EXPERIENCE OF LONG-TERM USE OF DIENOGEST FOR THE TREATMENT OF ADENOMYOSIS

2021 ◽  
pp. 92-99
Author(s):  
Kalinkina O.B. ◽  
Tezikov Yu.V. ◽  
Lipatov I.S. ◽  
Aravina O.R.
Keyword(s):  
Drug Therapy ◽  
Clinical Manifestation ◽  
Clinical Manifestations ◽  
Pain Syndrome ◽  
Management Plan ◽  
Uterine Bleeding ◽  
Dynamic Monitoring ◽  
Good Tolerability ◽  
Selection Of

Endometriosis refers to a chronic, often recurrent disease that requires the appointment of a long-term management plan and the patient with the appointment of therapy that effectively affects the clinic of this disease, at the same time having good tolerability, ensuring the patient's adherence to this method of treatment. This dictates the need for careful selection of a drug that meets such requirements. Moreover, studies of drug therapy for endometriosis should also be prolonged. In this case, they allow you to qualitatively assess the effectiveness of a particular type of treatment in the context of routine clinical practice. The main clinical manifestations of endometriosis of the uterine body-adenomyosis are pain syndrome, manifested by various types of pain (dysmenorrhea, dyspareunia, dyschesia, chronic pelvic pain) and the presence of abundant uterine bleeding. The presented clinical case demonstrates the effectiveness of long-term (for 36 months) use of dienogest at a dosage of 2 mg per day (the drug Vizanna) in a continuous mode in the treatment of a patient with adenomyosis. By the 4th month of therapy, the pain syndrome, manifested by dysmenorrhea and dyspareunia, which is the leading clinical manifestation of this pathology in the patient, was completely stopped. The proposed type of therapy has also demonstrated its effectiveness in relation to another clinical manifestation of the disease - heavy uterine bleeding. By the 6th month of therapy, the patient had developed persistent amenorrhea. Good tolerability and the absence of side effects, along with a pronounced clinical effect, led to a high adherence of the patient to this type of drug therapy and allowed her to continue it in the future with dynamic monitoring.

scholarly journals Elimination of pain syndrome in patients with advanced pancreatic head cancer

2019 ◽  
Vol 42 (1) ◽  
pp. 46-52
Author(s):  
T. G. Gevorkyan ◽  
I. A. Feinstein
Keyword(s):  
Quality Of Life ◽  
Pancreatic Cancer ◽  
Drug Therapy ◽  
Cancer Patients ◽  
Clinical Manifestations ◽  
Pancreatic Head ◽  
Pain Syndrome ◽  
Pancreatic Head Cancer ◽  
Surgical Methods

Pain syndrome, along with mechanical jaundice, is one of the most evident clinical manifestations of pancreatic cancer and is often a sign of tumor neglecting. Existing treatment options for chronic pain in cancer patients are diverse and include the various ways of impact on the different links of pathological pain: medicinal, endoscopic, surgical. With this pathology, drug therapy using analgesics, weak and strong opioids, is usually not effective enough. In such cases, preference is given to chemical neurolysis — denervation of the autonomic structures of the retroperitoneal space, carried out under the guidance of ultrasound or computed tomography. Conducting percutaneous neurolysis of the celiac plexus with the use of alcohol or phenol is prescribed upon insufficient effectiveness of pharmacotherapy. Surgical methods of anesthesia are used extremely rarely, as they considerably worsen the patient’s condition, without significantly affecting the quality of life or the prognosis. Thoracoscopic splanchnicectomy is considered a modern and effective method of endoscopic treatment of pain in unresectable pancreatic cancer, the conduction of which can significantly decrease the intensity of pain, reduce the number of narcotic analgesics and improve the quality of life of cancer patients. This minimally invasive intervention is the basis for the subsequent lifelong systemic drug therapy.

scholarly journals Evaluation of the efficacy of a vitamin B complex supplement in the combination treatment of lumbar radiculopathy

