POSSIBILITIES OF THERAPY OF PAIN SYNDROME IN ENDOMETRIOSIS

Therapeutic tactics of endometriosis are aimed primarily at overcoming the pain syndrome, the absence of recurrence of the underlying disease, maintaining fertility and improving the psycho-emotional state of women. The objective to develop, pathogenetically substantiate treatment and rehabilitation measures taking into account pathogenetic preconditions in women with endometriosis in combination with pain. Materials and methods 85 patients with genital endometriosis with severe pelvic pain (VAS 7-10 points) (n = 44) - group I and moderate (VAS 4-6 points) (n = 41) - group II. The mean age of women in clinical trials I and II of the study was 37.71 ± 0.93 and 41.05 ± 1.08 (M ± m) years, respectively. The choice of treatment tactics was determined on the basis of immunohistochemical markers: estrogen receptors (ER), progesterone (PGR), proliferation index (Ki-67), vasculoendothelial growth factor (VEGF), cyclooxygenase-2 (COX-2) in eutopic acid., psychoemotional characteristics and intensity of pelvic pain. Rеsultes of treatment in the examined patients a significant (p <0.05) reduction of pelvic pain was determined, both in the short and long term. After 6 months, the level of personal anxiety decreased - by - 38.62%, after 12 months. – at - 48.15% (p <0.05). The rate of decrease in the level of depressive disorders on the Hamilton scale of all studied women was: - 32.2% after 6 months and -42.15% after 12 months (p <0.05). Conclusion our approach to treating endometriosis helped to overcome pain in 83.53% of women, improve psycho-emotional and general condition, normalize sleep - was determined in 88.3% of women, reduce reactive anxiety and depressive disorders in 84.7% of patients, indicates the effectiveness proposed therapy.

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Evaluation of Effectiveness of Immunomodulatory Therapy in Combined Treatment of Patients with Chronic Nonbacterial Prostatitis

Health of Man ◽

10.30841/2307-5090.1.2021.232324 ◽

2021 ◽

pp. 27-32

Author(s):

Volodymyr Trishch ◽

Andrii Mysak

Keyword(s):

Pelvic Pain ◽

Standard Therapy ◽

Chronic Pelvic Pain ◽

Chronic Pelvic Pain Syndrome ◽

Pain Syndrome ◽

Pelvic Pain Syndrome ◽

Group I ◽

Chronic Nonbacterial Prostatitis ◽

Nonbacterial Prostatitis ◽

Group Ii

Among men of working age, chronic prostatitis is the most common urological disease, and its inherent symptoms are a common reason for seeking urological care. To date, there is no single universal successful therapy for chronic prostatitis. Therefore, it justifies the further search for new methods of treatment of patients with this pathology. The objective: the aim of the study was to evaluate the effectiveness of immunomodulatory therapy in treatment of patients with chronic nonbacterial prostatitis with inflammatory chronic pelvic pain syndrome (CP/CPPS (NIH IIIA)). Materials and methods. Under observation there were 78 patients with chronic nonbacterial prostatitis, with inflammatory chronic pelvic pain syndrome (NIH IIIA), with a disease duration of more than 2 years and low effectiveness of treatment on the background of standard therapy. All patients received standard therapy according to the clinical protocol. Some patients (group 58-II) on the background of standard therapy were additionally prescribed Overin (cridanimod sodium salt 250 mg/2 ml in 1 amp.) From the pharmaceutical company “Geolik Pharm Marketing Group” 2 ml intramuscularly once a day every 48 h, 10 injections, followed by a comparative evaluation of clinical results relative to the control group of patients (group 20 – I) who received only standard therapy, immediately after treatment and 6 months after treatment. Results. It was found that the use of standard therapy, Overin, in patients with chronic nonbacterial prostatitis with inflammatory chronic pelvic pain syndrome (CP/CPPS – NIHIII A), contributed to a longer and lasting clinical effect, in contrast to the results in the group of patients who received only standard therapy. According to the assessment of the general condition (S+QoL) in group I of patients after treatment and 6 months after the standard course of treatment, the indicator improved by 38.5 and 30.9 %, respectively (p<0.05). Whereas in group II of patients, the score (S+QoL) after treatment after 6 months was 52.8 % and 49.1 % lower than before treatment (p<0.05). Overin has also been shown to be more effective in terms of the severity of the inflammatory process according to the results of prostate secretion microscopy. Lack of inflammatory activity in the prostate, in the presence of less than 10 leukocytes in the field of view at microscopy of its secretion in patients of group I after treatment was observed in 55 %, after 6 months in 45 % of patients, respectively in group II was in 77.3 % after treatment and in 75 % of patients 6 months after treatment. A more visible positive dynamics of immune status in the second group of patients was obtained. Namely, after treatment, there was a probable increase in IFN-γ in the blood by 29.9 % and a decrease in IL-6 by 2.7 times (in ejaculate by 3.2) while maintaining the visible dynamics compared to input data before treatment after 6 months (p<0.05). Whereas in the blood of patients of group I IFN-γ increased after treatment by only 5.5 % and IL-6 decreased by 24.0 % (ejaculate by 22.9 %). The level of sІgA in the ejaculate of patients of group I after treatment increased by 15.7 %, while in group II by 30.2 % (p<0.05). After 6 months, the studied indicators of immune status in the blood and ejaculate of patients of group I, visibly did not differ from the data in this group before treatment (p>0.05). Conclusions. The use of Overin on the background of standard therapy in patients with inflammatory form of CP/CPPS, contributes to a stable and long-lasting clinical effect, which is confirmed by the dynamics of the obtained clinical and laboratory data.

