scholarly journals Pathogenetic effects of antibiotic resistance on a woman’s reproductive health

2020 ◽  
pp. 66-68
Author(s):  
О.V. Hryshchenko
Keyword(s):  
Inflammatory Diseases ◽  
Topical Therapy ◽  
Chronic Pelvic Pain Syndrome ◽  
Pain Syndrome ◽  
Pelvic Pain Syndrome ◽  
Vaginal Infections ◽  
Urogenital Infections ◽  
Increased Risk ◽  
Gynecological Diseases ◽  
Anti Inflammatory

Background. Over the last decade, women in many countries around the world have seen an increase in the number of urogenital infections, which occupy the first place in the structure of obstetric and gynecological morbidity. Risk factors for the development of inflammatory diseases include the invasive procedures and irrigations, sexual activity, unreasonable treatment, refusal to restore eubiosis after antimicrobial and antifungal therapy, the presence of intrauterine devices, etc. Objective. To characterize the influence of the spread of antibiotic-resistant pathogens on the course of gynecological diseases. Materials and methods. Analysis of literature data on this issue. Results and discussion. Peculiarities of the vaginal infections course’ nowadays include prevalence of self-treatment, uncontrolled antibiotics (AB) use, the development of AB resistance, and the presence of extragenital pathology. Pelvic inflammatory disease (PID) comprise 75 % of all gynecological diseases. PID cause such complications as chronic pelvic pain syndrome, purulent tubo-ovarian tumors, cervical neoplasia, and infertility. The risk of the latter increases depending on the number of episodes of PID. Principles of PID treatment include comprehensiveness, etiopathogenetic orientation, individualization and recurrence prevention. Antibacterial therapy (ABT), nonsteroidal anti-inflammatory drugs, infusions, transfusions, detoxification therapy, medications aimed at the improvement of hemodynamics and microcirculation, immunotherapy, and topical therapy are used in the treatment of PID. The consequences of irrational ABT include an increase in the resistance of pathogenic flora, disruption of the normal body biocenosis, increased risk of adverse reactions, impaired immune function and increased treatment costs. Macrolides, cephalosporins, fluoroquinolones and aminoglycosides are the main groups of AB used for the systemic ABT in PID. Tobramycin (one of the latter group) is active against 83.4 % of pathogens that cause urogenital infections. Other advantages of tobramycin include synergism with β-lactams and high activity against Pseudomonas aeruginosa – a bacterium with a high and dangerous potential for AB resistance. In turn, fluoroquinolones are active against 94 % of pathogens that cause urogenital infections; they are able to penetrate cell membranes and have a low potential for the formation of AB resistance. The combination of fluoroquinolone levofloxacin with ornidazole (Grandazole, “Yuria-Pharm”) can improve the general condition and reduce pain on the 3rd day of treatment of PID, normalize the temperature, reduce hospital stay. Co-administration of levofloxacin and ornidazole as part of an infusion solution is more rational than their separate use. Such treatment minimizes the risk of allergic reactions and side effects. For local sanitation of vagina and vulva, it is advisable to use decamethoxine (Dekasan, “Yuria-Pharm”) – a basic antiseptic that acts on various types of bacteria, viruses, fungi and protozoa. Additional benefits are anti-inflammatory, desensitizing and antispasmodic action. Decamethoxine also effectively reduces the adhesion of staphylococci and Escherichia coli. One of the main advantages of decamethoxine is the lack of effect on human cells. Conclusions. 1. PID are the most common diseases in the field of obstetrics and gynecology. 2. Care should be taken when choosing a drug for ABT. 3. The combination of levofloxacin and ornidazole can effectively treat PID, reducing the duration of inpatient treatment. 4. For local sanitation of the vagina and vulva, it is advisable to use decamethoxine.

scholarly journals Relevant issues of management of patients with inflammatory diseases of the pelvic organs

2020 ◽  
pp. 162-164
Author(s):  
І.V. Lakhno
Keyword(s):  
Chronic Inflammation ◽  
Inflammatory Diseases ◽  
Chronic Pelvic Pain Syndrome ◽  
Clinical Signs ◽  
Resistance Index ◽  
Pain Syndrome ◽  
Pelvic Pain Syndrome ◽  
Control Group ◽  
Low Efficiency ◽  
Rule Out