2021 ◽  
pp. 42-47
Author(s):  
Yu. N. Maksimov ◽  
D. Kh. Khaibullina ◽  
F. I. Devlikamova
Keyword(s):  
Quality Of Life ◽  
Clinical Manifestations ◽  
Pain Syndrome ◽  
Economic Losses ◽  
Lumbar Radiculopathy ◽  
Good Tolerability ◽  
Treatment Regimens ◽  
Complex Therapy ◽  
Group 1

Introduction. Radiculopathy is one of the causes of neuropathic pain. Among the causes of back pain, lumbar radiculopathy ranks second after non-specific musculoskeletal pain. Patients with radiculopathy have a marked decrease in the quality of life, a tendency to disability, which causes a large amount of diagnostic and therapeutic measures and associated economic losses. There is no unified view on the pathogenesis of radiculopathy, and the pain syndrome includes neuropathic and nociceptive components. The proposed treatment regimens for radiculopathy differ and are of a recommendatory nature.The purpose of the retrospective observational study was to study the effectiveness of the drug Neurobion® in the complex therapy of radiculopathy.Materials and methods. The study of outpatient records of 120 patients aged 25–65 years, suffering from lumbosacral radiculopathy was performed. The patients were divided into 2 groups and received basic therapy, which included NSAIDs, simple analgesics, muscle relaxants, and anticonvulsants. Patients of group 1 additionally received the drug Neurobion®.Results and discussion. Faster regression of clinical manifestations was observed in group 1 patients. The results of treatment in group 1 patients were higher both in terms of subjective feelings and objective criteria. The presence of two medicinal forms of Neurobion® allows a personalized approach to the patient’s therapyConclusions. The use of the drug Neurobion® is pathogenetically justified in the treatment of radiculopathy, provides earlier positive dynamics of subjective feelings of patients and objective indicators, improves the quality of life, leads to shorter treatment periods, reducing economic costs. The effectiveness and good tolerability of the drug Neurobion® allow us to recommend it for inclusion in the complex therapy of radiculopathy. 

scholarly journals THE ROLE OF URSODEOXYCHOLIC ACID IN THE TREATMENT OF CHRONIC VIRAL HEPATITIS

2017 ◽  
pp. 31-35
Author(s):  
R. G. MYAZIN
Keyword(s):  
Viral Hepatitis ◽  
Ursodeoxycholic Acid ◽  
Safety Profile ◽  
Clinical Manifestations ◽  
Chronic Viral Hepatitis ◽  
Good Tolerability ◽  
Effective Prevention ◽  
Term Administration

Along with etiotropic antiviral therapeutic schemes, treatment of chronic viral hepatitis today involves administration of medications that eliminate the clinical manifestations of the disease. In particular, the use of ursodeoxycholic acid (Urdoxa®), with its high safety profile and good tolerability in case of long-term administration, is justified for the effective prevention of cholestasis.

scholarly journals Results of the Preformed Physical Factors Application in the Rehabilitation Treatment of Corneal Ulcerative Defects

2021 ◽  
Vol 20 (4) ◽  
pp. 126-132
Author(s):  
Olga V. Yurova ◽  
Yaroslav A. Soloviev ◽  
Tatiana V. Konchugova
Keyword(s):  
Visual Acuity ◽  
Drug Therapy ◽  
Low Frequency ◽  
Pain Syndrome ◽  
Control Group ◽  
Physical Factors ◽  
Standard Drug ◽  
Corneal Ulcers ◽  
Combined Use

