Ultrasound parameters and the state of uterine hemodynamics in women with menstrual dysfunction in puberty

2020 ◽  
pp. 30-36
Author(s):  
O.A. Kovalishin ◽  

Studying the hemodynamic features of the pelvic organs in women is of great clinical importance, since it makes it possible to assess the degree of restoration of endometrial regeneration after menstruation, the possibility of implanting a fertilized egg and developing the placenta. In women with menstrual dysfunction in the puberty, determining the qualitative and quantitative parameters of uterine hemodynamics may be useful in choosing treatment tactics, evaluating its effectiveness, and will also help significantly in predicting the prospects for the restoration of their reproductive health. The objective: using ultrasound and dopplerometry to study the uterine hemodynamics and assess the ability of the endometrium to implant in women with menstrual dysfunction in the pubertal period. Materials and methods. To achieve this goal, 120 women of reproductive age from 19 to 32 years old were studied. According to the nature of the violations, the main group of women (n=90) with pathology of menstrual function in the puberty was divided into 3 subgroups (n=30): the first – women with primary oligomenorrhea in the anamnesis, the second – with late age menarche, the third – with puberty bleeding. The control group included women (n=30) with the correct rhythm of menstruation in puberty. Results. Based on a comparative analysis of the echographic parameters of the size of the uterus in women with menstrual irregularities in the puberty (main group) and women with the correct rhythm of menstruation (control group), it was found that in the middle stage of endometrial secretion, the uterus is 1,2 times smaller in women the main group (p<0.05) due to the width of the uterus (p<0.001). The ratio between the length of the body and cervix in the examined groups did not significantly differ. The thickness of the front wall of the uterus is less than the control values in women with late menarche (p<0.05) and puberty bleeding (p<0.01), which served as a predictor of the absence of combined uterine pathology. An echographic study of the thickness of the endometrium in the late stage of the proliferation phase in the group of women examined did not establish any significant differences with the control group. In the middle stage of the secretion phase, the endometrial thickness was less in women with menstrual dysfunction in puberty – 9.50±0.27 mm compared to 11.38±0.48 mm in the group with the correct rhythm of menstruation (p<0.001), but remained within the limits of reference values. To assess the functional activity and the possibility of secretory transformation of the endometrium, dopplerometry of the uterine arteries was performed, which did not reveal significant differences in women of the main and control groups. Conclusion. An analysis of the relationship between body and cervical lengths proves the absence of signs of genital infantilism in patients with menstrual dysfunction in the pubertal period. Dopplerometric studies of hemodynamics in the arteries of the uterus in this group of women in different phases of the menstrual cycle indicate an adequate blood supply to the uterus. And although as a result of the inferior phase of endometrial proliferation, its thickness in the middle stage of secretion remained insufficient (9.52±0.42 mm; p<0.01), normal blood flow in the radial and basal arteries of the uterus contributed to the successful implantation of a blastocyst. Keywords: menarche, oligomenorrhea, pubertal bleeding, uterine hemodynamics, endometrial proliferation, dopplerometry.

Author(s):  
Kovalyshyn O. A.