Background. Pelvic inflammatory diseases (PID) occur in 12-13 % of young women, 65-70 % of outpatients and 30 % of inpatients with gynecological diseases. The consequences of PID include infertility, chronic pelvic pain syndrome, menstrual disorders, etc. Treatment of PID is a multidisciplinary problem in the field of gynecology, urology, and venereology. Objective. To describe the modern treatment of PID. Materials and methods. Analysis of literature sources on this issue; own study to study the effectiveness of the PID treatment with Reosorbilact (“Yuria-Pharm”) and levofloxacin + ornidazole (Grandazole, “Yuria-Pharm”). Women of the main group were additionally prescribed fluconazole, diclofenac, vaginal baths with Dekasan (“Yuria-Pharm”). The treatment lasted 7 days. Treatment of the comparison group included ceftriaxone, metronidazole, diclofenac, doxycycline, fluconazole, chlorhexidine. Results and discussion. Chronic PID often have a latent course. 70 % of them are caused by the specific flora (Chlamydia trachomatis, Neisseria gonorrheae, anaerobes, gram-negative bacteria). The frequency of mixed polymicrobial processes and polychemical resistance is increasing. The presence of bacterial vaginosis allows the infections to recur constantly. Pathogens that cause PID can also cause extragenital pathological conditions (perihepatitis, Reiter’s syndrome, enteritis, colitis, cholecystitis). Diagnostic criteria for PID are the following: pain in the appendages or when the cervix is displaced during the bimanual examination, fever, leukorrhea and menorrhagia. If PID is suspected, a bimanual examination should be performed to rule out acute appendicitis. Ultrasound or computed tomography should be performed to rule out tuboovarian tumors and make a differential diagnosis with intestinal or urinary tract disease. The etiological diagnosis requires microbial and molecular examination of the contents of the vagina and cervix. Fluoroquinolones with metronidazole for 14 days are the first line therapy of uncomplicated PID. Chronic inflammation has no mechanisms of self-completion and can last for years and decades. In gynecology, chronic inflammation is divided into infectious, allergic and autoimmune type. Patients with recurrence of chronic PID are characterized by mixed infections and the formation of biofilms, allergies, low efficiency of immune cells. To overcome the polychemical resistance of pathogens, it is advisable to use effective hydrodynamic drugs that can act as a hydraulic conductor of the antibacterial agent, improve microcirculation in the inflammatory focus, optimize venous hemodynamics and lymphatic drainage. Sorbitol has all these properties. In addition, sorbitol increases the tropism of fluoroquinolones to gram-positive microorganisms and has own bacteriostatic effect. In the own study, it was found that the increase in the resistance index of the ovarian arteries was associated with increased intensity of pain in the lower abdomen, pathological vaginal discharge and fever, which justifies the use of vasoactive drugs in the treatment of PID. In the Reosorbilact and Grandazole treatment groups, normalization of clinical and laboratory parameters occurred in 100 % of women, whereas in 12.1 % of control group members the result was considered insufficient, requiring antibiotic replacement and continuation of therapy. Conclusions. 1. In women with PID, there is a connection between blood flow in the ovarian arteries and the severity of the clinical signs of PID, which justifies the use of hemodynamic drugs. 2. Improvement of intrapelvic hemodynamics on the background of Reosorbilact was the key to successful use of Grandazole. 3. Co-administration of Reosorbilact and Grandazole is a promising method of empirical therapy of PID.

DO ANDROGEN RECEPTOR POLYMORPHISMS CONTRIBUTE TO AN INCREASED RISK FOR CHRONIC PROSTATITIS/CHRONIC PELVIC PAIN SYNDROME (CP/CPPS) AND PROSTATE CANCER (CaP)?

2008 ◽  
Vol 179 (4S) ◽  
pp. 31-31
Author(s):  
Ki Hak Song ◽  
Donald E Riley ◽  
Teresa L Gilbert ◽  
In Rae Cho ◽  
Young Seop Chang ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Androgen Receptor ◽  
Pelvic Pain ◽  
Chronic Prostatitis ◽  
Chronic Pelvic Pain ◽  
Chronic Pelvic Pain Syndrome ◽  
Pain Syndrome ◽  
Pelvic Pain Syndrome ◽  
Increased Risk

scholarly journals Tamsulosin Monotherapy versus Combination Therapy with Antibiotics or Anti-Inflammatory Agents in the Treatment of Chronic Pelvic Pain Syndrome

