scholarly journals Optimization of diagnostic hyperplastic processes in the hormone-sensitiv organs (uterus, brest) during reproductive function reabilitation

2021 ◽  
Vol 6 ◽  
pp. 27-31
Author(s):  
O.D. Dubenko ◽  
M.A. Flaksemberh ◽  
A.Ye. Dubchak

The objective: a study of the condition of the mammary glands in women with uterine leiomyoma on the background of inflammatory diseases of the genital organs. Materials and methods. At the first stage of the research, a retrospective analysis of histories of 246 women with infertility and uterine leiomyoma on the background of inflammatory diseases and pathology of mamma glands, who were treated in the department of family planning and rehabilitation of reproductive function of State Institution “Institute of Pediatrics, Obstetrics and Gynecology of NAMS of Ukraine” named after Academician OM Lukyanova in 2015-2019 was done. In the second stage, a screening ultrasound examination to detect pathology of the breast was performed on the 6th-11th day of the menstrual cycle. Results. The severity of clinical manifestations of dyshormonal dysplasia of the breast depends on the influence of the most significant risk factors associated with mamma glands diseases: late reproductive age, number of interrupted pregnancies (abortion, miscarriage), genital diseases, age of menarche, the parameters of the menstrual cycle, disorders and duration of menstruations, duration of infertility and lactation, comorbid somatic pathology, especially liver disease, thyroid disease, frequent stress and severe heredity.Conclusions. The high frequency of combination of uterine leiomyoma and dyshormonal dysplasia of the breast in women with infertility indicates the need for timely diagnosis and adequate correction of this pathology as one of the factors in the development of mamma gland diseases and the earliest use of methods of rehabilitation of reproductive function. This will increase the effectiveness of infertility treatment and prevention of uterine and mammological pathology.

Author(s):  
Kalinkina O.B. ◽  
Tezikov Yu.V. ◽  
Lipatov I.S. ◽  
Aravina O.R.

Genital endometriosis is a disease of women of reproductive age, accompanied by infertility in 50% [1]. Adenomyosis can be considered as an endometriosis of the uterus. Histologically, this process is represented by ectopic, non-tumor endometrial glands, and stroma surrounded by hypertrophic and hyperplastic myometrium [2]. Adenomyosis is accompanied by pelvic pain of varying intensity as well as menstrual disorders [1]. The disease is accompanied by significant violations of reproductive function (infertility, unsuccessful attempts at pregnancy and miscarriage, abnormal uterine bleeding). Adenomyosis can be accompanied by a violation of the function of adjacent organs (such as the bladder, rectum). Often, one of the clinical manifestations of adenomyosis is the development of sideropenic syndrome, which is also caused by the development of chronic post-hemorrhagic iron deficiency anemia. This is accompanied by a deterioration in the general condition of patients, a decrease in their ability to work. Despite a large number of publications in Russian and foreign scientific sources devoted to this problem, reproductive doctors and obstetricians-gynecologists often underestimate the role of adenomyosis in pregnancy planning using assisted reproductive technologies. Without interpreting the anamnesis data obtained through an active survey, doctors do not prescribe additional methods for diagnosing this pathology, which is not complex and expensive. To confirm the diagnosis, a transvaginal ultrasound examination of the pelvic organs during the premenstrual period is sufficient. In cases that are difficult to diagnose, the MRI method of the corresponding anatomical area can be used. Underestimation of the clinical picture and under-examination of the patient did not allow prescribing timely correction of the pathology and led to unsuccessful attempts to implement the generative function using assisted reproductive technologies. The conducted examination with clarification of the cause of IVF failures and the prescribed reasonable treatment made it possible to achieve regression of endometriosis foci in this clinical situation, followed by the patient's ability to realize generative function.


2021 ◽  
pp. 12-22
Author(s):  
О.К. Koloskova ◽  
◽  
A.L. Kosakovskyi ◽  
T.M. Bilous ◽  
I.B. Horbatiuk ◽  
...  

