Prevention of peritoneal pelvic adhesion formation in women of reproductive age

The objective: a prevention of the peritoneal pelvic adhesions formation in women of reproductive age in the postoperative periodMaterials and methods. 132 women with tubal infertility were examined: І group – main one (n=68) and ІІ group – comparison group (n=64). In the postoperative period, the patients of the main group received treatment and prevention measures according to the developed approach (intraoperative administration of anti-adhesion gel 50 ml and 1 suppository of the tiotriazolin a day rectally from the 1st day after surgery for 14 days), and the comparison group – according to the traditional approach. 30 healthy women were examined as a control group.The level of fibrinogen, fibrinogen /fibrin degradation products (FDP), protein-bound hydroxyproline and free hydroxyproline were studied in blood. Pain syndrome was assessed on a 10-point scale.Results. An increase in fibrinogen and FDP levels in the plasma of all examined women were found. But in the main group the concentration of FDP from 4 hours after intervention was significantly higher (5.31±0.24 mg/l) compared to the comparison group (4.53±0.17 mg/l). The level of protein-bound hydroxyproline in the blood serum of the examined women demonstrated its significant increase in the comparison group 12 hours after surgery, with a maximum after 24 hours and maintaining the concentration in 1.9 times higher after 3 days (p<0.05). The level of free hydroxyproline in the main group was significantly (in 1.4–1.6 times) higher than in the comparison group.The increase of the fibrinolytic capacity (p<0.05) in the peritoneal fluid was found during postoperative period. The period of hyperemia in II group lasted 2 times longer than in I group. Also, II group predominates in the number of patients with hyperthermia for more than 3 days – 10 (15.6 %), compared with I group – 4 patients (5.8 %). The duration of stay in the hospital dominated in II group with a standard treatment regimen in the postoperative period – 3.1 %, compared with I group – 1.9 %.The patients after operation in I group evaluated postoperative pain on average by 1.8 points (p=0.00), in II group – at 3.6 points (p=0.06). Synthetic opioid analgesics and nonsteroidal anti-inflammatory drugs were administered intramuscularly for analgesia. The patients in II group required more injections per patient.Conclusions. The proposed approach is effective, pathogenetically reasonable and can be used as a pathogenetic prevention of adhesions formation in women of reproductive age.

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CURRENT ASPECTS OF DIAGNOSTICS AND TREATMENT OF ACUTE BILLARIAN PANCREATITIS

Medical Science of Ukraine (MSU) ◽

10.32345/2664-4738.3-4.2018.10 ◽

2018 ◽

Vol 14 (3-4) ◽

pp. 74-79

Author(s):

I.V. Kolosovych ◽

B.H. Bezrodnyi ◽

I.V. Hanol

Keyword(s):

Acute Pancreatitis ◽

Length Of Stay ◽

Comparison Group ◽

Abdominal Cavity ◽

Main Group ◽

Duct System ◽

Results Of Treatment ◽

Positive Clinical Effect ◽

Number Of Patients ◽

Comparative Group

Relevance. The article is devoted to the problem of diagnosis and treatment of acute biliary pancreatitis, which remains one of the most common surgical diseases of the abdominal cavity and accounts for 33.2% of the total number of patients with acute pancreatitis. Objective of the work is to improve the diagnosis and results of surgical treatment of patients with acute pancreatitis of biliary etiology. Materials and methods. The results of treatment of 264 patients with acute pancreatitis of biliary etiology are analyzed. Operative treatment was applied in 92 (34,8 %) patients: endoscopic operations were performed in 44 patients (16,7 %). Thus, in 10 (3,8 %) patients, endoscopic papilloprotectomy was performed with the auditory of the duct system and the extraction of concrements. In other cases, organo-preserving intervention was performed without disturbing the morphofunctional integrity of the sphincter apparatus of the duct system: the cannulation in 6 (2,3%) patients, mechanical (balloon) in 5 (1,9 %) cases, pharmacological (myogenic antispasmodic) dilatation of distal duct and a large duodenal papilla in 11 (4,2 %) patients. In residual choledocholithiasis, a technique of papillotomy under the control of choledochoscopy was proposed – 12 (4,54 %) patients. A comparative analysis of the effectiveness of the treatment of patients who used the "open" (comparative group) and noninvasive endoscopic interventions in the early disease (the main group) was performed. Results. So in the main group the length of stay in the hospital was 12±3,2 days, respectively, in the comparison group – 26±4,3 days. In 42 (95,4 %) patients who had undergone endoscopic surgery, a positive clinical effect, a rapid regress of the symptoms of acute pancreatitis was achieved. In two (4,5 %) patients in the main group, the course was complicated by the development of the abscess of the stuffing box, and puncture under ultrasound control was performed. In patients of the comparison group complications arose in 5 (41,6 %) patients, it is noteworthy that all of them had undergone operative interventions, which were limited only to the rehabilitation and drainage of the abdominal cavity, a stuffing box bag. The mortality rate among unopposed was 1,2 % (2 patients), and among the operated – 11,9 % (11 patients). Among prooperated patients who died, 81,8 % (9 people) were elderly patients. Conclusions. The use of minimally invasive endoscopic interventions in the early phase of the disease reduces the length of stay of patients in the hospital from 26±4,3 days (comparison group) to 12 3,2 days (main group) and the number of complications occurring by 37,1 % (P <0, 05). Application of the proposed method of papillotomy under the control of choledochoscopy makes it possible to reduce the risk of perforation of the wall of the duodenum with the development of peritonitis or retroperitoneal phlegmon by 1,2 % (P <0,05).