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Expression of Estrogen and Progesterone Receptors in a Tailgut Cyst with Carcinoid Tumor

American Journal of Clinical Pathology ◽

10.1093/ajcp/aqab191.161 ◽

2021 ◽

Vol 156 (Supplement_1) ◽

pp. S76-S77

Author(s):

N Mohamed ◽

D Rampisela ◽

L M Lopez

Keyword(s):

Carcinoid Tumor ◽

Pelvic Pain ◽

Rare Complication ◽

Progesterone Receptors ◽

Cystic Mass ◽

Proliferation Index ◽

Presacral Space ◽

Tailgut Cyst ◽

Ki 67 ◽

Female Predominance

Abstract Introduction/Objective Tailgut cysts (TC) are congenital lesions that arise in the presacral space. They originate from the embryonic hindgut and usually present between the ages of 30-60, with female predominance. TCs are usually asymptomatic or can present with lower back, perianal or pelvic pain. Malignant transformation of a TC is a rare complication, with adenocarcinoma being the most common, followed by carcinoid tumor. About thirty cases of carcinoid tumors arising in a TC have been reported in the literature so far with a slight female predominance (1.5:1). Methods/Case Report We describe a 40-year-old Hispanic woman with a 9-year history of cyclic pelvic pain related to her menstrual cycles. She was diagnosed with adenomyosis and underwent hysterectomy that did not completely resolve her symptoms. Follow-up serial imaging showed a growing complex-cystic presacral mass, which was eventually excised. Grossly, there was a 3.6×3.1×2.5 cm multiloculated cystic mass filled with mucoid material. Microscopically, there were multiple cystic spaces lined by benign squamous and mucinous columnar epithelium and surrounded by smooth muscle cells. A 6-mm carcinoid tumor was found within a cyst wall and confirmed by positive synaptophysin and chromogranin staining with a Ki-67 proliferation index of <2%. Estrogen and progesterone receptor immunostains were positive in the epithelial cyst linings and the stromal cells but not in the carcinoid tumor cells. Results (if a Case Study enter NA) NA Conclusion We conclude that the diagnosis of TC should be considered in the differential of gynecologic patients with unresolved cyclic pelvic pain and that estrogen and progesterone could have an important role in the pathogenesis of TCs. Furthermore, estrogen receptors can be a therapeutic target in patients with this entity.

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The effectiveness of non-steroidal anti-inflammatory drugs in the treatment of chronic pelvic pain syndrome

HEALTH OF WOMAN ◽

10.15574/hw.2018.133.111 ◽

2018 ◽

pp. 111-115

Author(s):

T.G. Romanenko ◽

◽

O.M. Sulimenko ◽

Keyword(s):