The study of hemodynamic features of the pelvic organs in women is of great clinical importance, since it allows assessing the degree of recovery of endometrial regeneration after menstruation, the possibility of implantating a fertilized egg and placental development. Women who have had menstrual dysfunction in puberty, the determination of qualitative and quantitative parameters of uterine hemodynamics can be useful while choosing treatment tactics, evaluating its effectiveness, and will also provide significant assistance in predicting the prospects for their reproductive health. The purpose of the study. To examine the hemodynamics of uterus and assess the ability of endometrium to implant in women with menstrual dysfunction in puberty with the help of ultrasound and dopplerometry.Materials and methods. To achieve the set goals, 120 women of reproductive age from 19 to 32 years old were examined. By the nature of the disorders, the main group of women (n = 90) with menstrual dysfunction in puberty were divided into 3 subgroups (n = 30): the first group - women with primary oligomenorrhea, the second one - with late menarche, the third one - with pubertal bleeding. The control group consisted of women (n = 30) with the correct rhythm of menstruation in puberty. Results. On the basis of a comparative analysis of the echographic parameters of the size of the uterus in women with menstrual dysfunctions in puberty (main group) and women with the correct rhythm of menstruation (control group), it was found that, on the average stage of endometrial secretion, the volume of the uterus is 1, 2 times smaller in women of the main group (p˂0.05) due to the width of the body of the uterus (p˂0.001). The ratio between the length of the body and cervix in the examined groups did not differ significantly. The thickness of the anterior wall of the uterus is less than the control values in women with late menarche (p˂0.05) and pubertal bleeding (p˂0.01), which was a predictor of the absence of combined uterine pathology. Echographic examination of the thickness of the endometrium at a late stage of the proliferation phase in the examined women did not reveal significant differences with the control group. In the middle stage of the secretion phase, the thickness of the endometrium was less in women, who had menstrual dysfunction in puberty - 9.50 ± 0.27 mm versus 11.38 ± 0.48 mm in the group with the correct menstruation rhythm (p <0.001), but remained within the reference values. Dopplerometry of uterine arteries was performed to assess the functional activity and the possibility of sectorial transformation of the endometrium, which did not reveal significant differences in women of the main and control groups. Conclusions. An analysis of the ratio between the body length and the cervix of the uterus proves the absence of signs of genital infantilism in patients with menstrual dysfunctions in puberty. Doppler studies of hemodynamics in the arteries of uterus in this group of women in different phases of the menstrual cycle indicate an adequate blood supply to the uterus. Although the inferior phase of proliferation of endometrial thickness in its middle stages remained insufficient secretion (9,52 ± 0,42 mm; p <0.01), however, the normal blood flow in the radial and basal uterine arteries contributed to the successful implantation of the blastocyst.


2020 ◽  
Vol 5 ◽  
pp. 16-20
Author(s):  
O. A. Kovalishin

The issue of preserving the reproductive health of women for many years does not lose its relevance. Fundamental studies of recent decades have made it possible to determine the basic mechanisms of functioning of the female reproductive system, but studies of the characteristics of pregnancy, complications in childbirth and the condition of newborn children in women with menstrual dysfunction in the puberty remain single.The objective: аccording to laboratory and instrumental methods of research, to study the characteristics of childbirth and the condition of newborns in women with menstrual dysfunction in the puberty.Materials and methods. According to the nature of the disorders, the main group of pregnant women (n=120) who had a menstrual pathology in the puberty were divided into 3 subgroups (n=40): the first – pregnant women with primary oligomenorrhea in the anamnesis, the second – with a late age menarche, the third – with puberty bleeding. The control group included pregnant women (n=40) with the correct rhythm of menstruation in puberty.Results. During the clinical study, significant differences in the biological readiness of the body for childbirth in all subgroups of the main group of pregnant women were noted compared with the control group. In 35 (29,2%) pregnant women with menstrual dysfunction during the puberty, an «unripe» or insufficiently «mature» cervix was observed in the expected period of labor, which was important in the violation of labor activity during spontaneous labor in the occipital presentation and an increase in the frequency of delivery using cesarean section (CS) operation. Caesarean section was performed in 51 (42,5%) pregnant women of the main group: planned CS in 39 (32,5%), urgent delivery in 12 (10,0%). In the group of pregnant women with the correct rhythm of menstruation, spontaneous delivery occurred in 37 (92,5%) women, planned CS due to the narrowed pelvis and large fetus in 2 (5,0%), emergency CS – 1 (2,5%) case. The frequency of complications during childbirth (violation of labor, premature rupture of the membranes, bleeding) in the main group is 4 times higher than in the control group (p<0,001), in a comparative aspect, the differences between the subgroups are not significant. 95,2% of newborns from mothers with menstrual dysfunction in the puberty were born in a satisfactory condition. The Apgar score is significantly higher in newborns from mothers receiving pregravid preparation. The frequency of individual conditions that occur in the perinatal period is the highest in newborns from mothers with a history of primary oligomenorrhea.Conclusion. The results of the studies confirm the presence of the biological unpreparedness of the body for the normal course of labor in women with menstrual dysfunction in the puberty, as evidenced by violations of labor, the main predictor of which is placental dysfunction. The frequency of individual conditions that occur in the perinatal period is significantly higher than in newborns from mothers who had the correct rhythm of menstruation. It is possible to reduce the frequency of obstetric and perinatal complications in women with reduced reproductive potential by optimizing the pregravid preparation program and introducing a scientifically based complex of treatment and preventive measures.