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MODERN METHODS OF PREVENTION AND TREATMENT OF COMPLICATIONS OF CERVICAL ESOPHAGO-ORGAN ANASTOMOSIS AT ESOPHAGOPLASTY

Wiadomości Lekarskie ◽

10.36740/wlek202008120 ◽

2020 ◽

Vol 73 (8) ◽

pp. 1696-1699

Author(s):

Volodymyr O. Shaprynskyi ◽

Yevhen V. Shaprynskyi ◽

Mustafa Bassam Hussein ◽

Oleg O. Vorovskyi ◽

Yaroslav V. Karyi ◽

...

Keyword(s):

Operative Treatment ◽

Postoperative Period ◽

Comparison Group ◽

Postoperative Mortality ◽

Diagnostic Algorithm ◽

Main Group ◽

Instrumental Method ◽

Complication Risk ◽

Esophageal Strictures ◽

Bed Days

The aim: To improve the results of operative treatment of esophageal strictures by decreasing the rate of failure and stricture of cervical esophago-organ anastomoses. Materials and methods: There were 45 patients with post-burn corrosive gullet strictures, 17 patients with postoperative corrosive strictures, 10 patients with peptic strictures secondary to reflux-esophagitis, 42 patients with esophageal cancer strictures. The patients were divided into two groups: the comparison group – 55 persons and the main group – 59 persons. Patients of comparison group underwent surgical treatment of esophageal strictures according to classic protocols and standards. In the main group of patients we applied proposed diagnostic algorithm with prediction of complication risk and the designed method of esophago-organ anastomosis formation. Results: The results of operative treatment in patients with esophageal strictures showed the development of early postoperative complications in 59 individuals (51.75 %). In the postoperative period six patients died: four – in the comparison group and two – in the main group. Failure of cervical esophago-organ anastomosis and esophageal strictures occurred in 7 patients (11.86 %) of main group and 20 patients (36.36 %) of the comparison group (p<0.05). Conclusions: Application of method predicting the risk of complications of cervical anastomosis, treatment program and instrumental method of formation anastomosis resulted in reduced incidence of failure and strictures of esophago-organ anastomosis from 36.36 % to 11.86 % (p<0.05); decreased time of hospitalization - from 28.2 ± 1.1 to 21.5 ± 0.5 bed-days (p<0.001), postoperative period - from 20.5 ± 1.1 to 16.1 ± 0.7 bed-days (p<0.01); decreased postoperative mortality - from 7.27 % to 3.39 %.

