scholarly journals Prolactin level correction in restoration of menstrual cycle in obese women

2021 ◽  
pp. 53-58
Author(s):  
T.F. Tatarchuk ◽  
N.V. Kosei ◽  
S.I. Reheda ◽  
M.I. Hlamazda ◽  
I.M. Shakalo
Keyword(s):  
Metabolic Syndrome ◽  
Menstrual Cycle ◽  
Reference Values ◽  
Prolactin Level ◽  
Experimental Studies ◽  
Main Group ◽  
Reproductive Age ◽  
Control Group ◽  
Upper Limit ◽  
Cycle Disorders

Obesity is a common problem among women of reproductive age. There are data from clinical and experimental studies indicating the role of hyperprolactinemia in the development of metabolic syndrome, as well as the metabolic benefits of treating hyperprolactinemia.Research objective: to evaluate the clinical efficacy of Vitex Agnus Castus standardized extract on hormonal and metabolic status in women with menstrual cycle disorders and obesity.Materials and methods. 60 women aged 19 to 35 years with obesity and menstrual cycle disorders with laboratory-confirmed insulin resistance and prolactin near the upper limit of the reference values or was slight increase were examined. All the patients were given recommendations for lifestyle modification. 30 of them, who formed the main group, received Cyclodynon. 30 patients of the control group were not prescribed Cyclodynon therapy.Results. At the end of the treatment, the menstrual cycle was normalized in 93.3% patients of the main group, and in 66.3% patients of the control group (p < 0.05). Ovulation signs were detected in 86.67% women of the main group and only in 30.0% women of the control group (p < 0.05). The mean prolactin value and the HOMA index were significantly lower in the main group; prolactin level did not exceed the physiological values in 86.67% women in the main group after 6 months, and in 40.0% of the control group, p < 0.05. There was a decrease in body mass index and waist/hip circumference ratio in patients of the studied groups; the dynamics was slightly higher in the main group but did not differ significantly. Conclusions. Cyclodynon is effective for the treatment of menstrual cycle disorders and metabolic disorders in women with obesity and metabolic syndrome. Good tolerability, absence of side effects, and sufficient efficacy of Cyclodynon allow it to be recommended as the drug of choice in patients with prolactin levels near the upper limit of the reference values or a slight increase of it and in patients with intolerance to synthetic dopamine agonists.

Clinical experience of non-hormonal correction of the luteal phase deficiency in women of reproductive age

2019 ◽  
pp. 24-26
Author(s):  
T.R. Streltsova ◽  
◽  
N.R. Simonov ◽  
Keyword(s):  
Menstrual Cycle ◽  
Blood Loss ◽  
Luteal Phase ◽  
Main Group ◽  
Reproductive Age ◽  
Control Group ◽  
Second Phase ◽  
Menstrual Disorders ◽  
Women Of Reproductive Age ◽  
Cycle Disorders

The objective: to study the clinical efficacy of two schemes of using the monocomponent herbal preparation Cyclodynon® in women of reproductive age with complaints of various menstrual cycle disorders diagnosed with latent hyperprolactinemia and second phase failure of the menstrual cycle based on the results of clinical and hormonal studies. Materials and methods. The study included 60 patients aged 25–38 years suffering from PMS. The main group (n = 30) received Cyclodynon® in an ascending pattern: from 1 to the 14th day of the menstrual cycle – 40 drops 1 time a day and from the 15th day to the end of the cycle – 40 drops 2 times a day. The control group (n = 30) – 40 drops 1 time per day until the end of the cycle for three menstrual cycles. Results. After 3 months in the main group there was a more significant decrease in the level of prolactin (from 28.3 to 18.4 ng / ml) as compared with the control (from 27.8 to 23.1 ng / ml). Increased progesterone and estradiol production was also more significantly observed in the main group. The dynamics of normalization of the duration of the menstrual cycle and the volume of blood loss was also more significant in the main group and amounted to 93.3%. Conclusion. The use of an increasing treatment regimen with Cyclodynon® in women with a luteal phase deficiency on the background of hyperprolactinemia has advantages over the use of a standard continuous regimen with respect to a more rapid normalization of hormonal homeostasis, the duration of the menstrual cycle and blood loss. Key words: luteal phase deficiency, hyperprolactinemia, menstrual disorders, Cyclodynon®.