2017 ◽  
pp. 85-88
Author(s):  
O.I. Ostapenko ◽  
◽  
V.P. Kvashenko ◽  
I.K. Akimova ◽  
I.N. Nosova ◽  
...  

The objective: the study of immunomodulatory effects of a probiotic, which contains lyophilized Lactobacillus (Lactobacillus rhamnosus) – 13 mg (2,0ґ109 CFU) and lyophilized bifidobacteria (Bifidobacterium lactis) – 4 mg (2,0ґ109 CFU) the level of serum immunoglobulin IgA as a marker of local immunity in the plasma of women of reproductive age with the violation of the biocenosis of the vagina. Patients and methods. The study involved 86 patients of reproductive age with the violation of the vaginal biocenosis, which were divided into two groups according to received treatment. A survey was conducted for all patients in both groups: determine the level of serum IgA, measuring pH of vaginal environment and the quantification of lactobacilli and pathogenic flora with the help of test-system «Florotsenoz» before treatment and in 6 weeks after treatment. The state of vaginal microbiocenosis in both groups before treatment was homogeneous. Patients in both groups as therapy at the first stage of treatment received, if necessary antimicrobial therapy depending on the selected flora. In the second stage (restoration of microflora) patient of the main group received systemic probiotic combined with a complex prebiotic local action, patients in the control group, the probiotic localy in the form of the vaginal candles or tablets. Results. The research stated the increasing level of serum IgA in blood plasma of patients of the main group compared to control group at 20%, normalizing the pH of the vaginal environment in the main group in 94% of cases, which indicates an increase of immunity in mucosal. Conclusion. The inclusion of the systemic probiotic in the scheme of treatment of disorders of biocenosis of the vagina system enhances the increasing of immunity of the mucous membranes, and the vaginal tablets prebiotic of local action restores the own normal microflora of the vagina. Key words: serum immunoglobulin A, local immunity, vaginal dysbiosis, probiotics, prebiotics, vaginal microbiocenosis, the pH of the vaginal environment.


2021 ◽  
Vol 21 (4) ◽  
pp. 54-59
Author(s):  
D. Yu. Sosnin ◽  
K. R. Galkovich ◽  
A. V. Krivtsov1

Background. There are not enough publications devoted to the study of erythropoietin in human sperm. According to the results of these studies, the erythropoietin takes part in the regulation of spermatogenesis, affecting the synthesis of hormones, in particular steroid ones. Currently, the physiological and pathogenetic effects of erythropoietin on human ejaculate have not been thoroughly studied. In this regard, the study of this protein in the ejaculate in patients with diseases of the male reproductive system, as well as in their absence, is relevant.The study objective is to determine the concentration of erythropoietin in ejaculate samples of healthy and men with oligoastenozoospermia.Materials and methods. Samples of ejaculate of 52 men of reproductive age were examined. The ejaculate was examined using the SQA-V sperm analyzer (MES, Israel). According to the results of the study, two groups were identified: the main group (n = 18) with reduced fertility and the control group (n = 34) with normal spermogram indicators. In seminal plasma samples, the concentration of erythropoietin was determined by solid-phase enzyme immunoassay using the test system “Erythropoietin-IFA-BEST” (A-8776) (Vector-best LLC, Russia).Results. Erythropoietin was detected in all ejaculate samples, the results ranged from 9.37 to 193.95 mME / ml and varied 20.7 times (p = 0.3). The median concentration in the main group was 64.49 mME / ml (41.96; 118.16 mME / ml) and 1.36 times higher than the results of the comparison group, which were 47.16 mME / ml (18.15; 90.94 mME / ml). No statistically significant regularities were found between the concentration of erythropoietin and the indicators of ejaculate fertility (r <|0,3|).Conclusion. In oligoastenozoospermia, there is a tendency to increase the content of erythropoietin in the seminal plasma, which requires further research, taking into account a more detailed stratification of the groups examined for reasons that caused a decrease in the number of spermatozoa.


2021 ◽  
Vol 11 (4(42)) ◽  
pp. 28-33
Author(s):  
A. Borshuliak ◽  
O. Andriets ◽  
A. Andriets ◽  
A. Semeniak

Іntroduction. Today, a quarter of the population of economically developed countries has a body weight that is 15% larger than the norm. According to various authors, the timely onset of menarche in women with various forms of obesity and reproductive dysfunction is observed in 31% of cases only. Obesity results in insulin resistance, which in its turn results in hyperinsulinemia. The main reason of the connection of insulin resistance with reproductive function disorders consists in the specific influence of insulin on ovaries. Insulin suppresses apoptosis, binding to receptors of various growth factors that promotes long existence of atresizing follicles. In the pathogenesis of the metabolic syndrome, along with the development of hyperinsulinemia and insulin resistance, a significant role belongs to the imbalance of adipocytokines, one of which is adiponectin. The aim is to analyze metabolic processes in the formation of menstrual dysfunction in adolescent girls with obesity to improve diagnostic methods of menstrual disorders. Material and methods. Clinical and laboratory examination of adolescent girls aged 12-18 years was held, among which 79 had obesity and complaints about menstrual dysfunction (the main group); 31 with normal body weight and regular menstrual cycle (the control group). Research methods: general clinical, biochemical (indicators of lipid and carbohydrate metabolism were determined), instrumental (ultrasound), statistical. Results. It was found that 53.3% of the girls from the main group had the beginning of the first menstruation after 14 years, delayed menstruation from 42 days to 6 days, duration 2.1 ± 0.05 days, which was significantly shorter, the volume of 10.2 ± 0.05; 0.4 points (average 1-2 pads per day) was significantly lower (p <0.05). Ultrasound showed uterine hypoplasia in almost every second girl in the main group - 36 (45.46%). Hyperleptinemia and leptin resistance was found in obesity of the first degree 34.8 ± 1.75, in obesity of the second degree 37.15 ± 2.12, in obesity of the third degree 40.64 ± 2.0. It was 14.35 ng / ml in the control group, p<0,01. Hyperleptinemia in the main group was accompanied by hyperinsulinemia in 26% of cases and insulin resistance. The relationship between low values of adiponectin and elevated body mass index in patients of the main group was established, which was confirmed by the results of correlation analysis (adiponectin & body mass index: ρ = -0.74). Analysis of the results revealed a decrease of A/L level in the main group by 4.3 times. Based on our own results, the A/L and HOMA-AD models can be considered more accurate for determining insulin resistance. Conclusions. 1. Changes of the menstrual cycle in overweight girls were found. The association of adipokines secretion disorders is characterized by hyperleptinemia, leptin resistance, decreased Adiponectin / Leptin index and hypoadiponectinemia, which, in combination with insulin resistance, indicates the participation of adipokines in the genesis of oligomenorrhea. The algorithm of adolescents’ treatment with menstrual dysfunction on the background of obesity must include the calculation of Adiponectin/Leptin and HOMA-AD, which will make it possible to avoid overdiagnosis of insulin resistance.


Author(s):  
V. H. Korniienko ◽  
A. S. Fitkalo

According to modern data, the cardiovascular system is a kind of indicator of the organism's adaptive activity, and the structure of the heart rhythm carries information about the development of adaptive reactions in response to irritating factors of the external and internal environment.The aim of the study – to investigate the functional state of the autonomic nervous system in pregnant women who have harmful habits by evaluating and analyzing the parameters of heart rate variability in order to prevent complications of non-delivery of gestational process.Materials and Methods. The study involved 73 pregnant women, 53 of them were pregnant (the main group) who had malignant habits in history. Before studying adaptive reactions in pregnant women, a study of cardiac rhythm variability was performed in practically healthy non-pregnant women of reproductive age (25.3±2.2) years). The control group consisted of 20 pregnant women without any harmful habits. Determination of heart rate variability was performed on the basis of peripheral heart rate recording, which included measuring the sequence of RR intervals for 5 minutes, followed by mathematical analysis using the PlsMntr software product.Results and Discussion. It was established that in the main group, in the complicated failure to pass the gestational process, violations of cardiac rhythm variability were detected in 59.7 % of cases. There is an increase in the frequency of very low frequency (VL F) waves (43.5 % relative to control, p<0.05), indicating a predominance of humoral and metabolic rate of regulation of the cardiac rhythm. At the threat of premature births, a decrease in the particle (LF) is observed at 36.6 %, a decrease in the share of high-frequency waves (НF) by 30.8 %. Taking into account the results of the study, one can speak of a decrease in the tone of the sympathetic and parasympathetic nervous system, reducing the influence of the reflexive vegetative level of regulation, which, in turn, indicates the depletion of regulatory mechanisms and the lack of an adaptive protective effect of n.vagus on the heart.Conclusions. Our innovative low-invasive method of evaluating the adaptive reactions of the organism through the determination and analysis of indicators of cardiac rhythm variability in pregnant women with the existing harmful habits offers us the opportunity to observe manifestations of functional stress of regulatory systems of pregnant women, preceding the development of complication of non-delivery of gestational process.