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PREVALENCE OF THE GENERALIZED PERIODONTITIS IN PATIENTS WITH DIFFERENT GROUPS BLOOD IN DEPENDING ON AGE AND PERIODONTAL BIOTYPE

Wiadomości Lekarskie ◽

10.36740/wlek202001123 ◽

2020 ◽

Vol 73 (1) ◽

pp. 119-122

Author(s):

Yurii L. Bandrivsky ◽

Orysia O. Bandrivska ◽

Roksolana Yu. Shkrebnyuk ◽

Volodimira T. Dyryk

Keyword(s):

Periodontal Disease ◽

Blood Group ◽

Comparison Group ◽

Main Group ◽

Number Of Patients ◽

Periodontal Biotype ◽

Initial Forms

The aim of the study was to investigate the prevalence of generalized periodontitis depending on age and biotype of periodontium. Materials and methods: We examined 855 males aged 20-55 years, who were divided into 2 groups: the main group – 570 surveyed with a generalized periodontitis, the comparison group – 285 dental healthy individuals.The diagnosis of generalized periodontitis was established by the classification Danilevsky M.F. (1994) and refined by using paraclinical indices. The periodontal biotype was determined using Hu-Friedy Colourvue Biotype Probe. Results: As a result of the conducted researches was establish, in the carriers of blood group O (I) and A (II), developed forms of generalized periodontitis were found, on average, 2.7 times more often than the initial forms of the disease. Instead, at the representatives of B (III) and AB (IV) groups blood the frequency of initial GP – I degree was on average, 1.2 times greater than the prevalence of developed forms of generalized periodontitis. Also as a result of our researches, we found that the cluster A1 had 39.30% patients, cluster A2 was found at 28, 77%, and cluster B – 31.93% of the total number of patients with generalized periodontitis. Conclusions: As a result of our research, it was found that in the carriers of the blood group O (I) and A (II), more advanced forms of generalized periodontitis were observed, which was confirmed by the presence of the biotype of the periodontal disease in the cluster A1 and A2.

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Comparative study of the efficacy of topical therapy of mixed vaginitis associated with cervicitis by combined medications

HEALTH OF WOMAN ◽

10.15574/hw.2018.132.42 ◽

2018 ◽

pp. 42-49

Author(s):

V.I. Pyrohova ◽

◽

S.O. Shurpyak ◽

Yu.R. Fayta ◽

M.Y. Malachinska ◽

...

Keyword(s):

Comparative Study ◽

Comparison Group ◽

Topical Therapy ◽

Local Therapy ◽

Main Group ◽

Reproductive Age ◽

Gardnerella Vaginalis ◽

Pathogenic Microorganisms ◽

Candida Spp ◽

Vaginal Suppository

The objective: to increase the effectiveness of local therapy for recurrent nonspecific vaginitis associated with cervicitis in women of reproductive age on the basis of a comparative evaluation of combined drugs Terzhinan and Neo Penotran Forte. Materials and methods. A prospective, open comparative study included 56 women aged 27.5±2.8 years with recurrent nonspecific vaginitis and cervicitis who were randomized to the main group and comparison group. Patients of the main group (n=28) received the drug Terzhinan® (1 vaginal tablet in the evening, before bed, for 10 days). The comparison group included 28 patients who received Neo-Pentran Forte (1 vaginal suppository in the evening, before bedtime, for 10 days), one vaginal suppository containing 750 mg of metronidazole and 200 mg of miconazole nitrate. The complex clinical-paraclinical examination included the determination of the state of the vaginal microbiota using several methods in parallel: a bacterioscopy of vaginal smears stained by Gram, a bacteriological rapid method using AFGENITAL SYSTEM (Liofilchem®, Italy), real-time PCR (Florocenosis) with detection antigens of chlamydia, herpes simplex virus, human papillomavirus, trichomonads. Results. The main reason for the treatment of patients were abundant pathological discharge from the genital tract (73.2%), pruritus (37.5%) and burning (23.2%) in the vulva, pain during sexual intercourse (8.9%), while 33.9% of women expressed combined complaints. Attention was drawn to the significant frequency of dyshormonal pathology among women with recurrent cervico-vaginal infections. In the examined women, uterine leiomyoma was diagnosed (28.6%), genital endometriosis (19.6%), fibrocystic breast disease (37.5%), combined benign dyshormonal diseases of the genital organs (14.3%). About 21.4% of patients treatment of thyroid gland dysfunction (hypothyroidism). According to the comprehensive examination, in all patients of clinical groups, decompensated vaginal dysbiosis was diagnosed, which was manifested by a sharp decrease in the absence of Lactobacillus spp strains in 39.3% of patients and an increase in the number of isolated opportunistic and pathogenic microorganisms to 1011 CFU/ml with an increase in the number of microorganisms in microbial associations (from 2–3 to 5–6 conditionally pathogenic and pathogenic pathogens) in all the cases analyzed. When using the genital express system in vaginal contents, women of the main group identified Escherichia coli (17.9%), Pseudomonas spp. (10.7%), Gardnerella vaginalis (39.3%), Staphylococcus aureus (17 9%), Enterococcus faecalis (25.0%), Streptococcus Group B (10.7%), Candida spp. (46.4%), Mycoplasma spp./Ureaplasma ur. in the title > 105 (14.0%). In the comparison group, the spectrum of detected pathogenic and conditionally pathogenic microorganisms did not differ significantly from the data of the main group. 92.6% of patients in the main group had a pronounced positive clinical effect, and a positive microbiological effect was achieved in 96.4% of cases that persisted during the next two months of follow-up. Without additional prescription of antifungal agents, a positive effect was achieved in 84.6% of patients in the main group with mixed bacterial-candidiasis vaginitis at 54.5% in the comparison group. The independent recovery of the lactobacilli pool to a titer of 107–109 CFU/ml in 17.9% of patients with a lack of detection of lactobacilli before treatment. A similar effect was not observed in the comparison group. Сonclusion. In a comparative study of the results of the use of Terzhinan and Neo-Penotran Forte in monotherapy in patients with inflammatory diseases of the lower genitalia (nonspecific recurrent vaginitis and cervicitis), the high clinical and microbiological efficacy of Terzhinan has been demonstrated. Key words: mixed vaginitis, cervicitis, Terzhinan, Neo-Penotran Forte.