The effect of probiotics on the level of immunoglobulin A in women with violation of the biocenosis of the vagina

2017 ◽  
pp. 85-88
Author(s):  
O.I. Ostapenko ◽  
◽  
V.P. Kvashenko ◽  
I.K. Akimova ◽  
I.N. Nosova ◽  
...  
Keyword(s):  
Immunoglobulin A ◽  
Lactobacillus Rhamnosus ◽  
Test System ◽  
Main Group ◽  
Reproductive Age ◽  
Local Action ◽  
Serum Immunoglobulin ◽  
Control Group ◽  
Local Immunity ◽  
Serum Iga

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.

scholarly journals Erythropoietin level in normal and abnormal human seminal fluid

2021 ◽  
Vol 21 (4) ◽  
pp. 54-59
Author(s):  
D. Yu. Sosnin ◽  
K. R. Galkovich ◽  
A. V. Krivtsov1
Keyword(s):  
Seminal Plasma ◽  
Seminal Fluid ◽  
Solid Phase ◽  
Human Sperm ◽  
Test System ◽  
Main Group ◽  
Reproductive Age ◽  
Control Group ◽  
Study Objective ◽  
Synthesis Of Hormones

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.

Genetic associations of the origin and predictive estimation of the acute non-ST segment elevation myocardial infarction in patients with metabolic syndrome

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
N Chumachenko ◽  
E.D Kosmacheva
Keyword(s):  
Myocardial Infarction ◽  
Metabolic Syndrome ◽  
Main Group ◽  
Control Group ◽  
Enos Gene ◽  
Funding Source ◽  
Genetic Associations ◽  
St Segment Elevation ◽  
Segment Elevation Myocardial Infarction ◽  
St Segment

Abstract Background and introduction Metabolic syndrome (MS) is a baseline condition that influencesthe management of patients with coronary heart disease (CHD). The assessment of genotyping characteristics in patients with MS with non-ST segment elevation myocardial infarction (nSTEMI) remains a challenge. Purpose To define characteristics of G Protein β3 subunit gene C825T polymorphism; T786C in the eNOS gene and G894T in the eNOS gene in patients with MS after nSTEMI, evaluate the prognostic specificity of genotypes in a study population. Methods The study included 150 patients with CHD and MS. The main group included 99 patients (69.7% males, a mean age of (67.4±0.7 y))with nSTEMI, preserved left ventricular systolic function who underwent urgent percutaneous coronary intervention. The control group included 51 patients with a mean age of (64.6±1.3 y) without the history of previous myocardial infarction and acute cerebrovascular disease. There was no statistically significant difference between gender and age in two groups (p&gt;0.05). The predictive significance of the main group genotypes was estimated with odds ratio and risk ratio of “cumulative point of undesirable effects” (CPUE) and included: cardiovascular death, acute coronary syndrome, repeat revascularization, hospitalization for congestive heart failure. The accuracy of the genotype distribution corresponded to the Hardy-Weinberg equilibrium (p&gt;0.05). The accuracy of the results was analyzed using Student, χ2, Fisher's criteria. Results We received high patient numbers with CC genotype of eNOS:786 gene in the main group (n=19 (19.2%)) as compared with the controls (n=3 (6.2%)) (p&lt;0.05, φ=0.03), with GG genotype of eNOS:894 (p&lt;0.01, χ2=8.0) in the main group (n=59 (59.6%)) as compared with the controls (n=18 (35.3%)), with CC genotype of eNOS:894 in the control group (n=40 (78.4%)) as compared with the main group (n=56 (56.6%)) (p&lt;0.05; χ2=7.0). Patients who were heterozygous for eNOS:894 gene prevailed in the main group (n=30 (30.3%)) as compared with the controls (n=27 (52.9%)) (p&lt;0.01, χ2=7.3). The statistically significant CPUE was more frequent diagnosed in patients with TT genotype of GNβ3:825 (OR=12.00, 95% confidence interval ((CI): 2.8–51.7, p&lt;0.05), CC genotype of eNOS:786 (OR=5.1, 95% CI: 1.3–20.0, p&lt;0.05) and TT genotype of eNOS:894 (OR=8.0, 95% CI: 1.8–35.2, p&lt;0,05). Conclusions 4 practically applicable categories of reviewed genotypes were found: 1) nSTEMI - -protective: CC genotype for GNβ3:825 gene, GT – eNOS:894, 2) nSTEMI – unfavorable: CT–GNβ3:825, CC – eNOS:786 and GG – eNOS:894, 3) CPUE – unfavorable: TT – GNβ3:825, CC – eNOS:786, TT – eNOS:894, and 4) nSTEMI, CPUE-neutral: TT and TC – eNOs:786. CC – eNOS:786 genotype is separated as unfavorable for the development of both nSTEMI and CPUE. More studies are necessary for a personified approach, taken into account the obtained features of genetic associations. Funding Acknowledgement Type of funding source: Public Institution(s). Main funding source(s): Scientific Research Institute - S.V. Ochapovsky Clinic Regional Hospital #1, Krasnodar

