Vol 20, No 3 (2018)

Articles
Human papilloma virus: from understanding of immunopathogenesis to rational tactics of management
Tikhomirov A.L., Sarsaniya S.I., Filatova G.A.
Abstract
The human papilloma virus (HPV) is the most common sexually transmitted infection. 440 million people in the world suffer from HPV infection of the genital. During the life of HPV, 50 to 80% of the sexually active population is infected, most often in the first years of sexual activity (the maximum prevalence is between 18-30 years of age). The treatment of subclinical forms of HPV epithelial lesions in 115 patients aged 26 to 42 years with a normal colposcopic pattern and the presence of coilocytosis was performed.
Gynecology. 2018;20(3):5-11
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Inflammatory diseases of the pelvic organs: pathogenetic aspects, diagnosis, clinic, treatment (review)
Buralkina N.A., Katkova A.S., Arutyunova E.E., Zhorova V.E., Batyrova Z.K., Vlasova G.A.
Abstract
The article deals with modern concepts of pathogenetic mechanisms of inflammatory diseases of the pelvic organs, as well as approaches to diagnosis and treatment from the perspective of the possibility of using Nimesil as part of complex therapy.
Gynecology. 2018;20(3):12-15
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Reproductive behavior of medical students: realities of contraceptive choice
Oboskalova T.A., Prohorova O.V.
Abstract
Representations of the society about the use of hormonal drugs for protection from unwanted pregnancy have the features of a deeply rooted behavioral and social stigmatization. Myths and superstitions are serious an obstacle to the successful use of contraception in general and hormonal contraception in particular. The level of contraceptive literacy of students medical universities can be considered as an indicator of awareness students as a whole and is a guarantee of correct reproductive behavior of medical students. The purpose of the study is to assess the level of knowledge of medical students and their attitudes towards modern methods of contraception, including hormonal drugs. Materials and methods. The analysis of questionnaires 117 students of the IV and VI courses of medical-prophylactic and pediatric faculties of Ural State Medical University of the Ministry of Health of Russia, Ekaterinburg. The questionnaire included 25 questions. The average age of the respondents was 22.6±0.7 years. 1st group consisted of 86 girls, the 2nd group of 31 boys. Results. 74.2% of girls and 89.5% of boys dream of creating a family, but 6.4% girls and 9.4% do not plan to have children. 70.9% of young people are for civil marriage, while 63.9% of girls do not even think about such a variant of the relationship. At the onset of an unplanned pregnancy, 50% of girls and 54.8% of young students noted that they exclude the option of interruption pregnancy. The most popular method of contraception in 100% of young men is 63% of girls are condoms. 33 (38.4%) of girls prefer to use contraceptives pills. When choosing a method of contraception, the decisive factor in all respondents was the reliability of the method, the absence of side effects (100% of women and 87.1% men), as well as the availability of the method (more than 90% in both groups); p>0.05. but among the interviewed 53 (61.6%) girls do not use hormonal contraception for various reasons: 34 (64.1%) are afraid of possible complications, 14 (26.4%) prefer more traditional methods, 5 (9.4%) plan a pregnancy. Only 9.7% of medical students turn to a doctor about their contraceptive behavior. The conclusion. Three-quarters of young men are loyal with regard to civil marriage, the same the number of girls have a negative opinion on this issue. Only half students of both sexes are ready to bear pregnancy in the event of unplanned offensive. Hormonal contraception, as the most reliable only 38.4% of girls use it. The overwhelming majority fears the use of this method, which may be due to lack of awareness. Low awareness of medical university students about the feasibility and clinical features of the use of various types of hormonal contraceptives dictate need for systematic provision of timely, accurate and relevant information on family planning methods in this social group from the first courses learning.
Gynecology. 2018;20(3):16-20
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Biomicroscopy of vessels of bulbarian conjunctives in diagnostics of gestation complications associated with development of thrombofilia
Zhmerenetsky K.V., Bloshchinskaya I.A., Bloshchinskiy S.A.
Abstract
Microthrombogenesis in the microcirculation system underlies many types of obstetric pathology. Objective. To substantiate the diagnostic significance of changes in the main parameters of microcirculation in the development of gestational complications associated with the manifestation of thrombophilia. Subects and methods. The method of biomicroscopy of the vessels of the bulbar conjunctiva and the study of the main parameters of the hemostatic system in 68 pregnant women with the established diagnosis of placental insufficiency from 24 patients with placental insufficiency development in connection with thrombophilia and 87 pregnant women with high thrombogenic risk with an unfavorable pregnancy outcome in history. Results. Characteristic changes in the microcirculation have been established both at the clinical stage of placental insufficiency caused by thrombophilia and before clinical manifestations of placental insufficiency: disturbances of venous outflow; the aggregate state of the blood elements. Conclusions. The method of biomicroscopy of vessels of bulbar conjunctiva can be used as a screening one to diagnose signs of placental insufficiency associated with the development of thrombophilia for the subsequent appointment of anticoagulant therapy.