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In vitro fertilization outcome in women with tubal factor of infertility and previous chlamydial infection

Journal of obstetrics and women s diseases ◽

10.17816/jowd63454-59 ◽

2014 ◽

Vol 63 (4) ◽

pp. 54-59

Author(s):

Valeriya Sergeyevna Myuller ◽

Igor Yuryevich Kogan ◽

Alevtina Mikhaylovna Savicheva

Keyword(s):

Live Birth ◽

Follicular Fluid ◽

Chlamydial Infection ◽

Comparison Group ◽

Main Group ◽

Previous Exposure ◽

Miscarriage Rate ◽

Tubal Infertility ◽

Tubal Factor

In order to examine the results of IVF and IVF/ICSI programs in women with tubal infertility (TFI) and previous exposure to chlamydial infection a total of 242 women were enrolled in the study. Materials and methods. Sera and follicular fluid samples were tested using EIA for antibodies to chlamydial antigens: the major outer membrane protein (MOMP - IgG, IgA) and heat shock protein chsp60 (IgG). Prevalence of antichlamydial antibodies in sera was 50,4 % (122/242), 10,7 % (26/242) and 5,8 % (14/242); in follicular fluid - 30,2 % (73/197), 3,7 % (9/197) and 4,5% (11/197) coordinaly. Patients were divided to two groups: main group (with IgG to C. trachomatis MOMP in sera, N = 122) and comparison group (absence of antibodies, N = 120). Results. The miscarriage rate after conventional IVF or IVF/ICSI cycle in main group patients was 28 % (7/30), compared to 3,3 % (1/30) in comparison group, р = 0,018. Pregnancy and live birth rate in women from main group was 40 % (22/55) and 30,9 % (17/55); in patients of comparison group - 22,2 % (16/72) and 15,3 % (11/72); р = 0,03 and р = 0,035, coordinaly. Results showed no difference in efficiency of IVF/ICSI programs for the examined groups of patients. Conclusion. Antibodies to C. trachomatis antigens are detected in blood serum of half, in follicular fluid - of every third patient with tubal factor of infertility. Serological evidence of previous exposure to chlamydial infection in these women is associated with decreased IVF success - lower pregnancy and live birth rates and higher risk of miscarriage.