2011 ◽  
Vol 15 (2) ◽  
pp. 92 ◽  
Author(s):  
Tae Hyo Kim ◽  
Ki Soo Lee ◽  
Jeong Ho Kim ◽  
Joon Yeop Jee ◽  
Young Eun Seo ◽  
...  
Keyword(s):  
Combination Therapy ◽  
Pelvic Pain ◽  
Chronic Pelvic Pain ◽  
Chronic Pelvic Pain Syndrome ◽  
Pain Syndrome ◽  
Pelvic Pain Syndrome ◽  
Anti Inflammatory

scholarly journals PHARMACOGENETIC PROFILE AND PERSONALIZATION POSSIBILITIESIN TREATMENT OF PATIENTS WITH CHRONIC PELVIC PAIN SYNDROME

2021 ◽  
Vol 11 (1) ◽  
pp. 56-59
Author(s):  
Regina Mamina ◽  
Bela Kantemirova ◽  
Aleksei Zhidovinov ◽  
Vladimir Belopasov ◽  
Ekaterina Orlova ◽  
...  
Keyword(s):  
Pelvic Pain ◽  
Chronic Pelvic Pain ◽  
Chronic Pelvic Pain Syndrome ◽  
Pain Syndrome ◽  
Pelvic Pain Syndrome ◽  
Cyp2c9 Gene ◽  
Inflammatory Drugs ◽  
Anti Inflammatory ◽  
Personalized Approach

Chronic pelvic pain syndrome (CPPS) is equally common in both men and women, causes worsening quality of life, social isolation and disability. The treatment of CPPS requires long-term pharmacotherapy associated with the development of class-specific side effects of nonsteroidal anti-inflammatory drugs (NSAIDs). Genetic study of the carriage of polymorphic alleles of the CYP2C9 gene involved in the metabolism of non-steroidal anti-inflammatory drugs (NSAIDs) prescribed to patients with CPPS is an urgent and in-demand task of modern healthcare. This study allows us not only to determine the genotypes of patients with CPPS but also to identify ways of personalized approach to therapy.

Algorithms for personalized administration of non-steroidal anti-inflammatory drugs for patients with chronic pelvic pain syndrome based on pharmacogenetic testing

Pharmateca ◽  
2021 ◽  
Vol 3_2021 ◽  
pp. 73-80
Author(s):  
R.M. Mamina Mamina ◽  
B.I. Kantemirova Kantemirova ◽  
V.V. Belopasov Belopasov ◽  
E.A. Orlova Orlova ◽  
R.A. Sadretdinov Sadretdinov ◽  
...  
Keyword(s):  
Pelvic Pain ◽  
Chronic Pelvic Pain ◽  
Chronic Pelvic Pain Syndrome ◽  
Pain Syndrome ◽  
Pelvic Pain Syndrome ◽  
Pharmacogenetic Testing ◽  
Inflammatory Drugs ◽  
Anti Inflammatory

IL-17 Exacerbates Experimental Autoimmune Prostatitis via CXCL1/CXCL2-Mediated Neutrophil Infiltration

2021 ◽  
Author(s):  
Cheng Zhang ◽  
Jia Chen ◽  
Hui Wang ◽  
Jing Chen ◽  
Mei-Juan Zheng ◽  
...  
Keyword(s):  
Molecular Mechanisms ◽  
Inflammatory Diseases ◽  
Chronic Pelvic Pain Syndrome ◽  
Neutrophil Migration ◽  
Pain Syndrome ◽  
Neutrophil Infiltration ◽  
Pelvic Pain Syndrome ◽  
Neutralizing Monoclonal Antibody ◽  
Inflammatory Changes ◽  
Experimental Autoimmune

Abstract Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is a poorly understood disease. Accumulating evidence suggests that autoimmune dysfunction is involved in the development of CP/CPPS. IL-17 is associated with the occurrence and development of several chronic autoimmune inflammatory diseases. However, the molecular mechanisms underlying the role of IL-17 in CP/CPPS remain unclear. Herein, we first confirmed that IL-17 was increased in the prostate tissues of experimental autoimmune prostatitis (EAP) mice. Corresponding to the increase of IL-17 in the prostate of EAP, neutrophil infiltration and the levels of CXCL1 and CXCL2 (CXC chemokine ligands 1 and 2) were also increased. Treatment of EAP mice with IL-17-neutralizing monoclonal antibody (mAb) resulted in a decreased number of infiltrated neutrophils, as well as the CXCL1 and CXCL2 level. Depletion of neutrophil by anti-Ly6G antibodies ameliorated inflammatory changes and hyperalgesia caused by EAP. Fucoidan, which could potently inhibit neutrophil migration, could also ameliorate the manifestations of EAP. Our finding suggested that IL-17 promoted the production of CXCL1 and CXCL2, which subsequently triggered neutrophil chemotaxis to prostate tissues. And fucoidan might be a potential drug for the therapy of EAP by the effectively inhibiting on neutrophil infiltration.

