety of this dose for endometrium, identified features of its pharmacodynamics and pharmacokinetics, depending on various factors.In the first, a study of the lowest effective doses of DR/E for the treatment of HF in postmenopausal women was made. It led to the conclusion that the com-bination of DR 0,25 mg/E of 0,5 mg is the minimum effective dose. Efficacy of low doses of DR/E correlated with exposure DR and E in serum, while smoking had a negative impact on the Efficacy of treatment.Another study assessed the risk of endometrial hyperplasia and bleeding pattern in patients receiving 0,25 mg DR/E of 0,5 mg for 12 months. At the end of the study no evaluable women in the DR/E2 group had an endometrial biopsy result of hyperplasia or worse, which endometrial confirmed the safety of receiving DR 0,25 mg/E of 0,5 mg.Thus, the minimum effective dose for the relief of HF without causing any significant impact on the endometrium is DR of 0,25 mg/E of 0,5 mg. According to the results of the pharmacokinetic study a correlation between effectiveness of low dose DR/E with DR and E exposure levels was showed, and smoking reduces the effectiveness of hormonal therapy. This drug not only copes with moderate to severe hot flashes, but also reduces the incidence of symptoms of vulvovaginal atrophy, improving quality of life.
Gynecology. 2015;17(1):34-40
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Endometrial ablation for prevention of recurrent endometrial pathology in postmenopausal breast cancer patients receiving tamoxifen
Mamikonyan I.O., Sarkisov S.E., Boiko M.A., Gyurdjyan S.A., Sattarov S.N., Ulankina O.G.
Abstract
Objective. To comparatively assess treatment and prevention methods for endometrial changes in postmenopausal patients taking tamoxifen. Subjects and methods. One hundred twenty three tamoxifen-treated women with breast cancer who had the endometrium more than 5 mm by USG. All the examinees were postmenopausal. The study evaluated the effectiveness of the coagulation hysteroresectoscopic endometrial ablation. Results. The results of treatment were assessed at 12 months. Patients of the first group recurrence of endometrial pathology detected in 1,4% of cases, while in the second group 60%. Conclusion. Thus, by analyzing the results of hysteroresectoscopic endometrial ablation and only diagnostic hysteroscopy in patients with endometrial pathology receiving adjuvant therapy for breast cancer, it was demonstrated that the efficiency of ablation is much higher than hysteroscopy and curettage (98,6 and 40% respectively).
Gynecology. 2015;17(1):41-44
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Pregnancy under control. Modern methods of determining ovulation
Korotkykh I.N., Kryshtopina O.S.
Abstract
The definition of ovulation moment, during which the probability of conception is maximal, can be considered as the basis for planning pregnancy. The following article deals with the accessibility and effectiveness of methods for determining ovulation tests; the evaluation of their benefits is based on immuno-chromatographic determination of the peak concentrations of luteinizing hormone.
Gynecology. 2015;17(1):45-48
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Didrogesteron use in multiple pregnancy
Bushtyreva I.O., Kuznetzova N.B., Kovaleva A.V., Bushtyrev A.V., Dmitrieva M.P.
Abstract
Multiple pregnancy is a pregnancy of high risk, as it demands careful observation in highly specialized medical centers (regional perinatal centres), that possess required experience, material and technical potential and human resources.Aim of the study: to evaluate the effectiveness of didrogesteron (Dufaston) use in pregnant women with twins.Materials and methods: we studied 257 pregnant women with twins, that were observed and delivered in perinatal center. 99 pregnant women recived didrogesteron 10 mg twice a day till 20 weeks of pregnancy to provide first wave of tromboplast invasion.Results: administration of didrogesteron to pregnant women with twins decreased the pregnancy of preterm birth. Besides, it became possible to transfer thetime of delivery from early preterm birth (28,0-33,6 weeks) to preterm birth (34,0-36,6 weeks). That is very important for the condition of premature infants.
Gynecology. 2015;17(1):48-51
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Vitamins and minerals in the prevention of obstetric and perinatal complications
Sokur T.N., Dubrovina N.V.