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Results of prevention of massive postural bleeding in women with preeclampsy

Infusion & Chemotherapy ◽

10.32902/2663-0338-2020-3.1-30 ◽

2020 ◽

pp. 37-38

Author(s):

M.Ya. Kamilova ◽

N. Amin-Zade

Keyword(s):

Blood Loss ◽

Tranexamic Acid ◽

Comparison Group ◽

Thrombus Formation ◽

Laboratory Data ◽

Massive Bleeding ◽

Main Group ◽

Severe Preeclampsia ◽

Reproductive Age ◽

Significant Difference

Objective. To evaluate the effectiveness of a tranexamic acid for the prevention of critical bleeding in women with preeclampsia. Materials and methods. 31 puerperas with postpartum hypotonic bleeding. Inclusion criteria: reproductive age, severe preeclampsia, postpartum hemorrhage, volume of blood loss – 700 ml, voluntary consent to the administration of the tranexamic acid. Exclusion criteria: delivery by the caesarean section. When providing emergency care, along with other standard measures, 14 women (the main group) were injected with the tranexamic acid when blood loss reached 700 ml, 17 women (the comparison group) did not receive the tranexamic acid. Research methods: measurement of the volume of blood loss (by the calculation method and by the method of measuring blood loss), statistical analysis – comparison of populations by qualitative characteristics. Results and discussion. A bleeding with a blood loss of 700-800 ml was registered in 7 women of the main group and in 6 women of the comparison group, with a blood loss of 800-900 ml – in 6 and 4 women, with the blood loss 900-1000 ml – in 1 and 7 women, respectively. There was a significant difference in outcomes (blood loss – 900-1000 ml) depending on the use of the tranexamic acid (Fisher’s exact test – 0.04537; p<0.05). Evaluation of the strength of the relationship between the frequency of aggravation of bleeding and the use of the tranexamic acid for the prevention of massive bleeding established a relationship of average strength (Cramer’s criterion – 0.387). Pregnant women with severe preeclampsia are at risk of the developing obstetric bleeding, which is associated with secondary changes in the hemostatic system in women with preeclampsia. With obstetric bleeding in women with preeclampsia, the balance between the coagulation, anti-coagulation and fibrinolytic systems is disturbed faster. Fibrinolysis is activated faster due to the limitation of thrombus formation due to the breakdown of fibrin in thrombi and the fibrinolytic properties of the fibrin breakdown products themselves. The use of the tranexamic acid in the obstetric bleeding is justified by the antifibrinolysis effect of the drug. Further research on the use of the tranexamic acid for the prevention of massive bleeding, confirmed by laboratory data, is highly relevant. Conclusions. The use of tranexamic acid with the onset of obstetric bleeding in women with risk factors for the secondary thrombocytopathy will prevent the aggravation of coagulopathy and reduce the incidence of massive obstetric bleeding caused by a disseminated intravascular coagulation.

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A complex approach to the diagnosis and treatment of pelvic pain in women: clinical and economic aspects

Kazan medical journal ◽

10.17816/kmj2147 ◽

2012 ◽

Vol 93 (1) ◽

pp. 61-67 ◽

Cited By ~ 1

Author(s):

N V Moskovenko

Keyword(s):

Pelvic Pain ◽

Chronic Pelvic Pain ◽

Comparison Group ◽

Treatment Time ◽

Economic Effect ◽

Laboratory Data ◽

Main Group ◽

Diagnostic Methods ◽

Reproductive Age ◽

Doppler Flowmetry

Aim. To improve the results of treatment of chronic pelvic pain in women secondary to chronic nonspecific salpingoophoritis and chronic cystitis. Methods. Examined were 91 women of reproductive age suffering from pelvic pain. The patients comprised two groups. The first group included 68 women in the treatment of which physical exercise therapy, electromagnetic resonance radiation and laser treatment were used. The comparison group included 23 women who received conventional therapy. Used were the generally accepted clinical and special methods of investigation: determined was the content of gonadotropic and steroid hormones, conducted were sonographic, urodynamic studies, laser Doppler flowmetry, assessed was the heart rate variability by the R.M. Baevskiy technique. The medical and psychological examination of women included a study of a women’s personality traits with the help of classical psycho-diagnostic methods. Results. Chronic pelvic pain in women is accompanied by a disturbance of the autonomic balance, increase in the activity of the regulatory systems and psychoemotional disorders, in the structure of which anxiety and depression conditions dominate. The influence of these disturbances on the major categories of quality of life has been established. After treatment was completed marked improvement was observed in the women of the main group; herein the disappearance of major symptoms, normalization of laboratory data, ultrasound investigation data, indicators of microcirculation occurred in a shorter time; the duration of treatment decreased. In the long-time registered was a decrease of the frequency of exacerbations of the disease in the main group of women by 2.6 times relative to the comparison group of patients. The economic effectiveness of the proposed methods of treatment was 40.2%. Conclusion. The usage of physiotherapy techniques in the treatment of pelvic pain made it possible to reduce the treatment time, reduce the frequency of exacerbations of the disease, to establish an economic effect.