Pelvic Pain ◽

Chronic Pelvic Pain ◽

Chronic Pelvic Pain Syndrome ◽

Pain Syndrome ◽

Antiplatelet Agents ◽

Reproductive Age ◽

Pelvic Pain Syndrome ◽

Group I ◽

Inflammatory Drugs

Evidence-based medicine is an approach to medical practice in which the decision on the appointment of therapeutic, diagnostic or preventive measures is based on the evidence of their effectiveness and safety. The objective: assessment of the effectiveness and safety of the use of NSAIDs in the treatment of chronic pelvic pain in women of reproductive age. Materials and methods. Under our supervision, there were 101 women of reproductive age with chronic pelvic pain syndrome (CPPS) on the background of chronic inflammatory processes of the pelvic organs. Patients, depending on the received treatment, were randomly divided into two groups: Group I (n=54) – complex antibiotic (AB) therapy was conducted in combination with antiplatelet agents, antihypoxants, analgesics; Group II (n=47) – complex antibiotic (AB) therapy was performed in combination with antiplatelet agents, antihypoxants and NSAIDs (DICLOSAFE, diclofenac sodium 100 mg). The exclusion criterion was the presence of an endometriosis in a patient. When patients were included in the study and 6 months after the completion of the treatment, a questionnaire was conducted to determine the severity of the pain syndrome, psychological status and quality of life. Results. Positive dynamics of quantitative and qualitative characteristics of the pain syndrome, as well as dynamics of its intensity as a result of conservative treatment for 6 months in group ІІ, was noted. Also, in group ІІ, statistically significant data on the reduction of depression and personal anxiety are noted, in contrast to the indicators of group I. The results of the questionnaire of patients in group II after treatment indicated improvement of all components of physical health. Statistically significant differences with the indicators of Group I were obtained on the scale of the effect of pain on daily activity (BP). In addition, after treatment in the II group, the patients showed statistically significant changes in mental health and all its components: vital activity (VT), social activity (SF), limitation of daily activity due to emotional problems (RE) and mental health I (MH). Conclusion. Pathogenetically grounded use of NSAIDs (DICLOSAFE suppositories) in the complex treatment of patients with CPPS allows to achieve a significant improvement in quality of life indicators due to the correction of pain syndrome. Key words: chronic pelvic pain syndrome, treatment, nonsteroidal anti-inflammatory drugs.

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Prognostic significance of immunohistochemical markers in Primary CNS lymphomas

IP Archives of Cytology and Histopathology Research ◽

10.18231/j.achr.2021.038 ◽

2021 ◽

Vol 6 (3) ◽

pp. 160-165

Author(s):

Indu Ramachandran Nair ◽

Pooja Phalak ◽

Bindhu Mangalath Rajamma ◽

Aiswarya Pradeep ◽

Ayyadurai Retnathankom ◽

...

Keyword(s):

Survival Data ◽

Prognostic Significance ◽

Primary Cns Lymphoma ◽

Proliferation Index ◽

Cns Lymphoma ◽

Ki 67 ◽

Non Hodgkin Lymphoma ◽

Immunohistochemical Markers ◽

Cns Lymphomas ◽

Ihc Markers

Primary CNS lymphoma (PCNSL) is a rare form of extra nodal Non-Hodgkin Lymphoma that is typically conﬁned to the brain, spinal cord, lepto meninges and eyes. We studied the clinico pathological features of PCNSLs, immuno histochemical (IHC) markers expressed and the association of morphological features & IHC markers with clinical outcome. 30 cases of primary CNS lymphomas were studied. 25 cases were diffuse large B cell lymphomas, which were sub classified using Hans algorithm into GCB and non-GCB. The IHC markers done were CD20, CD3, BCL2, BCL6, MUM-1, CD10 and c-myc. Mean proliferation index Ki was 80%. Follow up and survival data was collected and the association of each IHC marker and subtype with prognosis was assessed. PCNSL forms around 2% of all lymphomas as well as primary CNS tumours. Non GCB type is more common (72%). Mean overall survival was 9.7 months. Ki-67 index of 80% or more is the only independent variable of prognostic significance. None of the other IHC markers or sub typing had any influence on the outcome.

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Features of psychological status in women with functional ovarian cysts

Perm Medical Journal ◽

10.17816/pmj36641-47 ◽

2020 ◽

Vol 36 (6) ◽

pp. 41-47

Author(s):

E. A. Sandakova ◽

I. G. Zhukovskaya ◽

A. F. Vaganova

Keyword(s):

Pain Syndrome ◽

Psychological Status ◽

Ovarian Cysts ◽

Second Phase ◽

Pituitary Dysfunction ◽

Group I ◽

Social Functioning Scale ◽

Reactive Anxiety ◽

Characteristic Features ