scholarly journals Novel treatment modalities for pelvic inflammatory disease using immunomodulating therapy

2021 ◽  
Vol 4 (2) ◽  
pp. 149-154
Author(s):  
Yu.E. Dobrokhotova ◽  
◽  
P.A. Shadrova ◽  
Keyword(s):  
Pelvic Inflammatory Disease ◽  
Inflammatory Disease ◽  
Antibacterial Agents ◽  
Bacterial Flora ◽  
Treatment Modalities ◽  
Complex Treatment ◽  
Inosine Pranobex ◽  
Good Tolerability ◽  
Immunomodulating Therapy ◽  
Novel Treatment

Pelvic inflammatory disease (PID) is a significant issue of public health due to its devastating effects on female reproductive health and fertility. Despite extensive development of medicine and the emergence of novel groups of antibacterial agents, the risks of antibacterial resistance rapidly grow, thus requiring complex treatment of infectious inflammatory disorders caused by bacterial flora. The modulation of immune response is the heart of recently developed treatment modalities for various diseases (infections, oncology etc.). A detailed understanding of molecular immunology contributes to the rational development of novel types of immunotherapy, which can be successfully introduced into clinical practice. Numerous findings demonstrate the efficacy of inosine pranobex for various diseases, in particular, in immunocompromised patients. This medication has proven itself due to good tolerability and the lack of serious side effects. Inosine pranobex being a safe drug that can be used in many treatment schedules, including complex treatment for chronic PID with antibacterial agents. KEYWORDS: inosine pranobex, pelvic inflammatory disease, salpingo-oophoritis, infertility, immunotherapy, sexually transmitted infections, bacterial vaginosis. FOR CITATION: Dobrokhotova Yu.E., Shadrova P.A. Novel treatment modalities for pelvic inflammatory disease using immunomodulating therapy. Russian Journal of Woman and Child Health. 2021;4(2):149–154. DOI: 10.32364/2618-84 30-2021-4-2-149-154.

scholarly journals Clinical pathogenic basis for anti-adhesive treatment for appendicular-genital syndrome in women of reproductive age

2020 ◽  
Vol 3 (4) ◽  
pp. 228-232
Author(s):  
V.V. Simrok ◽  
◽  
I.A. Popova ◽  
D.V. Mel’nikova ◽  
◽  
...  
Keyword(s):  
Pelvic Inflammatory Disease ◽  
Inflammatory Disease ◽  
Clinical Symptoms ◽  
Adhesion Formation ◽  
Fold Increase ◽  
Reproductive Age ◽  
Complex Treatment ◽  
Women Of Reproductive Age ◽  
Peritoneal Adhesions ◽  
Normal Ranges

Aim: to assess the efficacy of penicillamine for the complex prevention of pelvic peritoneal adhesions in appendicitis associated with the acute conditions of uterine appendages (appendicular-genital syndrome, AGS) based on the changes in the levels of hydroxyproline and the major clinical symptoms of pelvic inflammatory disease. Patients and Methods: 157 women of reproductive age with AGS who were urgently or routinely admitted to a gynecological or surgical hospital were examined. Comparison group women were prescribed with conventional anti-inflammatory treatment or surgery as needed. Study group women additionally received penicillamine 250 mg twice daily for a month. Pre- and post-treatment non-invasive assessment of the peritoneal adhesive process was performed by measuring the levels of protein-bound and free hydroxyproline. Treatment efficacy was evaluated after 1 month by the changes in hydroxyproline levels, major clinical symptoms, and ultrasound. Results: it was demonstrated that pelvic acute inflammatory disease results in > 1.5-fold increase in the levels of protein-bound and free hydroxyproline. Penicillamine as a component of the complex treatment for pelvic inflammatory disease reduces the levels of hydroxyproline to normal ranges. The changes in the major clinical symptoms and ultrasonic findings after penicillamine therapy were more significant compared to the standard treatment. Conclusions: penicillamine as a component of the complex treatment for pelvic inflammatory disease significantly accelerates the improvement of symptoms and remission as well as the formation of peritoneal adhesions. This prevents both pelvic adhesive disease and tubal- and peritoneal-factor infertility. KEYWORDS: appendicular-genital syndrome, inflammation, hydroxyproline, penicillamine, pelvic peritoneal adhesions, prevention, adhesion formation. FOR CITATION: Simrok V.V., Popova I.A., Mel’nikova D.V. Clinical pathogenic basis for anti-adhesive treatment for appendicular-genital syndrome in women of reproductive age. Russian Journal of Woman and Child Health. 2020;3(4):228–232. DOI: 10.32364/2618-8430- 2020-3-4-228-232.

