Vol 17, No 4 (2015)

Articles
Contraception and hyperandrogenism. Clinical effects of a drug containing chlormadinone acetate
Prilepskaya V.N., Mezhevitinova E.A., Kuzemin A.A.
Abstract
The article is devoted to the importance of means of hormonal contraception as a method alternative to abortion, that can aid in preserving the reproductive health of women. The advantages, the main effects and the effectiveness of hormonal contraception and in particular drugs containing chlormadinone acetate (HMA), in patients with irregular menstrual symptoms and hyperandrogenism are discussed as well. The data comes from the study, which allows to regard HMA-containing COCs not only as an effective contraceptive agent with a low percentage of side effects, but a compound having a non-contraceptive effects in the form of a therapeutic effect on acne vulgaris, seborrhea, and other manifestations of hyperandrogenism.
Gynecology. 2015;17(4):4-8
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Influence of mono-estrogen therapy for state mammary glands in women of menopausal period
Trokhanova O.V., Hitrov M.V., Bryancev M.D., Chijova Y.A.
Abstract
For the treatment of genitourinary disorders is an effective means of appointment of local forms of estriol. The article presents the results of assessing the impact of estriol on the breast using the method of electrical impedance mammography. The absence of negative impact and no change in the state of mammary glands using local forms of estriol.
Gynecology. 2015;17(4):9-15
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Predicting the effectiveness of hormone replacement therapy in postmenopausal osteoporotic changes correction
Zakharov I.S., Kolpinskiy G.I., Ushakova G.A.
Abstract
The paper presents a model for predicting the protective efficacy of hormone replacement therapy (HRT) on the basis of a comprehensive evaluation of mineral density and metabolic activity of bone tissue. A positive correlation between the ratio of the differential rates of accumulation, representing the ratio between the standardized rates of accumulation of the lumbar vertebrae and femoral neck, and increase bone mineral density (BMD) of the lumbar vertebrae (L2-L4) using HRT. Determined inverse relationship between the initial level of the BMD and its growth against the backdrop of 12 months of use of HRT drugs. Established predictive model will allow a reasonably prescribe HRT that will enhance the efficiency of correction postmenopausal osteoporotic changes and reduce the side effects associated with the use of this group of drugs.
Gynecology. 2015;17(4):16-18
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Vitamin D and its role in the formation of postmenopausal diseases (a literature review)
Pestrikova T.Y., Yachinskaya T.V.
Abstract
In the literary review the modern data proving an important physiological role of vitamin D and its deficiency for women’s health in postmenopausal period is presented. Vitamin D deficiency is associated with health risks including the cardiovascular diseases, cancer, strength of bones, obesity, insulin resistance, multiple sclerosis, diabetes, mental health problems. High percentage of women of postmenopausal age is deficient in vitamin D, medicamentous correction of vitamin D deficiency can have a huge impact on the health care strategy in the prevention of various diseases in postmenopausal period.
Gynecology. 2015;17(4):19-22
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Office hysteroscopy in the diagnosis and treatment of intrauterine pathology
Korennaya V.V.
Abstract
The main method of endometrial pathology diagnosis is outpatient ultrasonography (US) of the pelvic organs. Despite its high accuracy and specificity, false-positive or false-negative results, according to different authors, can occur in 20-30% of cases. To clarify the status of the cervix and uterus, as well as provide treatment ("see-and-treat" principle) in the outpatient setting it becomes possible with using office hysteroscopy. Carrying out such surgical procedures as an endometrial biopsy, separation walls and uterine adhesions, removal of polyps and submucous myomas, sterilization and removal of foreign bodies of the uterus is also possible. Each of these manipulations requires the use of standardized methods, allowing to reduce the operation time and improve the safety of the intervention. To reduce the risk of complications, it is important to observe a number of technical specifications relating to the situation of the patient, the characteristics of dilation of the uterus, and the rules for the use of electrosurgical equipment. Should these conditions be met, about 60% of all patients with endometrial pathology can be treated as outpatients.
Gynecology. 2015;17(4):23-26
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Optimization of the treatment of patients with proliferative diseases of the uterus
Lapina I.A., Nasyrova N.I.
Abstract
Proliferative diseases of the uterus, including uterine fibroids, endometriosis, endometrial hyperplasia are characterized by a rather wide distribution in the structure of gynecological pathology offset towards the younger population. These diseases are often combined in the same patient, which complicates the treatment of this group of patients and increases the frequency of relapses.
Gynecology. 2015;17(4):27-31
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Influenza during pregnancy: vaccinal prevention of complications
Fedotova I.S., Pavlovich S.V., Malyshev N.A., Kisteneva L.B.
Abstract
The review outlines the clinical features of prenatal development and outcomes of acute respiratory viral infection and influenza, and preventive measures for complications. The review focuses on vaccination and World Health Organiztion, European Centre for Disease Prevention and Control and American College of Obstetricians and Gynecologists recommendations for flu vaccination of all pregnant women despite their gestational age. The results of numerous randomized clinical investigations conducted within more than 40 years have proved the safety and efficiency of flu vaccination during pregnancy. It is vitally important to decrease maternal morbidity and mortality in order to perform flu vaccination during preconceptional and antenatal care.
Gynecology. 2015;17(4):32-37
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Season fluctuations of level of 25-hydroxycholecalciferol in pregnant women living in Saint Petersburg
Khazova E.L., Shirinyan L.V., Zazerskaya I.E., Bart V.A., Vasilieva E.Y.