Gynecology. 2018;20(3):21-25
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The influence of antiepileptic drugs on menstrual and reproductive function of women (review of literature)
Tsallagova E.V., Generalov V.O., Sadykov T.R., Borovkova V.V.
Abstract
The article presented more fully set forth the theory of occurrence of disorders of the reproductive function of women taking anti-epileptic therapy and put forward his own theory of the mechanism disorders in patients receiving valproic acid preparations.
Gynecology. 2018;20(3):26-31
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Personalized approach of a hormonal contraceptive for patients requiring control of body weight (review)
Pestrikova T.Y., Yurasova E.A.
Abstract
Hormonal contraceptives are protected from undesirable pregnancy, but also have a row of other useful, uncontraceptive effects, both in regard to the reproductive system and all organism on the whole. An in this connection not insignificant role is executed by progestagens that is included in the complement of contraceptive. Drospirenone is enters in complement of a hormonal contraceptives, possesses to antimineralocorticoid activity, prevents to the delay of natrium and liquid in an organism, that supports stability of body weight, level of arterial pressure, prevents to sickly increase of mammary glands. Drospirenone renders an effect on the RAAS-system, similar spironolactone. Personalized approach of a hormonal contraceptive which contains of drospirenone is the mortgage of control of normal body weight, what is discussed in the article on the example of the drug Midiana.
Gynecology. 2018;20(3):32-35
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Metabolic profile and functional state of vascular endothelium in women with various forms of premature ovarian insufficiency
Pozdnyakova A.A., Marchenko L.A., Runikhina N.K., Sharashkina N.V., Ivanets T.Y.
Abstract
Objective. Compare levels of biochemical and functional markers of cardiovascular risk in the molecular-genetic and autoimmune forms of premature ovarian insufficiency (POI). Materials and methods. The study included 68 women with POI, 49 of them - with molecular-genetic form (a subgroup IA), 16 women with autoimmune form (a subgroup IB), 3 women - idiopathic form (a subgroup IC), and 85 women with regular periods (group II - control). Hormonal profile, levels of biochemical and functional markers of endothelial dysfunction [total cholesterol (TC), triglycerides, low density lipoproteins (LDL), high density lipoproteins, atherogenic index, apolipoproteins A1 and B, uric acid, high-sensitivity C-reactive protein (hsCRP), glucose, insulin, insulin resistance index HOMA, right and left carotid intima-media thickness (cIMT), brachial artery flow-mediated dilatation (FMD)] were assessed in all the participants. Results. The levels of cholesterol, LDL, cIMT were statistically significantly increased in subgroups IA and IB compared to group II. The patients with autoimmune form of POI (subgroup IB) had statistically increased levels of cholesterol and LDL compared to group with molecular-genetic form (subgroup IA). The women in subgroup IA also had significantly increased levels of uric acid, a highly sensitive CRP, endothelin-1 and decreased brachial artery FMD in comparison with the control group. Conclusion. Molecular-genetic POI is associated with more pronounced adverse changes in the profile of cardiovascular disease risk markers.
Gynecology. 2018;20(3):36-41
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Anti-age strategies and menopausal hormone therapy: from the regulation of cellular metabolism to the preservation of quality of life
- -.
Abstract
В апреле 2018 г. в Самаре состоялась ежегодная научно-практическая конференция «Дни МГТ в России - 2018». На одной площадке мероприятие объединило международных и российских лидеров в области ведения женщин позднего репродуктивного возраста, пери- и постменопаузы. Акушеры-гинекологи, эндокринологи, онкологи, хирурги и представители других медицинских специальностей поделились опытом, обсудили диагностические, профилактические и лечебные возможности, позволяющие добиться индивидуального подхода для сохранения здоровья и качества жизни женщин этих возрастных когорт.
Gynecology. 2018;20(3):42-47
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Progesterone contraceptives: a place in practical gynecology (to practitioner aid)
Dobrokhotova Y.E., Borovkova E.I., Zalesskaya S.A.