scholarly journals CHARACTERISTICS OF METABOLIC PROCESSES IN THE FORMATION OF MENSTRUAL FUNCTION DISORDERS IN ADOLESCENT GIRLS WITH OBESITY

2021 ◽  
Vol 11 (4(42)) ◽  
pp. 28-33
Author(s):  
A. Borshuliak ◽  
O. Andriets ◽  
A. Andriets ◽  
A. Semeniak
Keyword(s):  
Insulin Resistance ◽  
Body Mass Index ◽  
Body Weight ◽  
Menstrual Cycle ◽  
Body Mass ◽  
Adolescent Girls ◽  
Main Group ◽  
Leptin Resistance ◽  
Control Group ◽  
Menstrual Dysfunction

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.

scholarly journals ПОРУШЕННЯ ВАРІАБЕЛЬНОСТІ СЕРЦЕВОГО РИТМУ ЯК МЕТОД ОЦІНЮВАННЯ АДАПТАЦІЙНИХ РЕАКЦІЙ ОРГАНІЗМУ ВАГІТНИХ ПРИ НАЯВНОСТІ ШКІДЛИВИХ ЗВИЧОК

2018 ◽  
Author(s):  
V. H. Korniienko ◽  
A. S. Fitkalo
Keyword(s):  
Heart Rate ◽  
Heart Rate Variability ◽  
Nervous System ◽  
Pregnant Women ◽  
Cardiac Rhythm ◽  
Main Group ◽  
Reproductive Age ◽  
Control Group ◽  
Cardiac Rhythm Variability ◽  
Adaptive Reactions

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.

scholarly journals Endometrial E-cadgerin Expression in Women with Reproductive Dysfunctions and Healthy Fertile Women with Ovulatory Menstrual Cycle

2019 ◽  
Vol 6 (3) ◽  
pp. 44-52 ◽  
Author(s):  
S. S. Aganezov ◽  
V. N. Ellinidi ◽  
A. V. Morotskaya ◽  
A. S. Artemyeva ◽  
A. O. Nuganen ◽  
...  
Keyword(s):  
Menstrual Cycle ◽  
Endometrial Biopsy ◽  
Main Group ◽  
Control Group ◽  
Luminal Epithelium ◽  
History Of ◽  
Design And Methods ◽  
To Receive ◽  
Fertile Women ◽  
E Cadherin