Modern view on the problem of pelvic inflammatory disease in women

2017 ◽  
pp. 57-64
Author(s):  
Z.M. Dubossarskaya ◽  
◽  
Yu.A. Dubossarskaya ◽  
L.P. Grek ◽  
T.B. Ushakova ◽  
...  
Keyword(s):  
Pelvic Inflammatory Disease ◽  
Antibacterial Therapy ◽  
Inflammatory Disease ◽  
Inflammatory Diseases ◽  
Clinical Effectiveness ◽  
Reproductive Age ◽  
Complex Treatment ◽  
Combination Drug ◽  
Anaerobic Infections ◽  
Aerobic And Anaerobic

The objective: to learn the efficacy of some fluoroquinolones II and III generation (combination drug Orcipol (ciprofloxacin with ornidazole) and Levoximed (levofloxacin) from World Medicine Pharmaceutical Company, UK) in the treatment of urogenital mixed infections in patients with pelvic inflammatory disease (PID) for vaginal sanitation and restoration of reproductive health. Patients and methods. A clinical examination and complex treatment of 50 patients of reproductive age for the first or second episode of PID of moderate severity was held. Patients of the 1st group (n=25) with mixed aerobic and anaerobic infections, Chlamydia were prescribed Levoximed for 7–14 days. Patients of the 2nd group (n=25) with mixed aerobic and anaerobic infections, bacterial vaginosis or trichomoniasis received a combined drug – Orcipol for 5–7 days. Results. The use of Levoximed and combined antibacterial therapy with Orcipol in the complex treatment of patients with PID was successful. The efficacy of Levoximed and Orcipol in the complex treatment of PID in the groups surveyed was comparable, and it was good in most cases – 92% in Group 1 and 88% in Group 2. Conclusions. The use of combined antibacterial therapy with the inclusion of drugs that overlap the spectrum of aerobic and anaerobic pathogens, protozoal sexually transmitted infections, is an important factor in the successful treatment of inflammatory diseases of the genitals in women. High clinical effectiveness of treatment with the use of drugs Levoximed and Orcipol in patients with PID can recommend them for widespread use in gynecological practice. Key words: pelvic inflammatory diseases, urogenital infections, Levoximed, Orcipol.

scholarly journals Characteristics of Vaginal Microbiome in Women with Pelvic Inflammatory Disease in Korea

2021 ◽  
Vol 70 (3) ◽  
pp. 345-357
Author(s):  
SUKYUNG KIM ◽  
HOONHEE SEO ◽  
MD ABDUR RAHIM ◽  
HANIEH TAJDOZIAN ◽  
YUN-SOOK KIM ◽  
...  
Keyword(s):  
Pelvic Inflammatory Disease ◽  
Patient Group ◽  
Inflammatory Disease ◽  
Human Life ◽  
Treatment Modalities ◽  
Control Group ◽  
Vaginal Fluid ◽  
Rrna Gene ◽  
Increased Risk ◽  
Significant Difference