Currently, an infectious corneal ulcer, a defect in the corneal epithelium, remains one of the main causes of monocular blindness,which necessitates the development of new effective methods of treatment. Aim. To develop and evaluate the effectiveness of the technique for the complex application of preformed physical factors of local andsegmental action in patients with corneal ulcers. Material and methods. The study involved 85 patients with corneal ulcers aged 18 to 60 years divided into three groups. Patients ofthe control group (29 people) received the standard drug therapy, the comparison group (29 people) underwent a course of magnetophoresiswith solcoseryl on closed eyelids against the background of standard drug therapy, patients of the main group (27 people)received standard drug therapy, magnetophoresis and low-frequency electrostatic fields on the collar area. All patients were evaluatedfor visual acuity, the size of the ulcer and the area of stromal infiltration. The subjective severity of pain syndrome (VAS scale),psychoemotional state (SAN test) were assessed. Statistical analysis of the data was performed using SPSS Statistics v.25. Results. Immediately after treatment, the use of preformed physical factors made it possible to shorten the period of the ulcer epithelializationand suppression of the inflammatory reaction in the cornea, which significantly improved the clinical and functionalparameters of the eye, as well as considerably reduced the severity of pain syndrome in comparison with standard drug treatment. Conclusion. In the long-term period, the use of preformed physical factors contributed to a significant decrease in the size of thecorneal infiltration area (residual opacities) and an improvement in the quality of life of patients according to the General MentalWellbeing scale, which exceeded the effectiveness of standard drug therapy, while the combined use of a low-frequency electrostaticfield and magnetophoresis allowed to noticeably improve the indicators of visual acuity in comparison with standard drug therapyand isolated use of magnetophoresis.

scholarly journals Conservative treatment of traumatic injuries of the rotatory-bicepital complex

2019 ◽  
Vol 16 (1) ◽  
pp. 7-12
Author(s):  
О. A. Danilenko ◽  
E. R. Makarevich ◽  
N. S. Serdiuchenko
Keyword(s):  
Conservative Treatment ◽  
Clinical Manifestations ◽  
Pain Syndrome ◽  
Regional Hospital ◽  
Long Term Results ◽  
Treatment Results ◽  
Traumatic Injuries ◽  
Treatment Indications

The effectiveness of the developed approaches to the conservative treatment of traumatic injuries of the rotatory-bicepital complex is assessed. The long-term results of conservative treatment of 29 patients for the period from 2004 to 2017 and treated in the Mogilyov regional hospital and the SCTC of the 6th Minsk city clinical hospital were studied. The conservative treatment indications were considered to be the cases with traumatic partial local or extensive injuries of the rotator-bicepital complex in the presence of clinical manifestations in the form of pain syndrome and limitation of limb movements and in the absence of a decrease in limb strength in the sectoral testing of elements. The proposed tactical approaches implied immobilization, physiotherapy, local injection therapy.The developed conservative approaches to treating patients with damage to the rotary element of RBC allowed one to achieve a favorable outcome in the absolute majority of cases with long periods of patient follow-up, which improved the performance evaluation indicators according to the Oxford questionnaire for Me shoulder from 56 [48–58] to 12 [12–32] (Me [Q25–Q75]). The applied conservative approaches to treating patients with damage to the rotary element of RBC are a promising way to improve the clinical treatment results of patients with partial injuries of the rotator-bicepital complex.

scholarly journals The dynamics of quality of life in young patients with vertebrobasilar insufficiency and pathobiomechanical changes in the musculoskeletal system against the background of complex non-drug therapy

2018 ◽  
Keyword(s):  
Cervical Spine ◽  
Drug Therapy ◽  
Musculoskeletal System ◽  
Affective Disorders ◽  
Myofascial Pain ◽  
Young Patients ◽  
Clinical Manifestations ◽  
Pain Syndrome ◽  
Myofascial Pain Syndrome ◽  
Sf 36

The main reason for the development of dysgemic disorders in the vertebrobasilar system in young people is pathobiomechanical changes in the cervical spine and myofascial pain syndrome of the cervico-brachial localization. The aim of the study was to study the dynamics of life quality in young patients withVBI, biomechanical disorders of the cervical spine and myofascial pain syndrome of the neck and shoulder localization on the background of complex non-drug therapy (biomechanical correction of the musculoskeletal system, medical exercises, acupuncture and the dry needling). 83 patients (mean age – 37,4 ± 4,8 years) with clinical manifestations of VBI on the background of pathobiomechanical changes of the cervical spine and myofascial pain syndrome of the neck-brachial localization were investigated. They were divided into 2 groups depending on the chosen treatment strategy: 1 group - 42 patients, in the treatment of which were used complex non-drug therapy, 2 group - 41 patients, in the treatment of which were used drug therapy (nicergoline 30 mg / day, meloxicam 15 mg / day). The control group consisted of 20 healthy individuals (37 ± 3,7 years). Evaluation of the severity of VBI according to the VBI scale, vertebro-neurological examination with the calculation of the muscle syndrome index, pain syndrome assessment (VAS), affective disorders (HADS), quality of life (MOS SF-36) in the dynamics - before the start of therapy, at 11 and on the 31st day after the start of therapy. The results of evaluating QOL using the MOS SF-36 questionnaire in young patients with VBI on the background of pathobiomechanical changes in the musculoskeletal system showed a significant decrease in all indicators of the questionnaire scales, which is associated with the presence of clinical manifestations of VBI in these patients, as well as painful , musculo-tonic syndrome of neck and shoulder localization and affective disorders. The use of complex non-drug therapy in the treatment of these patients, aimed at the biomechanical correction of the musculoskeletal system and the elimination of myofascial pain of neck and shoulder localization, has contributed to a more effective regression of manifestations of VBI, affective disorders, pain and musculo-tonic syndrome, leading to a significant increase in all indicators of QOL and had advantages over traditional treatment with the use of vasoactive drugs and non-steroidal anti-inflammatory drugs.

Analysis of the severity of clinical manifestations of endometriosis in the long term after radical surgical treatment

2021 ◽  
Vol 50 (4) ◽  
pp. 21-24
Author(s):  
V. I. Konovalov ◽  
A. V. Vorontsova
Keyword(s):  
Comparative Analysis ◽  
Surgical Treatment ◽  
Clinical Manifestations ◽  
Pain Syndrome ◽  
Pelvic Area

Comparative analysis of the endometriosis main clinical manifestations (pain syndrome in the small pelvic area, menstrual and generative functions disorders, adjacent organs dysfunction) has been carried out in 111 women in long-term period after efficient operative interventions and 371 women with endometriosis who didnt get any treatment. None of the above-mentioned methods of the efficient surgical treatment turned to be optimal (long-term and effective) for cutting short the main clinical manifestations of endometriosis.

Algorithm for management of patients of the period of menopausal transition with recurrence of anomalous uterine bleeding associated with beneficial proliferative changes of endometry

GYNECOLOGY ◽  
2020 ◽  
Vol 22 (3) ◽  
pp. 49-54
Author(s):  
Sergei D. Sinchikhin ◽  
Ekaterina V. Kostenko ◽  
Lusine V. Stepanyan
Keyword(s):  
Clinical Laboratory ◽  
Morphological Changes ◽  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
Menopausal Transition ◽  
Dynamic Monitoring ◽  
Results Of Treatment ◽  
Third Stage ◽  
Uterine Mucosa ◽  
Selection Of

Aim. To compile an algorithm for managing patients during the menopausal transition with a relapse of abnormal uterine bleeding associated with benign proliferative changes in the endometrium and evaluate its outcomes. Materials and methods. The observation of 150 patients aged 4555 years who had recurrence of abnormal uterine bleeding due to benign proliferative changes of the endometrium. All patients underwent hysteroresectoscopic ablation of the endometrium according to the monopolar coagulation-vaporization technique using Olympus equipment (Japan). The patients were divided into two groups. One group was formed by 98 women who, before hysteroscopic ablation of the endometrium, received hormonal preparations for 14 months, with the help of which suppressive changes in the uterine mucosa up to 34 mm were achieved. The other group consisted of 52 patients of the menopausal transition who did not receive preoperative drug therapy, and the thinning of the endometrium before hysterectomy was performed instrumentally. After hysteroresectoscopy, the period of clinical and instrumental observation was 2 years. Results. Based on the results of the study, an algorithm has been compiled for the treatment of women during the menopausal transition with abnormal uterine bleeding, including at the first stage a clinical, laboratory and instrumental examination with the selection of a group of patients to be treated by endometrial ablation, and at the second stage, measures for the preoperative thinning of the uterine mucosa, at the third stage performing hysteroresectoscopic ablation of the endometrium; and at the fourth stage dynamic monitoring during ie 2 years. The preoperatively achieved medical atrophy of the endometrium, followed by hysteroresectoscopy, contributes to an improvement of 20.3% in the results of treatment of patients in comparison with mechanical thinning of the endometrium before hysteroresectoscopy. In general, the developed algorithm increases the effectiveness of anti-relapse treatment to 92.8%. Conclusion. In practical health care, the proposed algorithm should be used, including successive steps. Following the algorithm, a differentiated approach to the choice of therapeutic tactics is carried out, taking into account not only morphological changes in the endometrium, but also the associated gynecological and somatic pathology of the patient, as well as justifying the conduct of preoperative preparation for hysteroresectoscopic ablation of the endometrium and determining the order of subsequent dynamic observation.