scholarly journals Nutraceutical treatment and prevention of benign prostatic hyperplasia and prostate cancer

2019 ◽  
Vol 91 (3) ◽  
Author(s):  
Arrigo F.G. Cicero ◽  
Olta Allkanjari ◽  
Gian Maria Busetto ◽  
Tommaso Cai ◽  
Gaetano Larganà ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Medicinal Plants ◽  
Pelvic Pain ◽  
Chronic Pelvic Pain ◽  
Protective Factor ◽  
Chronic Pelvic Pain Syndrome ◽  
Pain Syndrome ◽  
Pelvic Pain Syndrome ◽  
Serenoa Repens ◽  
Anti Inflammatory

During the last years, pharmaceutical innovations in primary care are dramatically less frequent and will be even more rare in the next future. In this context, preclinical and clinical research oriented their interest toward natural compounds efficacy and safety, supporting the development of a new “nutraceutical” science. Medicinal plants, in the form of plant parts or extracts of them, are commonly used for the treatment of prostate diseases such as benign hypertrophy, prostatitis and chronic pelvic pain syndrome. The pharmacological properties searched for the treatment of prostatic diseases are anti-androgenic, anti-estrogenic, antiproliferative, antioxidant and anti-inflammatory. The most studied and used medicinal plants are Serenoa repens, Pygeum africanum and Urtica dioica. Other promising plants are Cucurbita pepo, Epilobium spp, Lycopersum esculentum, Secale cereale, Roystonea regia, Vaccinium macrocarpon. In parallel, epidemiological studies demonstrated that diet may play an important role on incidence and development of prostatic diseases. The Mediterranean diet is rich of elements with anti-oxidant properties that act as a protective factor for prostatic cancer. Similarly, low intake of animal protein, high intake of fruits and vegetable, lycopene and zinc are a protective factor for benign prostatic hyperplasia (BPH). Serenoa repens in the treatment of symptoms of BPH has been tested either alone or, more frequently, in combination with other medicinal plants, alpha-blockers and inhibitors of 5- alpha reductase (5-ARI). Recent meta-analyses found the effectiveness of Serenoa repens similar or inferior of that of finasteride and tamsulosin but clearly higher than that of placebo in the treatment of mild and moderate low urinary tract symptoms (LUTS), nocturia and discomfort. Clinical trials showed potential synergistic effect of Serenoa repens with other medicinal plants and drugs. In addition to Serenoa repens, there are many other medicinal plants for which clinical evidence is still controversial. Urtica dioica, Pygeum africanum and Curcubita pepo can be considered as an adjunct to the common therapies and their use is supported by studies showing improvement of symptoms and flowmetric indices. Lycopene and selenium are natural products with antioxidant and anti-inflammatory action. The combination of lycopene and selenium with Serenoa repens was able to reduce inflammation in histological prostate sections and to further improve symptom scores and urinary flow in patients with BPH on tamsulosin treatment. Similar effects could be obtained with the use of other carotenoids, such as astaxanthin, and/or zinc. Efficacy on symptoms of patients with BPH of some polyphenols such as quercitin, equol and curcumin have been demonstrated by clinical studies. Pollen extract is a mixture of natural components able to inhibit several cytokines and prostaglandin and leukotriene synthesis resulting in a potent anti-inflammatory effect. Pollen extracts significantly improve symptoms, pain, and quality of life in patients affected by chronic pelvic pain syndrome and chronic prostatitis. Beta-sitosterol is a sterol able to improve urinary symptoms and flow measures, but not to reduce the size of the prostate gland. Palmitoylethanolamide (PEA) is an endogenous fatty acid amide-signaling molecule with anti-inflammatory and neuroprotective effects that can have an interesting role in the management of chronic pelvic pain syndrome and chronic urological pain. Finally, several plant-based products have been subjected to preclinical, in vitro and in vivo, investigations for their potential pharmacological activity against prostate cancer. Some epidemiological studies or clinical trials evaluated the effects of beverages, extracts or food preparations on the risk of prostate cancer. Some plant species deserved more intense investigation, such as Camelia sinensis (green or black tea), Solanum lycopersicum (common tomato), Punica granatum (pomegranate), Glycine max (common soy) and Linum usitatissimum (linen).

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