TRAUMA ◽  
2021 ◽  
Vol 22 (4) ◽  
pp. 46-51
Author(s):  
I.I. Trufanov

Background. Acetabular fractures are severe intra-articular injuries that require anatomical reposition and early function, but they are often complicated by degenerative changes in both the acetabulum and the femoral head, leading to the development of post-traumatic coxarthrosis. The purpose was to study the clinical effectiveness of surgical treatment and postoperative management of patients using autologous platelet-rich plasma in patients with fractures of the acetabulum. Materials and methods. Twenty-eight patients with acetabular fractures of various degrees were operated at the City Emergency Hospital of Zaporizhzhia and the Municipal Clinical Hospital No 9 from 2017 to 2019. Gender composition: 22 men (78.57 %), 6 women (21.43 %), average age 46.64 ± 2.21 years, with a 95% confidence interval 42.31–50.96. Nineteen victims (67.86 %) had road traffic injuries, 7 (25 %) domestic injuries, and 2 (7.14 %) had industrial injuries. Results. In the main group of patients treated with platelet-rich plasma, radiologically visible adhesion of the injured area after 8 weeks occurred in 10 people (83.4 %). In one person (8.3 %), the adhesion occurred after 12, and in another (8.3 %) — 16 weeks after surgery. In the control group, adhesions at 8th week were registered in 14 patients (60.87 %), in 8 (34.78 %) — at 16th week. Given the general recovery of the body in the main group, the activation and social adaptation of patients occurred 2–3 weeks earlier. The assessment was performed radiologically and by the criteria of functional recovery.


2018 ◽  
Vol 25 (3) ◽  
pp. 40-45
Author(s):  
E. V. BURDYUKOVA ◽  
A. N. ARKHANGELSKAYA ◽  
S. N. ALEKSEENKO ◽  
I. A. YAKIREVICH ◽  
E. A. DMITRIEVA ◽  
...  

Aim. To evaluate the effectiveness of the developed special sports complex in the prevention of hypodynamia and obesity among firefighters-rescuers.Materials and methods. A survey of 490 men with no history of chronic infectious and non-infectious diseases aged 20-59 was conducted. 328 people were the main group, 162 people were the control group. The baseline data included anthropometric development indicators, bioimpedance test results, the extraction of biochemical blood test results; the body mass index (BMI) and the ratio of waist and hip circumference were determined. A questionnaire was conducted to identify hypodynamia (according to the IPAQ questionnaire) and the nutrition structure (according to the questionnaire on the food label literacy questionnaire, past). Both questionnaires were adapted to the Russian Federation. Statistica for Windows 8.0 was used for statistical processing. We used a comparison of the means of the Student method. To compare the values expressed in percent, the method of inverse trigonometric Fisher transformations was used.Results. We have developed and proposed for firefighters-rescuers, included in the main group, special sports complexes, which were used for 6 months. These complexes represent additional physical training by the developed method. There are two of them: one with an emphasis on the prevention and rehabilitation of people with osteochondrosis of the lumbar spine, and the other for cervical and thoracic localization, including with a syndrome of shoulder-scapular periarthritis.Classes were held 3 times a week, the duration of 1 session was 45-50 minutes. The choice of the complex was carried out at the request of firefighters-rescuers. The first complex was selected by 52 people. Based on the results of the study, against the background of the use of sports complexes, there was a 2-fold decrease in the incidence of obesity. Such a high efficiency is due to the fact that obesity of the I degree prevailed among the firefighters-rescuers. In addition, the frequency of occurrence of dyslipidemia, hyperglycemia, and hypodynamia decreased.Conclusion. The use of this sports complex can reduce the risk factors for development of disability among rescue firefighters by preventing hypodynamia and reducing the incidence of hyperglycemia and dyslipidemia, as factors in the development of obesity.