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Modern approaches to the treatment of bacterial vaginosis and mixed nonspecific vaginitis

HEALTH OF WOMAN ◽

10.15574/hw.2017.124.89 ◽

2017 ◽

pp. 89-95

Author(s):

O.V. Golyanovsky ◽

◽

V.V. Mehedko ◽

M.A. Budchenko ◽

◽

...

Keyword(s):

Bacterial Vaginosis ◽

Standard Treatment ◽

Main Group ◽

Reproductive Age ◽

Control Group ◽

Complete Disappearance ◽

Complete Elimination ◽

Women Of Reproductive Age ◽

High Effectiveness ◽

Treatment Regimens

The objective: to evaluate the effectiveness of treatment of women with various dysbiotic vaginal conditions with Limenda. Materials and methods. 58 women of reproductive age with BV and mixed nonspecific vaginitis participated in the study. The main group included 30 women, whose treatment was carried out with Limenda drug. The control group consisted of 28 women, whose treatment was performed according to the standard scheme using a combination of drugs. Results. Based on the results of control tests, complete elimination of pathogens occurred in 29 (96.67%) patients of the main group and in 26 (92.86%) patients of the control group. Five days after the treatment, all 30 (100%) women in the main group noted complete disappearance of symptoms on the control visit, and 2 (7.14%) of the control group complained of minor discomfort in the vagina, which required continued treatment. The conclusion. For the treatment of nonspecific vaginitis and bacterial vaginosis, especially chronic and often recurrent forms, it is better to use combined local remedies. The results of this study reliably testify to the high effectiveness of the combined drug Limenda compared with standard treatment regimens. Key words: vaginitis, bacterial vaginosis, vaginal biocenosis, conditional resistance, metronidazole, miconazole, Limenda.

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Experience of the usage of nabumetone in oncogynecologic patients

HEALTH OF WOMAN ◽

10.15574/hw.2017.119.118 ◽

2017 ◽

pp. 118-122

Author(s):

S.M. Kartashov ◽

◽

E.M. Oleshko ◽

Keyword(s):

Antioxidant Activity ◽

Postoperative Period ◽

Comparison Group ◽

Surgical Intervention ◽

Malonic Dialdehyde ◽

Pain Syndrome ◽

Main Group ◽

Narcotic Analgesics ◽

Diene Conjugates ◽

Results Of Treatment

Objective: to study the effect of nabumetone in oncogynecologic patients in the postoperative period. Materials and methods. There were examined 98 patients of 40-78 years old, who were divided into two groups: the main group - 58 patients, of which 37 - patients with endometrial cancer I-III and 21 - with ovarian cancer of II-IV stage (FIGO); The comparison group included 40 patients (17 and 23 patients respectively). All patients underwent surgical treatment. In the postoperative period, were used NSAIDs - nabumeton. Before the operation and on the 10th day of the postoperative period, the following parameters were studied: a clinical blood test, TNF-a, ceruloplasmin, diene conjugates (DC), malonic dialdehyde (MDA), antioxidant activity (AOA). The content of TNF-a, in the blood serum was determined by radioimmunological, and DC, MDA, AOA by biochemical method. Results. Established: the content of the leukocyte formula before the start of treatment in the compared groups did not reveal any significant differences. After surgical intervention, both groups showed an increase in the absolute values of all leukocyte fractions. The level of ceruloplasmin in the patients of the comparison group increased significantly in the postoperative period, and in the main group the parameters of ceruloplasmin did not differ significantly. The level of TNF-a in the pre- and postoperative period in the compared groups did not differ. On the 10th day of the postoperative period, it significantly increased in the comparison group, and when nabumetone was used during the postoperative period, the level of TNF-a did not increase. The initial indicators characterizing the processes of LPO and AOA in both groups did not differ significantly. Assessing the dynamics of indicators before and after the operation, it was noted that in patients in the blood, the level of DC in both the baseline and in the comparison group increased. The use of nabumethon led to a slight increase in DC. The maintenance MDA in the postoperative period has increased in both groups, however it is unreliable in comparison with parameters before surgical intervention. In the comparison group, after the treatment, the antioxidant defense was reliably reduced. In the main group, the use of nabumetone contributed to a smaller decrease in AOA. The use of nabumeton allowed abandoning of narcotic analgesics in earlier periods of the postoperative period. Conclusion. Use of nabumeton in the postoperative period allows to reduce the pain syndrome, the number of inflammatory complications; contributes to the normalization of LPO processes, inhibits the inhibition of the antioxidant system, which contributes to the reduction of endogenous intoxication and improves the results of treatment of oncogynecologic patients. Key words: nabumeton, oncogynecologic patients, anti-inflammatory action, tumor necrosis factor, ceruloplasmin, diene conjugates, malanialdehyde, antioxidant activity.