scholarly journals Abdominal pain syndrome and quality of life in patients with cholelithiasis after cholecystectomy during a 10-year follow-up

2017 ◽  
Vol 89 (2) ◽  
pp. 70-75
Author(s):  
Yu V Makarovа ◽  
N V Litvinova ◽  
M F Osipenko ◽  
N B Voloshina
Keyword(s):  
Quality Of Life ◽  
Abdominal Pain ◽  
Time Course ◽  
Clinical Manifestations ◽  
Pain Syndrome ◽  
Assess Quality ◽  
Group 1

Aim. To estimate the incidence of abdominal pain syndrome (APS) and to assess quality of life (QOL) in patients within 10 years after cholecystectomy (CE). Subjects and methods. This investigation is part of a long-term prospective follow-up study of patients after CE for cholelithiasis (CL). It enrolled 145 people: 30 (21.5%) patients with baseline asymptomatic CL and 115 (80.7%) with its clinical manifestations. The time course of changes in APS and QOL were analyzed. Results. Over 10 years, all the patients showed a decrease in the incidence of APS from 84.1% (n=95) to 66.4% (n=75; p=0.004). In Group 1 (n=89), APS was at baseline detected in all the patients; 10 years later, its incidence declined to 67.4% (n=60; p < 0.001). Biliary pains were predominant; these had been identified significantly less frequently over the 10-year period in 47 (52.8%) patients; p

scholarly journals Impact of different methods of treatment of hip osteoarthritis on the clinical manifestations during short- and long-term observation

2018 ◽  
Vol 22 (1) ◽  
pp. 77-82
Author(s):  
V.G. Lutsyshyn ◽  
A.V. Kalashnikov ◽  
O.V. Maiko ◽  
V.M. Maiko
Keyword(s):  
Hyaluronic Acid ◽  
Motor Function ◽  
Observation Interval ◽  
Clinical Manifestations ◽  
Hip Osteoarthritis ◽  
Pain Syndrome ◽  
Treatment Regimens ◽  
Long Term Prognosis ◽  
Long Term Observation

The course of coxarthrosis, its short-term and long-term prognosis remains sufficiently unknown, and the influence of one or another method of treatment on the course of the disease and the time of onset of irreversible changes is still the subject of scientific research. The aim of the study is to evaluate the dynamics of clinical data in patients with the initial stages of coxarthrosis in the observation interval of 1–5 years with various treatment regimens that include both medical therapy and arthroscopic intervention. The analysis of the dynamics of clinical parameters (using the modified Harris scale) in the course of various treatment methods (non-steroidal anti-inflammatory drugs with / without chondroprotector or hyaluronic acid) with a group of arthroscopically operated patients was carried out after 1, 3 and 5 years from the diagnosis of 225 patients with initial stages coxarthrosis. All quantitative data obtained are processed by variational statistics methods (Wilkoxon test for 2 groups of dependent populations and Mann-Whitney U-test for 2 groups of independent populations). It has been established that the combination of NSAID therapy with symptom-modifying delayed-action drugs contributes to the solution of individual therapeutic problems in patients with coxarthrosis during the short and medium term observation period. Reception of chondroprotectors improves the effectiveness of pain control, intra-articular administration of hyaluronic acid contributes to a longer preservation of the motor function of the affected joint. The most effective method in overcoming the progression of loss of motor function of the hip joint and increasing the intensity of the pain syndrome is arthroscopic treatment. The obtained data allow us to state that arthroscopy has a pathogenetic and preventive orientation, slows the progression of the disease and, as a consequence, improves the patient's quality of life.

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