Infectious and inflammatory diseases of the respiratory tract in children are the «leaders» among all pathologies of childhood. Optimization of therapeutic and prophylactic approaches for infectious and inflammatory pathologies of the respiratory system by reducing the frequency of unreasonable antibiotic therapy and eliminating polypragmatic use is a relevant problem of modern pediatrics and otolaryngology. According to WHO guidelines, modern standardized herbal medicines are not inferior in efficiency to synthetic ones. The aim — to analyze the results of assessment by doctors of the preventive and therapeutic efficacy of the remedy «Alpicol» on the basis of a questionnaire, as well as clinical examination of patients before using the medication and after completion of the course of treatment. Materials and methods. The advantages of «Alpicol» were analyzed through a questionnaire offered by first contact practitioners to children in order to receive feedback on the assessment of the preventive and therapeutic efficacy of this medication. Doctors from 9 regions of Ukraine were involved, and 6,093 questionnaires of children of different ages were analyzed. Results. The frequency of registration of a pronounced paediatric pain (3 scores) with the use of the «Alpicol» medication significantly decreased (23.7 times), a moderate manifestation of the disease (2 scores), was 17 times less at the same time, mild manifestations of paediatric pain remained at the same level. Patients with a comorbid pathology of the respiratory tract in the form of recurrent lesions of the upper and lower airways during the 2nd visit received a zero score (no symptoms) significantly less frequently than children with pathology of the upper respiratory tract with 62.6% of cases versus 72.2% of observations, respectively (p<0.05). As a result of the use of the course of «Alpicol» medication, a statistically significant decrease in the severity of the catarrhal symptom complex was achieved, since the proportion of the course of disease, assessed by the maximum number of scores, decreased by 29.6 times, moderate (score 2) — 13.3 times, and zero scores appeared 5.7 times more often. At the same time, the proportion of patients with a mild course of catarrh practically did not change. Conclusions. «Alpicol» has a multi;vector efficacy against the complex of symptoms that accompany infectious and inflammatory exacerbations of recurrent respiratory diseases. This is manifested by a decrease in the severity of clinical manifestations of the disease, as well as in an increase in cases of clinical stabilization of the patient's condition, which demonstrates the therapeutic and prophylactic effect of the drug «Alpicol» on the course of recurrent respiratory diseases in children. The study was carried out in accordance with the principles of the Declaration of Helsinki. The study protocol was adopted by the Local Ethics Committee of all institutions indicated in this research. The informed consent of parents and children was obtained. The authors declare that they have no conflicts of interest. Key words: ecurrent respiratory diseases, treatment and prevention, children, phytocomplexes.


2021 ◽  
Vol 26 (2) ◽  
pp. 33-39
Author(s):  
V.A. Bocharov ◽  
V.V. Bocharova ◽  
M.M. Lebediuk ◽  
A.A.S. Sarayreh ◽  
L.V. Kuts

According to the decisions of international scientific forums, the problem of phenomenon of rosacea (acne rosacea), a common dermatosis with numerous unexplained aspects of etiopathogenesis is a promising area of modern medical research. The aim of the study was theoretical substantiation of the essential features of the mechanisms of occurrence, development and clinical manifestations of the first signs of rosacea in women of reproductive age. The use of a systematic analytical methodical approach to assess the data of clinical and laboratory examinations of women with rosacea, conducted in different regions of the world, allowed to establish the originality of such manifestations of dermatosis as the appearance of unexpected rushes to limited areas of the face, accompanied by local redness and local heat areas of the skin differring significantly from similar rushes in other diseases or syndromes (menopause, migraine, etc.). It is established that the peculiarity of the relationship of these clinical characteristics (from English: rush, ruddy, redness, rosacea, reproductive age of women, reaction) allows to indicate the first signs of dermatosis as a phenomenon inherent in this disease Rush-Ruddy-Rosacea-Reproduce-Reaction (abbreviated – «5-R»), the key pathophysiological target of which (as well as the disease as a whole) is a disorder of a set of hierarchically dependent mechanisms of the evolutionarily determined motivational need to ensure reproductive function in women (both at the cellular level and extracellular structures of the ovaries, and at different levels of subcortical formations and centers of the cortex of the cerebral hemispheres). The phenomenon of rosacea rush is closely related to other phenomena of this dermatosis – hypersensitivity of bradykinin receptors, actinic elastosis, development of post erythematous telangiectasia. The prospect of further research on the problem of rosacea is to study the relationship of disorders in the functional systems of molecules of signaling compounds of different classes (hormones, eicosanoids, neuropeptides, kinins, cytokines and others) in the pathogenesis of the disease.


2016 ◽  
Vol 23 (3) ◽  
Author(s):  
O. M. Makarchuk ◽  
Abdulrakhman Abdulbaset Moslem

Introduction. Analysis of uterine leiomyoma incidence indicates not only its growth but also the increase in the number of women of early reproductive age. However, the problem of trigger mechanisms for its development is still uncertain and actual.The objective of the research was to assess the characteristic features of hyperplastic processes in uterus on the background of dishormonal and metabolic disorders.Materials and methods. 60 women of reproductive age with uterine leiomyoma participated in the clinical trial. They gave their informed written consent. The control group consisted of 20 healthy women of reproductive age. Statistical analysis was conducted using material package “STATISTICA for Windows®-6.0” and methods of odds ratio (OR) calculating and its 95% Confidential Interval (95% CI).Results and their discussion. According to the results of the research the main factors contributing to uterine fibroid development in women with obesity were determined. They included: the age of 30-45 years, instrumental intervention in the womb (abortion, diagnostic curettage, etc. (OR = 8.2; 95% CI: 5.1-13.5)); chronic inflammatory diseases of genitalia (OR = 7.9; 2.9-21.9); hormonal imbalances (fibro-cystic breast disease, thyroid disorders (OR = 8.61; 3.1-23.8), liver and gastrointestinal tract disorders (OR = 5.8; 2.1-15.9) sexual disorders and stress inductive factors (OR = 2.6; 1.4-7.1) (usually fibroids occur in 1-2 years after severe stress). There is a significant percentage of adenomyosis and endometrial hyperplastic processes. Growth of tumors in women with obesity increases to 35-40 years of age, and is associated not only with a progressive decrease in the functional activity of the ovaries, their sensitivity to gonadotrophic stimulation, but also with chronic functional exertion of regulation systems on the background of metabolic disorders of hemostasis and homeostasis in this category of women.Conclusions. One of the most significant risk factors for hyperplastic processes of the reproductive organs is obesity and associated metabolic disorders. In case of metabolic disorders activity and hepatocytes on the background of obesity the number of combined forms of hyperplastic processes in the uterus increases by 1.9 times. The main risk factor for fibroids in obese women is hepatocytes dysfunction on the background of a high percentage of hepatobiliary pathology, endocrine pathology – 68.3% (thyroid dysfunction, fibro-cystic breast changes). Morphological and histological structure of endometrium in obese women leads to the growth of endometrial polyps (36.66%).