Background. E-cadherin is known as one of the endometrial receptivity biomarkers.Objective: to conduct a comparative analysis of the endometrial E-cadherin expression in healthy fertile women and patients with reproductive dysfunctions with the ovulatory menstrual cycle.Design and methods. The main group consisted of patients with infertility (n = 81) and early pregnancy loss (n = 40), the control group — of 16 healthy fertile women. All subjects underwent endometrial biopsy and venipuncture to receive peripheral blood sample (to determine estradiol and progesterone levels) at 6–8 days after ovulation. Endometrial specimens were assessed by histological and immunohistochemical (evaluation of e-cadherin expression) methods.Results. In patients with reproductive failure, the frequency of apparent E-cadherin expression in the luminal (89 %, n = 84 out of 94) and glandular (74 %, n = 89 out of 121) epithelium did not differ from the corresponding indicators in fertile women (luminal epithelium — 94 %, n = 15 out of 16, gland — 88 %, n = 14 out of 16) (p > 0.05 for all indicators). The frequency of reduced E-cadherin endometrial expression was similar in patients of the main group with complete secretory transformation of the endometrium (1), incomplete secretory transformations (2) and in healthy women (3): respectively in the luminal epithelium — 7 % (n = 3 out of 43) (1), 14 % (n = 7 out of 52) (2), 6 % (n = 1 out of 16) (p > 0.05); in the glands — 20 % (n = 10 out of 51) (1), 31 % (n = 22 out of 70) (2), 13 % (n = 2 out of 16) (3) (p > 0.05).Conclusion. In patients with the history of reproductive disfunctions freaquency of lower/higher E-cadherin expression was similar to those in healthy fertile women.

scholarly journals Genital endometriosis and melatonin: a role in the pathogenesis and its possible use in the treatment of the disease

2019 ◽  
Vol 68 (3) ◽  
pp. 51-60 ◽  
Author(s):  
Maria I. Yarmolinskaya ◽  
Saimat Sh. Tkhazaplizheva ◽  
Arseniy S. Molotkov ◽  
Natalia N. Tkachenko ◽  
Valentina L. Borodina ◽  
...  
Keyword(s):  
Menstrual Cycle ◽  
Melatonin Receptors ◽  
Reproductive Age ◽  
Control Group ◽  
Eutopic Endometrium ◽  
Relative Expression ◽  
Treatment Regimens ◽  
Daily Urine ◽  
New Treatment

Hypothesis/aims of study. Melatonin is found in almost all living organisms, the range of its effects being quite diverse. Effects of this hormone in the human body are realized via two ways, through specific receptors and non-receptor pathways. Melatonin may act through both membrane and nuclear receptors. In the present work, the expression of MTR1 and MTR2 melatonin receptors was studied in the eutopic endometrium and endometrioid heterotopies, and the level of melatonin metabolite, 6-sulfatoxymelatonin, in daily urine in patients with genital endometriosis (GE) was analyzed. Study design, materials and methods. The experimental group included 67 patients of reproductive age with a verified diagnosis of GE, and the control group consisted of 18 individuals with an ovulatory menstrual cycle without gynecological pathology. The 6-sulfatoxymelatonin level in daily urine was determined by enzyme immunoassay. The study of MTR1 and MTR2 melatonin receptor expression in the endometrium and endometrioid heterotopies was performed in 24 patients with GE and in 10 women of reproductive age who were examined for infertility who did not have gynecological pathology based on diagnostic laparoscopy. To study the expression of melatonin receptors, the endometrium and endometrial heterotopy sampling was carried out from day 18 to day 22 of the menstrual cycle. Morphological assessment included histological and immunofluorescence studies using confocal laser scanning microscopy. Results. In patients with GE, there was found a tendency to a decrease in 6-sulfatoxymelatonin excretion in daily urine compared to the control group. It was also found that the total relative expression area of melatonin receptors in the endometrium of women with GE was significantly lower compared to the endometrium of patients from the control group. Significant differences between the average brightness and optical density were not found. In addition, it was revealed that the relative expression areas of MTR1 and MTR2 melatonin receptors in the eutopic endometrium and in endometrioid heterotopies did not differ significantly. A negative correlation was stated between the relative expression area of melatonin receptors and GE prevalence. Particular attention is paid to the role of melatonin in the development of GE and to the possibilities of working out new treatment regimens with its use. Conclusion. The data obtained confirm the undoubted role of melatonin in the pathogenesis of GE, however, the development of new treatment regimens with its use requires further study.

