Vol 21, No 3 (2019)

Articles
HPV-associated cervical diseases: screening, methods of examination, principles of treatment
Prilepskaya V.N.
Abstract
This article presents information about modern principles of diagnosis and treatment of HPV-associated diseases. Behind cervical cancer morbidity and mortality rates over the past 10 years increase significantly. Examination and observation of patients with human papillomavirus persistence of highly oncogenic types is important a link in cancer prevention. The article presents diagnostic methods, treatment of cervical diseases, as well as the possibility of pharmacotherapy in HPV-associated diseases.
Gynecology. 2019;21(3):6-8
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Epigenetic factors and molecular markers of the risk of early pregnancy losses
Frolova N.I., Belokrinitskaya T.E.
Abstract
Background. Miscarriage is a common complication in early pregnancy. Current studies have shown a higher prevalence of miscarriage, ranging from 10 to 20%. The review is devoted to modern concepts of etiology and pathogenesis of early pregnancy losses. Aim. Assess the role of epigenetic factors and molecular-genetic markers in the pathogenesis and prediction of early pregnancy losses Materials and methods. In order to write this review domestic and foreign publications were searched in Russian and international search systems (PubMed, eLibrary, etc.) for the last 10-15 years. Relevant articles from the peer-reviewed literature and clinical practice guidelines were included. Results. Many recent studies have proved the contribution of various epigenetic factors to the pathogenesis of spontaneous miscarriages, and the molecular-genetic determination such kinds of pregnancy complication has been confirmed. Conclusion. The miscarriage in early gestation is driven by combined impact of epigenetic and molecular-genetic factors, as well as the presence of intergenic interactions. It is may lead to deterioration of physiological functions, and maternal pathologenic pathways could be changed as during her periconceptional period as so during the pregnancy.
Gynecology. 2019;21(3):9-16
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Hormonal contraception as a method of social adaptation of women in modern society
Pestrikova T.Y., Yurasova E.A., Yurasov I.V., Kovaleva T.D.
Abstract
Relevance. Currently, women make up more than 40% of the global workforce and more than half of students studying at universities around the world. Women's education, especially at a high level, tends to increase female employment. The mismatch of the style and rhythm of modern life with a genetically determined and working millennium reproductive program requires the choice of a specific approach to social adaptation. Aim. Analysis of literary sources on the use of hormonal contraception as a method of social adaptation. Materials and methods. To write this review, domestic and foreign publications were searched in Russian and international search systems (PubMed, eLibrary, etc.) for the last 2-10 years. The review included articles from peer-reviewed literature. Results. The review describes the features of modern hormonal contraceptives. Their non-contraceptive effects are presented. The individual non-contraceptive effects of a combined oral contraceptive containing 30 mg of ethinyl estradiol and 2 mg of chlormadinone acetate were determined. It has been established that the use of this contraceptive helps to improve the well-being and mood of patients, which allows you to actively use this contraceptive in routine clinical practice with premenstrual syndrome, dysmenorrhea, without the use of analgesics. Conclusions. The numerous positive effects of ethinyl estradiol and chlormadinone acetate allow the use of the drug as a means to increase social adaptation, and, consequently, improve the quality of life.
Gynecology. 2019;21(3):17-21
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Uterine fibroids, laparoscopic surgery and morcellation. Literature review
Seregin A.A., Nadezhdenskaya A.B., Asaturova A.V., Ovodenko D.L.
Abstract
Aim. To analyze the literature data on modern approaches to morcellation of myomatous nodes in laparoscopic surgery and to highlight this area in a historical aspect. To form an idea of the main difficulties associated with morcellation, which contributed to and contribute to the improvement of the technique of this manipulation. Materials and methods. The review includes data from foreign articles published in the elibrary.ru and PubMed databases on this topic. Results. It describes both modern trends in the surgical treatment of patients with uterine myoma, and historical aspects of improving methods aimed at reducing risks, reducing the time of surgical intervention and improving its safety. Analyzed data on the use of electromorcellation, carried out both with the use of plastic containers, and without them. Conclusion. High requirements for surgical interventions contributed to the emergence of such a method of intracorporeal fragmentation of drugs, such as morcellation, which led to a significant reduction in the proportion of laparotomic operations in the treatment of patients with my uterus. The introduction of laparoscopy in the surgical treatment of uterine myoma allowed to achieve a fundamentally new high level of rehabilitation of patients. Removing removed drugs from the abdominal cavity is associated with a certain risk. Despite the significant number of proposed methods and devices for morcellation, they all require further improvement, since it is necessary to completely exclude contact of the myoma node tissue with abdominal organs in the extraction process. Currently, active research continues on ways to realize all the benefits of minimally invasive technologies in compliance with the rules of oncological safety.