World Science ◽  
2018 ◽  
Vol 1 (10(38)) ◽  
pp. 28-32
Author(s):  
Донська Ю. В. ◽  
Лоскутова Т. О. ◽  
Сімонова Н. В. ◽  
Петулько А. П.

The worsening demographic situation encourages the search for new reserves to improve reproductive potential. The maximum incidence of chronic endometritis (97.6%) is 26-35 years old - the most important in the implementation of reproductive function. The lack of a single concept for the pathogenesis of HE, the purge of clinical manifestations impedes the creation of well-grounded therapy in women of childbearing age. The aim of the study was to increase the effectiveness of treatment of patients with confirmed chronic endometritis in order to restore fertility. It is proved that the use of the scheme, which includes antibacterial (doxycycline 100 mg orally 2 times a day and metronidazole 500 mg 2 times a day for 14 days in one menstrual cycle) and cyclic progestogen (didrogesterone at a dose of 20 mg per day with 15 to 25 days of the menstrual cycle - within three months), therapy can restore the morpho-functional endometrium potential by 88% compared with the initial rates.


2018 ◽  
pp. 102-106
Author(s):  
M.A. Flaksemberg ◽  

The objective: in this work represented part of materials of department rehabilitation of reproductive function for the examination and treatment of 250 patients with uterine fibrods in order to study and determine in detail the predictors of the disease, develop methods of treatment (conservative and surgical), as well as rehabilitation of the reproductive function, depending on the type and localization of the nodes. Materials and methods. The analysis of the anamnestic data, taking into account both objective and subjective data, analysis of anamnestic data of close relatives (maternal and paternal lines), concomitant genital and extragenital pathology is carried out. Results. The most numerical group of patients with uterine fibroids, according to our data, in the age groups of 26–35 years (32%) is 36–40 years (28.4%), which are the most socially and reproductively active. In this category, women with a high education of 33.6% and social status (30.4% and 22.4%) prevailed. The transferred inflammatory diseases of the genitals were noted in 48% of the examined, weighed gynecological anamnesis (abortions, miscarriages) were noted in 42.4%. Conclusion. Also for this category of patients is characterized by a high percentage of endometrial pathology – 60.8%, as well as concomitant adenomyosis – 34% and adhesion process of pelvic organs – 26.8%. Key words: clinical course, uterine fibroids, reproductive age.


2018 ◽  
pp. 31-35
Author(s):  
A. Kornatska ◽  
◽  
O. Danylenko ◽  
M. Flaksemberg ◽  
◽  
...  

The objective: was to study and evaluate changes of psychoemotion of female patient reproductive age with uterine leiomyoma in the dynamics of treatment and rehabilitation of reproductive function depending on the type of therapy. Materials and methods. SAN questionnaires, WHO mental disorder criteria, and the methods of Zung, K. Heck, and I. Hess were used to study changes in psychoemotional states. Psychoemotional changes were studied in 234 patients with conservative and surgical (organ-preserving) treatment, conservative treatment was received – 93 (39.74%) patients; the surgical group was 141 (60.26%). and was divided into two subgroups ІІа – 51 (21.8%) patients without the use of preoperative hormonal training, and ІІб – 90 (38.46%) patients using preoperative preparation. Results. In patients of reproductive age with uterine leiomyoma revealed changes in the psycho-emotional state, which depend on both internal and external factors. These changes were expressed in increased anxiety, neuroticism, mood swings, activity, wellbeing.These changes were observed in both groups, but their severity and depth depended on the duration of the disease. Conclusion. During the examination of female patient reproductive age with uterine leiomyoma was discovered same psychoemotion change. They was related both from internal and external factor and could be declared as increased anxiety neuroticism changes in health, activity, mood. The severity of these changes depends on the initial psycho-emotional state of the patient, the duration of the disease, the effectiveness of previous treatment. Therefore, in some cases an individual approach to the correction of the detected changes was used Keywords: reproductive age, uterine leiomyoma, psychoemotion change.


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