scholarly journals Fetoplacental complex parameters’ changes during repeated increase of the blood volume in female rabbits

2020 ◽  
Vol 11 (6) ◽  
pp. 37-44
Author(s):  
Nataliya G. Pavlova ◽  
Anastasiya A. Yakovleva
Keyword(s):  
Blood Volume ◽  
Functional State ◽  
Saline Solution ◽  
Experimental Studies ◽  
Main Group ◽  
Placental Insufficiency ◽  
New Drugs ◽  
Control Group ◽  
Fetoplacental Complex ◽  
Preclinical Trials

One of the mandatory stages of introducing new drugs into obstetric practice is preclinical trials, the purpose of which is to study the effect of drugs on the development of fetuses and placentas. When conducting experimental studies, the main group of animals receiving the drug is compared with the control group of animals that do not receive drugs. At the same time, the volume of the test drug itself can significantly change the blood volume (BV) of an experimental animal, especially a small one, and such administration repeated repeatedly over several days can accumulate this effect, having an adverse effect on the functional state of the fetus. A model of chronic placental insufficiency created on the 18th day of pregnancy in female rabbits by ligating 1/3 of the preplacental vessels in one uterine horn was used to study the effect on the development of the brain and placenta of normally developed and retarded fetuses of multiple daily (1928 days of pregnancy) infusions of saline solution to females in a volume of 6% of the animals BV and comparable to the volume of medications used in the treatment of placental insufficiency in clinical practice (main group of rabbits). It was found that repeated daily administration of saline solution to a female rabbit in the second half of pregnancy, which is about 6% of the BV, causes a violation of the functional state of her normally developed and, to an even greater extent, retarded fetuses. This is manifested by a 1.4-fold reduced survival rate of fetuses in the intact horn of the uterus and a more pronounced violation of brain metabolism in fetuses of the intact and experimental horns compared to those of the control group of females.

scholarly journals ДЕСТРУКТИВНИЙ УСКЛАДНЕНИЙ ПОЛІОНІХОМІКОЗ І ВРОСТАННЯ НІГТІВ: КЛІНІКО-БІОХІМІЧНІ ПАРАЛЕЛІ (КЛІНІЧНІ СПОСТЕРЕЖЕННЯ)

2018 ◽  
Author(s):  
A. R. Vergun ◽  
B. M. Parashchuk ◽  
M. R. Krasnyi ◽  
O. M. Vergun ◽  
Z. M. Kit ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Metabolic Syndrome ◽  
Conservative Treatment ◽  
Nail Plate ◽  
Main Group ◽  
Control Group ◽  
Homa Index ◽  
Complex Treatment ◽  
System Therapy ◽  
Ingrown Nail