Human vaginal microorganisms play an important role in maintaining good health throughout the human life cycle. An imbalance in the vaginal microbiota is associated with an increased risk of pelvic inflammatory disease (PID). This study aimed to characterize and compare vaginal microbial profiles of premenopausal Korean women with and without PID. 74 Korean premenopausal female vaginal samples were obtained; 33 were from healthy women (a control group) and 41 from PID patients. Vaginal fluid samples were collected from the vaginal wall and posterior cervix and then analyzed by 16S ribosomal ribonucleic acid (rRNA) gene-based amplicon sequencing. Results showed a significant difference between the vaginal microbial communities of the two groups (Jensen-Shannon, p = 0.014; Bray-Curtis, p = 0.009; Generalized UniFrac, p = 0.007; UniFrac, p = 0.008). Lactobacillus accounted for the highest percentage (61.0%) of the control group but was significantly decreased (34.9%) in PID patients; this was the most significant difference among all bacterial communities (p = 0.028, LDA effect size = 5.129). In addition, in the PID patient group, species diversity significantly increased (Simpson, p = 0.07) as the proportion of various pathogens increased evenly, resulting in a polymicrobial infection. Similarly, lactate, which constituted the highest percentage of the organic acids in the control group, was significantly decreased in the PID patient group (p = 0.04). The present study’s findings will help understand PID from the microbiome perspective and are expected to contribute to the development of more efficient PID diagnosis and treatment modalities.

Diagnostik und Therapie der Adnexitis (Pelvic Inflammatory Disease)

2020 ◽  
Vol 77 (4) ◽  
pp. 164-170
Author(s):  
Franziska Siegenthaler ◽  
Elke Krause ◽  
Michael D. Mueller
Keyword(s):  
Pelvic Inflammatory Disease ◽  
Inflammatory Disease ◽  
Diagnostik Und Therapie ◽  
Operative Exploration

Zusammenfassung. Die Adnexitis, im anglo-amerikanischen Sprachgebrauch hat sich der Sammelbegriff Pelvic Inflammatory Disease (PID) durchgesetzt, stellt ein häufiges medizinisches Problem dar. Die Diagnose einer PID kann schwierig sein, da die klinischen Manifestationen unspezifisch sind und sie andere Becken- und Bauchprozesse imitieren können. Infektionen im Bereich der Adnexen können schwerwiegend sein und Langzeitkomplikationen (chronische Unterbauchschmerzen, Infertilität) verursachen, weshalb eine rasche Diagnosestellung und der frühzeitige Beginn einer adäquaten Antibiotika Therapie von grosser Wichtigkeit sind. Unkomplizierte PID haben meistens einen günstigen Verlauf, bei komplizierten Formen mit Tuboovarialabzess ist meist eine operative Exploration notwendig.

Peritoneal Fluid and Plasma Fibrinolytic Activity in Women with Pelvic Inflammatory Disease

1992 ◽  
Vol 68 (02) ◽  
pp. 102-105 ◽  
Author(s):  
P J Dörr ◽  
E J P Brommer ◽  
G Dooijewaard ◽  
H M Vemer
Keyword(s):  
Pelvic Inflammatory Disease ◽  
Inflammatory Disease ◽  
Peritoneal Fluid ◽  
Fibrinolytic Activity ◽  
Degradation Products ◽  
Adhesion Formation ◽  
High Rate ◽  
Control Group ◽  
The Difference ◽  
Fibrinolytic Parameters

SummaryPrevious studies have shown that the fibrinolytic activity of peritoneum is depressed in local inflammation. We measured fibrinolytic parameters in peritoneal fluid and in plasma of 10 women with pelvic inflammatory disease (PID). Nine women, in whom laparoscopy for sterilisation was performed, served as a control group.In the peritoneal fluid of women with PID, PAI-Ag, t-PA-Ag and u-PA-Ag were many times higher than in the control group. In contrast to the antigens which may be present in inert complexes, the potentially active compounds, measured as t-PA activity and plasmin-activable scu-PA, were not significantly different in the two groups, and in none of the samples was the active enzyme tcu-PA detectable. Nevertheless, the mean peritoneal fluid TDP and FbDP concentrations were about twenty times higher in the PID group than in the control group. In plasma of PID patients, none of the parameters except u-PA-Ag differed from those in the control group. The difference between control and patient plasma u-PA-Ag was statistically significant, but too small to attach any relevance to the observation.Our data suggest that, in contrast to the classical concept of decreased fibrinolytic activity as a cause of adhesion formation, intraperitoneal fibrinolysis is enhanced in peritoneal inflammation through stimulation of the local production of t-PA and u-PA. Despite concomitant production of PAI, fibrinolysis occurs at a high rate, resulting in high levels of fibrin degradation products. Since this activated fibrinolysis does not meet the demand, therapeutic enhancement should be considered to prevent adhesions.

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