Abstract
The article reflects the modern views on the problem of the use of vitamin and mineral supplements for pregnant women and nursing mothers. Given are the norms of physiological needs for energy and nutrients for women during pregnancy and nursing, as well as qualitative and quantitative composition of essential vitamins and mineral complexes used in our country.
Gynecology. 2015;17(1):51-54
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NSAIDs in the treatment of patients with primary dysmenorrhea
Korennaya V.V.
Abstract
Primary dysmenorrhea is one of the most common forms of menstrual disorders in young age. This often leads to disablement of patients for several days and requires high-speed and efficient preparations. The first line of therapy in primary dysmenorrhea is considered to be the nonsteroidal anti-inflammatory agents (NSAIDs). When persistent menstrual dysfunction occurs, leading to recurrent episodes of pain, perhaps the appointment of combined hormonal contraceptives can be considered as the best method. The effectiveness of alternative treatments, although confirmed by a number of researchers, it lags behind the traditional approaches. According to recent data, the highest efficiency in the treatment of primary dysmenorrhea was shown by NSAID ibuprofen 400 mg.
Gynecology. 2015;17(1):55-58
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The value of vitamin and mineral complexes in the normal course of pregnancy and fetal development
Kuznetsova I.V., Konovalov V.A.
Abstract
Vitamins and minerals are essential for normal conception, pregnancy, fetal and child's development. Widespread micronutrient deficiency in the modern population adversely affects the health of both mothers and children. The use of vitamins and minerals in step pregravidal preparation and during pregnancy is an important factor in the prevention of miscarriage, premature delivery, impaired function of the fetoplacental complex, fetal malformations and weight lacking infants or immature ones, and, the best way to introduce the necessary micronutrients is the use of vitamin-mineral complexes .Vitamin and mineral complexes have obvious advantages in comparison with a subsidy of some micronutrients in pregnant women. The review highlights the role of vitamins and minerals in a successful pregnancy and justified their prophylactic use.
Gynecology. 2015;17(1):60-64
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Estriol (local and systemic forms) in the treatment of atrophic vulvovaginitis
Prilepskaya V.N., Ledina A.V.
Abstract
Atrophic processes of the urogenital tract, and atrophic vulvovaginitis are an actual gynecological problem due to declining estrogen levels. Diagnosis of this condition is not difficult, based on characteristic clinical picture of the disease, but requires an examination of cytological control. Treatment is based on the shortfall of estrogen. This predominance of symptoms of urogenital atrophy requires estriol based treatment in its local forms.
Gynecology. 2015;17(1):66-68
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Molecular mechanisms of reproductive function abnormalities in women with lipid metabolism disorders (a review of literature)
Kuznetsova I.V., Vedzizheva E.R., Uspenskaya Y.B., Vasilyeva I.V.
Abstract
In recent years a large amount of data on a varied effect of the adipose tissue on a female reproductive system was accumulated. Molecular mechanisms of regulation reproductive function by hormones of the adipose tissue are discussed in the article. It describes the mechanisms of development different variants of reproductive function abnormalities with the obesity.
Gynecology. 2015;17(1):69-73
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Experience of using the ascorbic acid based drugs in patients with bacterial vaginosis
Dobrohotova Y.E., Ibragimova D.M., Mandrykina Z.A.
Abstract
The article investigates the recurrence of bacterial vaginosis, and methods of modern management of patients .
Gynecology. 2015;17(1):74-76
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Methods of organ-preservation of uterine fibroids. Is there a cause for debate?
Korennaya V.V., Podzolkova N.M., Puchkov K.V.
Abstract
Over the past years, new conservative methods of treatment of uterine fibroids and minimally invasive techniques that allow more frequent organ preserving interventions to take place. Accumulated experience allows us to compare the reproductive outcomes, quality of life in the postoperative period and other long-term results. Based on these data a gynecologist can make an informative decision about the optimal algorithm of patients with different clinical manifestations of myomas. This review presents recent data on the use of uterine artery embolization, the use of intrauterine shaver and possible ways of optimizing the laparoscopic myomectomy in order to improve the safety and efficacy of treatment.
Gynecology. 2015;17(1):78-82
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