Causes of unsatisfactory outcomes of ingrown nail and mycotical pathology complex treatment were insufficiently studied for approaches to preventing relapses. The need for complex research on surgical nail pathology is primarly determined by a large number of clinical observations of uncomplicated and complicated cases, especially relapses. The mycotic paronychia and the chronic subungual abscess are compressed along the nail edge. Not all surgical procedures that have been successfully treated paronychia you can apply for the correction of ingrown nail. Late compression relapses with monoonychocryptosis are 5–18 %, and with ingrown nail combined with onychomycosis – 30–70 %, which is also confirmed by our previous studies. Fungal infections of the nails (onychomycosis) in combination with ingrowth remain one of the most serious problems of dermatology and dermatological surgery. In domestic literature there is a significant number of works devoted to pathology of the nail plate, however, the surgical aspects of the onychology are assigned a minimal, secondary role.The aim of the study – optimal sequence of surgical treatment, local and system antimycotic therapy, clinical and biochemical parallels after moving away of the incarnated nails at trichophytosis and destructive polyonychomycosis, complicated by the secondary ingrown nail for some patients with the complicated defeat of nails.Materials and Methods. Over a five-year period 436 unguis incarnates diagnosis (among them 325 cases of incarnated multifocal mycotical-assotiated nail pathology – the main group, included sub-selections of patients with diabetes mellitus and metabolic syndrome) in 259 men and 177 women 28–86 years old were performed. Adequate system therapy of patients with comorbid diabetes mellitus and metabolic syndrome was carried out. In 182 patients late relapses of onychocryptosis were confirmed after previous surgeries at other clinics. Conservative treatment was recommended only at early stages of ingrowth. Removal of the affected nails was performed in patients with mycotic lesions (local and systemic fungicide therapies were used). Investigation of the morphogenesis of destructive aspect of the mycotic lesions was carried out. The analysis justifies the feasibility of establishing predictive relationships between clinical variants of chronic purulent necrotic infections and combined comorbidity.Results and Discussion. 363 cases of destructive purulent-necrotic superficial chronic, combined and combined lesions of the distal phalange of the toes with nail plate ingrowth were studied in patients aged 12–75 years, 236 men and 127 women operated in surgical departments were investigated. All surgical procedures are performed correctly according to local protocols. Nosological forms of lesions are associated with some degree of onychocryptosis, according to the dominant clinical manifestations of ICD 10 were divided into sub-samples – actually onychocryptosis, dermatophytosis and candidal onychomycosis with incarnation of the nail. Other 73 patients with uncomplicated mycosis some conservative treatment were performed correctly according to local protocols. Analysis of subonychial scraping allowed stating the prevalence of red trichophytia, where in 74 % of cases it was associated with mold, in 26 % cases it was associated with yeast fungi; and in 31 % cases – with the bacterial flora; applied 4 "pulses" of itraconazole 400 mg/day. We studied some indicators in the lipid profile, which were significantly higher in both groups of patients, p <0.01 for both groups; noted the positive correlation between the level of total cholesterol and leptin (p <0.01). The concentration of high-density lipoprotein cholesterol in patients of the main group – (5.2±0.1) mmol/L compared with patients in control group – (2.8±0.2) mmol/L. The average content of nitrogen oxide in the study group (metabolic syndrome) was higher than that in healthy patients – (15.1±0.9) mcmol/L, p <0.05. Patients of the main and the comparison groups with type 2 diabetes mellitus with ingrown polyonychomycosisexperienced considerable decreasing HOMA -index of β-cells function and increasing HOMA -index of insulin resistance (8.11±1.1) in the main group and (2.2±1.2) in the control group). The late unsatisfactory results of the complex treatment of destructive onychomycosis associated with incarnation (occurrence of compression relapses) are determined by the technical errors of the operation interventions (inadequate selection of the method and volume of resection, traumatic performance of onychectomy, failure to perform partial matrixectomy), disregard of pathogenetic and morphogenetic factors of destructive onychomycosis, the refusal to perform simultaneous surgical interventions on deeply placed structures in case of combined mycotic-associated lesions, ineffective pre- and intraoperative prophylactic actions to prevent spreading mycotic infection to deeply placed structures.Conclusions. In all cases of mycotic onychocryptosis (secondary ingrown toenail) underwent a comprehensive treatment of comorbid pathology, system therapy of itraconazole to operative treatment (basic onychial defeats sanation) and in a postoperative period was carried out, some patients with combined pathology got 4 seven-day system "pulses" of 400 mg/day itraconazole therapy. Sanation of other nails for prevention of mycotic reinfection was carried out by ciclopirox or amorolfine lacquer. We recommend using more radical and effective three-component surgical methods: nail resection or removal of the nail plate, supplemented by excision of pathologically altered eponycheal tissues and partial marginal matrixectomy in the area of ingrowth. In patients, the low-impact methods of excision of the nail and partial marginal matricectomy by mechanical carving and coagulation with the further dermatophytoma scraping off with the Volkmann spoon were embedded and applied.

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