Abstract
In this article there are shown cohort prospective research results of 25-hydroхуholecalciferol level estimation in blood serum during pregnancy among women depending on the season of the year. The aim of this research is to estimate the intensity of the body of pregnant women with vitamin D in different seasons during pregnancy, who live in Saint Petersburg. There are involved 205 pregnant at I trimester. It was finished by 192 patients. All patients were divided into 4 subgroups depending on the season of the year while involving to the study. At 12-14 weeks there was first blood sampling. From the I trimester till delivery all patients took 500 IU of сolecalciferol contained in multivitamin complexes. During pregnancy 25-ОН-D level in blood serum was measured at 12-14, 24-26, 34-36 weeks of gestation. There are not found significant differences of the initial mean level of 25-ОН-D in all pregnant (17.5, 21.3, 22.6, 19.9 ng/ml, accordingly to the 1st, 2nd, 3rd and 4th subgroups). It was defined the maximal intensity of vitamin D at I trimester of pregnancy during summer - 22.6 ng/ml, which refers to the criteria of vitamin D insufficiency. Minimal concentration of 25-ОН-D among subgroups was revealed during winter - 17.5 ng/ml, which refers the criteria of vitamin D deficiency. Total concentration of 25-ОН-D authentically does not differ between subgroups. The increase the level of 25-ОН-D from the I to the III trimester takes place regardless of the season. The study showed no significant changes in the level of 25-OH-D in blood serum of pregnant depending on the season.
Gynecology. 2015;17(4):38-42
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Obstetric and perinatal outcomes among pregnant women after influenza vaccination and after transferred respiratory infection
Kostinov M.P., Cherdantsev A.P., Semenova S.S., Tarbaeva D.A., Savisko A.A., Serova O.F., Iozefson S.A., Akhmatova N.K., Kostinova T.A., Praulova D.A.
Abstract
Objective. To examine a course of pregnancy, perinatal outcomes in pregnant women vaccinated against influenza and pregnant women who have had an acute respiratory infection (ARI). Material and methods. A comparative study of 108 pregnant women, vaccinated against influenza with vaccines Grippol® plus and Agrippal S1, and 93 unvaccinated; as well as study of 185 pregnant women (50 of whom had experienced ARI during pregnancy, 135 - not) during the 2009-2010 influenza pandemic. Were applied clinical, instrumental, immunological, statistical methods. Results. It has been proven that immunization with inactivated subunit vaccines in the second and third trimester does not impact on the clinical course of pregnancy or the intrauterine growth of fetus. Respiratory infections result in increased frequency of obstetrics pathologies (subcompensated placental insufficiency 49.6%, chronic fetal hypoxia 49.6%, gestosis 35.5% and other). Adaptation in the early neonatal period among infants born to the vaccinated women is comparable to that of infants from the placebo group. The infants born to the women having a history of ARI were 3 times or more frequent to have impaired adaptation, grade I cerebral ischemia, neonatal hyperbilirubinemia. Conclusion. Vaccination of pregnant women in the II and III trimester of gestation with immunoadjuvant and unadjuvanted subunit influenza vaccine does not affect the course of pregnancy and the early neonatal period.
Gynecology. 2015;17(4):43-46
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Modern approaches to the treatment of vulvovaginal candidiasis
Artymuk N.V., Chernyaeva V.I.
Abstract
The review presents the current data on the approach to the management of vulvovaginal candidosis (VVC). It is shown that the main current trend in the management of acute VVC is the use of short courses of antifungal therapy with a local application of azole. Fenticonazole is currently the drug of choice in the treatment of VVC has a high efficiency and safety.
Gynecology. 2015;17(4):47-49
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Evaluation of comprehensive treatment of cervical pathology associated with HPV
Pestrikova T.Y., Pushkar V.A.
Abstract
A comprehensive examination and treatment using the drug inosine pranobex (Isoprinosine), was performed on 123 patients with cervical pathology associated with human pathology virus (HPV). The study of the structure of the microbial landscape in patients with cervical pathology showed that among types of HPV with high statistical significance the HPV type 16 prevailed, the second highest rate spread was HPV 18. Inclusion of Isoprinosine complex therapy in patients with CIN I (LSIL, at virus load of 3 Lg/10¥5) was not required to further degrade the pathological process of the cervix , in 96.23±2.62% of cases, and contributed to the positive effect in total of 91.06% of patients with pathology of the cervix, which is statistically significant.
Gynecology. 2015;17(4):50-53
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The effective local therapy of vaginal discharge
Tikhomirov A.L.
Abstract
In the article from the contemporary positions the effectiveness of the local treatment of vaginal discharge is examined. Is evaluated the role of the combined preparations at treatment and preventive maintenance of vaginal infections.
Gynecology. 2015;17(4):54-55
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Sexually transmitted diseases therapy. Rational choice
Khryanin A.A.
Abstract
A generic or an original drug in sexually transmitted diseases therapy? In the report we tried to analyze the situation in the russian pharmaceutical market of original and generic antibacterial drags. The author findings give a possibility for doctors to choose medicine for patients.
Gynecology. 2015;17(4):56-58
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The effectiveness of rehabilitation of the endometrium using bacteriophages in women with reproductive failure on the background of chronic nonspecific endometritis
Motovilova T.M., Kachalina T.S., Borovkova L.V., Grechkanev G.O., Zinoviev A.N., Gorshunova L.G., Garevskaya Y.A., Ponomareva I.V., Ghurikova M.S., Nefedov S.G.
Abstract
This article provides information about traditional and alternative approaches to the etiotropic treatment of chronic endometritis, the side effects of antibiotics, based clinical practicability of using bacteriophages and it's advantages in case of inflammation of endometrium.
Gynecology. 2015;17(4):59-63
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