Abstract
Progesterone-containing contraceptives do not have a significant impact on metabolic processes and can be prescribed to patients with systemic (diabetes mellitus, obesity) and other diseases. Desogestrel is a part of oral preparations in a dose of 75 mcg. The main mechanism of its contraceptive action is Suppression of ovulation (in 97% of cases). The frequency of pregnancy is 0.17 for 100 women-years. Progesterone-containing contraceptives should not be considered, as preparations of the second choice when deciding on the issue of family planning. According to the recommendations of the Center for Disease Control and Prevention organization of health, desogestrel is an acceptable contraceptive option for women with somatic diseases, defined tumor pathology and thrombotic states in the anamnesis.
Gynecology. 2018;20(3):48-51
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Genitourinary syndrome of menopause: optimization of therapyfor vaginal symptoms
Eprikyan E.G., Yureneva S.V., Ermakova E.I., Glazunova A.V.
Abstract
The aim of the study was to investigate the dynamics of atrophic changes оn the use of low-dose regimens of local therapy with a druge containing only estriol and a druge containing estriol, progesterone and a culture of lactobacilli in patients with postmenopausal vulvovaginal atrophy on the basis of subjective and objective criteria. Materials and methods. 44 patients with vulvovaginal atrophy were randomized into 2 groups of 22 people. In the first group, a drug containing estriol in a dose of 0.5 mg was used, in the second group, a preparation containing a lyophilized culture of lactobacilli, estriol - 0.2 mg; progesterone - 2.0 mg was used. Methods of the study included questioning of patients, cytological examination of the vaginal wall with evaluation of the epithelial maturation index, pH-metrics of the vaginal secretion, definition of the vaginal health index (IVS), PCR diagnostics of the vaginal biocenosis. Results. The use of a low-dose regimen of local therapy with estriol contributed to the restoration of the vaginal epithelium, which was confirmed by a statistically significant increase in ISEV and IVS, in the number of lactobacilli and a decrease in pH, However, the use of a combination drug led to a more effective recovery of lactoflora and normalization of the vaginal microflora.
Gynecology. 2018;20(3):52-56
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Possibilities of the self-sampling method application in the cervical cancer screening (review)
Apolikhina I.A., Bashirova L.K., Gorbunova E.A.
Abstract
It was performed an analysis of literature data on the possibility of using self-sampling methods for the screening of cervical cancer. It is indicated that the slow progression of the disease, the presence of several stages of precancerous conditions and the relative accessibility of the tumor for manipulation provide opportunities for timely diagnosis and prevention of the tumor. It is reported that a number of specialists believe that an independent sampling of material for human papillomavirus analysis can be considered as an alternative method for screening cervical cancer. Using this approach will significantly increase the coverage of the population participating in screening programs. The need for further research on improving the technical aspects and assessing the clinical and economic characteristics of the application of the method of self-sampling of cervical-vaginal material to be separated in clinical and epidemiological practice was noted.
Gynecology. 2018;20(3):57-60
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The influence of lignans on the quality of life of women of perimenopausal age
Serebrennikova K.G., Arutyunyan N.A.
Abstract
Problems associated with the state of health of women in the second half of her life are one of the priorities of modern medicine. The aim of the study was to determine the efficacy and safety of the drug in comparison with placebo in patients of perimenopausal age. Materials and methods. A randomized study was conducted in 40 patients aged 38 to 55 years without chronic somatic and gynecological diseases. The I group included 20 women who underwent therapy with the test drug (7-hydroxymatairesinol-lignan formula), in the second group - 20 women, placebo-controlled (similar dose of placebo). Conclusion. The results of the study showed that 7-hydroxymatairesinol has an effect on peripheral vasodilation, does not cause side effects (drowsiness, weakness, decreased efficiency, does not lead to fluid retention), improves general condition, causes a decrease in foliculostimulant hormone, has a positive effect on breast tissue, increases sexual activity, affects weight loss, improves carbohydrate and lipid metabolism, as well as intracellular enzymatic activity of the liver.
Gynecology. 2018;20(3):61-65
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Modern methods of influence at endometrial receptivity in patients with recurrent implantation failure (review)
Polovneva M.I., Korneeva I.E., Bourmenskaya O.V.
Abstract
Objective. To carry out an analysis of the data available in scientific literature on modern methods of influence at endometrial receptivity in patients with recurrent implantation failure. Materials and methods. The review includes the data of foreign and Russia papers published on PubMed during the last 7-10 years. Results. There are studies described the role of endometrial scratching, infusion granulocyte colony stimulating factor, autologous peripheral blood mononuclear cells, autologous platelet-rich plasma, the endometrial receptivity array in treatment for patients with repeated implantation failure. Conclusion. Several adjuvant therapies and diagnostic tests have been used along with IVF to increase the pregnancy rates for women with repeated implantation failure. Perhaps a new test-system to find personal predictors of endometrial receptivity can tern up a positive effect at patients with RIF.
Gynecology. 2018;20(3):66-70
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