2021 ◽  
Vol 74 (4) ◽  
pp. 884-886
Author(s):  
Svitlana Y. Karatieieva ◽  
Nataliia Y. Muzyka ◽  
Karolina I. Yakovets ◽  
Oksana V. Bakun ◽  
Ksenia V. Slobodian

The aim: was to improve the course of purulent wounds in diabetes by using physical therapies. Materials and methods: we investigated 122 patients with diabetes mellitus and wound processes. We divided all patients on the two groups. Our study groups were 50 patients who had therapy by ozone together with other general treatment and surgery treatment (daily dressings, ointments and solutions). Our control groups were 72 patients, who had treated only by general methods and surgery treatment (daily dressings, ointments and solutions).The patients of our explore group had received intravenous injection of saline ozone solution together with other general treatment and surgery treatment (daily dressings, ointments and solutions). Results: it had studied of indicators of oxidative modification of proteins, lipid peroxidation in blood plasma, antioxidant protection during this period, there were no significant changes in these parameters between the control and experimental groups. As the result of the study was found that the leukocyte index of intoxication in patients in the main and control groups was almost indistinguishable. Regarding the indexes of hematological index of intoxication, which decreased during the treatment of patients of the main group, and different from the patients of the control group, in which this indicator increased sharply. The result of the study of changes in the indicators of sorption capacity of erythrocytes showed that the level of sorption capacity of erythrocytes in patients in the main group during treatment, also decreased, compared with patients in the control group. Conclusions: Therefore, the use of ozone in the treatment of patients with complicated forms of diabetes does not cause a negative impact on the dynamics of homeostasis and indicators of the level of intoxication of the body. Ozone therapy has a beneficial effect on the course and wound process in patients with diabetes with purulent processes.


Author(s):  
Yu. O. Novikov ◽  
A. R. Shaiakhmetov ◽  
G. M. Musina

Introduction. In connection with the widespread introduction of osteopathy into practical medicine, new facts confi rming its effectiveness are appearing. These facts need theoretical justifi cation. The biodynamic approach is the least studied and scientifi cally proven approach in osteopathy. There are only a few works describing the benefi cial effects of this type of treatment on the autonomic nervous system based on an assessment of heart rate variability. One of the most sensitive indicators of changes in the state of the body is the electrical activity of the skin (EAS), which is widely used in modern polygraphic devices.Goal of research — to investigate the EAS in the physician and in the patient during the session of craniosacral biodynamics (CSB).Materials and methods. The study involved 32 patients who were randomly divided into 2 groups — control group (10 patients) and main group (22 patients). In the control group there were 8 women and 2 men aged from 20 to 65 years (mean age 42±20 years). In the main group, 16 women and 6 men aged from 18 to 68 years (mean age 40±16 years) were examined. Two professional certifi ed computerized polygraphs «Chris» were used, simultaneously recording the EAS values of the doctor and the patient. In the main group, the background indicators were recorded at the fi rst stage (10 minutes), then the procedure of the CSB, which lasted 20 minutes, was recordered. The control group was used only for registration of EAS. At the same time, patients were in the same conditions as in the main group.Results. During the CSB, the state of both the doctor (p<0,001) and the patient (p<0,001) has changed signifi cantly. At the same time, the tendency of changes in individual indicators of EAS in patients during treatment was logical. The altered state of the physician practically did not depend on its original level (p>0,05). However, there was a high relationship between the states of the doctor during contact and non-contact treatment (correlation coeffi cient 0,80, p<0,001). The patient′s initial condition had a moderate, statistically signifi cant relationship with his condition during the treatment (p<0,001). Since the beginning of the craniosacral biodynamics, the patient′s condition has hardly changed. At the same time, the contactless impact on the patient′s body was comparable with the contact effect (correlation coeffi cient 0,97, p<0,001). There was no signifi cant relationship between the states of the physician and the patient before the beginning of the treatment (correlation coeffi cient 0,18, p>0,05). However, in the process of craniosacral biodynamics, a statistically signifi cant relationship was formed between them with a correlation coeffi cient for non-contact exposure equal to 0,49 (p<0,01) and for contact exposure — 0,34 (p<0,05). Biodynamic treatment statistically signifi cantly improved the state of the autonomic nervous system.Conclusion. The study of the electrical activity of the skin in craniosacral biodynamics is a highly informative method, which allows to verify and quantify the changes occurring in the patient and in the physician during the treatment.


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