Gynecology. 2019;21(3):22-25
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Factors affecting the difficulty of diagnosing and preventing chlamydial infection
Dubrovina S.O., Rubanik L.V., Ardintseva O.A., Gimbut V.S.
Abstract
This publication briefly reviews contemporary methods of laboratory diagnosis of chlamydial infection. Differences in the development of immune response are due to genetic factors in the body, especially the antigenic structure of strains of Chlamydia trachomatis and the influence of innate resistance factors.
Gynecology. 2019;21(3):26-29
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Optimization of complex therapy of inflammatory diseases of women pelvic organs
Ziganshin A.M., Mudrov V.A.
Abstract
Inflammatory diseases of women pelvic organs in reproductive period reach 60% among outpatients and 30% among inpatient gynecological patients. Aim. The aim of the study was to evaluate therapy effectiveness of women pelvic organs deseases with Galavit as part of combination therapy compared to standard treatment. Materials and methods. The study included 120 patients with diagnosis of inflammatory diseases of pelvic organs, randomized to 2 equal groups (n=60). In the main group, the patient in complex therapy received Galavit, according to the scheme: for 5 days, 100 mg intramuscularly 1 time per day, then 100 mg every 72 hours (No. 20); in the control group - only standard treatment. Results. Improvement of clinical condition (reduction of severity, normalization of body temperature, reduction of pain syndrome) in patients of the main group was observed 2 times faster than in patient of control group. Quickly resolve the signs of inflammation by ultrasound in the main group. The number of leukocytes, ESR, LII in the main group normalized faster than in patient of control group. On the background of treatment complications of inflammatory diseases of women pelvic organs was observed in 6 (5%) patients of the main group and 9 (7.5%) patients of the control group; aftercare of patients of the main group with ineffectiveness of therapy was achieved without tubectomy. The duration of treatment in the study group was 8±2.6 days us 10±3.9 days in the control group. Conclusion. The inclusion of Galavit in the complex therapy of inflammatory diseases of women pelvic organs accelerates relief of inflammation symptoms and reduces frequency of complications, which allows to preserve reproductive function. Galavit can be recommended for treatment inflammatory diseases of women pelvic organs.
Gynecology. 2019;21(3):30-34
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The specific features of cervical intraepithelial neoplasia associated with persistent HPV infection
Klinyshkova T.V., Buyan M.S.
Abstract
Aim. Of the study was to assess the clinical and laboratory features of cervical intraepithelial neoplasia (CIN) with persistent human papillomavirus infection and the development of prognostic criteria for persistence of HPV. Materials and methods. The prospective study included 63 patients with HPV-associated CIN. Assessment of persistence of HPV was based on detection of HPV when retesting 12 months. Depending on the results of retesting there were 2 groups: group 1A (main group, n=26), including patients with CIN and HPV persistence after treatment, mean age - 33.69±1.92 years; group 1B (comparison, n=37) - patients with CIN without HPV persistence after treatment, mean age - 34.43±2.09 years. Results. According to the results of the first HPV genotyping (before treatment) among patients of group 1A there was a predominance of two or more HPV types (34.6% vs 16.2% of patients of group 1B; p<0.05). Both groups were dominated by HPV type 16 (p>0.05). According to the results of the second genotyping (12 months after complex treatment) there was a 3.5-fold prevalence of patients with mono-infection against HPV co-infection in group 1A (p<0.05). Among patients with HPV-associated CIN, relapse and no regression of CIN I were observed in 9.52% of cases, exclusively in group 1A (p<0.01). Based on the results of the evaluation of clinical and laboratory data of the study participants, a model for assessing the risk of HPV persistence formation was developed. Conclusion. In patients with CIN associated with HPV co-infection with clinically significant viral load and concomitant genital infection, the risk of persistent papillomavirus infection is increased, which in turn increases the risk of recurrence of CIN.
Gynecology. 2019;21(3):35-39
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Menopause hormone therapy is an effective tool in the hands of a gynecologist
- -.
Abstract
Gynecology. 2019;21(3):40-45
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Metastatic brain lesions in patients with cervical cancer: a case report
Sevyan N.V., Karakhan V.B., Bekyashev A.K., Naskhletashvili D.R., Kozlov N.A., Prozorenko E.V., Belov D.M., Aftomonov D.E., Mitrofanov A.A., Lomaya M.V., Mamedova L.T., Polyakov B.I.
Abstract
Brain metastases from uterine cervical carcinoma are very rare. The development of intracranial metastases is a long-term adverse event indicating poor prognosis. In this paper, we present a case of cervical cancer with a brain metastasis in a patient who received combination therapy and demonstrated long-term progression-free survival.
Gynecology. 2019;21(3):46-48
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