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Characteristics of phenotypes (clinical variants) of polycystic ovary syndrome in women of reproductive age

Reproductive health of woman ◽

10.30841/2708-8731.2.2021.232519 ◽

2021 ◽

Vol 2 ◽

pp. 27-31

Author(s):

V.G. Syusyuka ◽

M.Y. Sergienko ◽

G.I. Makurina ◽

O.A. Yershova ◽

A.S. Chornenka

Keyword(s):

Polycystic Ovary ◽

Free Testosterone ◽

Main Group ◽

Reproductive Age ◽

Control Group ◽

Women Of Reproductive Age ◽

Ovary Syndrome ◽

Comprehensive Examination ◽

Clinical Variants ◽

Research Show

The objective: on the basis of a comprehensive examination of women of reproductive age to establish the frequency of phenotypes (clinical variants) of polycystic ovary syndrome (PCOS).Materials and methods. 34 patients (main group) who complained of menstrual disorders and/or dermatopathies by recommendation of a dermatologist were examined. The control group is represented by 30 women without gynecological and somatic pathology. The mean age of women in the main group was 26,4±0,9 years and 29,1±0,9 years in the control group (p>0,05). The age of women in the study groups ranged from 18 to 35 years. Patients underwent a comprehensive examination to assess the severity of hirsutism and the severity of acne, as well as the body mass index was determined. All women underwent ultrasound examination in the dynamics and quantitative assessment of the concentration of hormones in the blood plasma, namely cortisol, thyroid-stimulating hormone, prolactin, free testosterone and its index, androstenedione, dehydroepiandrosterone sulfate, 17-α-OH-progesterone, sex hormone binding globulin. Variation-statistical processing of the results was carried out using the program «STATISTICA 13».Results. The results of the conducted research show that 73,5% had menstrual irregularities, and 52,9% – infertility. Acne and hirsutism in every 3rd woman were combined and were diagnosed in 47,1% and 41,2% of women, respectively. Ultrasound signs of polycystic ovaries were found in 94,1% of patients according to the criteria for the diagnosis of PCOS, and in 88,2% – anovulation. According to the laboratory examination, hyperadrogenism was found in 55,9%, which is confirmed by statistically significant (p<0,05) predominance in the main group compared with the control group of androstenedione, free testosterone and its index. In addition, it should be noted statistically significant (p<0,05) higher levels of 17-α-OH-progesterone and prolactin in the main group, but their indicators were within the reference values of the norm. Analyzing the frequency of phenotypes (clinical variants) of PCOS, it was found that phenotype A (classical) occurred in 32,4%. Phenotype B (incomplete classical) was diagnosed in 14,7%, and phenotype C (ovulatory) – only 8,8%. The most often, namely in 15 (44,1%) women with PCOS, the phenotype D (non-androgenic) was established.Conclusions. The results of the conducted research show that in women with PCOS clinical symptoms are characterized by menstrual dysfunction (73,5%), infertility (52,9%) and dermatopathies, namely acne (47,1%) and hirsutism (41,2%). According to the laboratory exanination, hyperadrogenism was found in 55,9%, which is confirmed by statistically significant (p<0,05) predominance in the main group compared with the control group of androstenedione, free testosterone and its index. Among the clinical variants of PCOS, the non-androgenic phenotype (phenotype D) was the most often diagnosed, the frequency of it was 44,1%. Classical (phenotype A) and incomplete classical (phenotype B) were found in 32,4% and 14,7%, respectively. It should be noted that only 8,8% of women with PCOS are diagnosed with phenotype C (ovulatory).

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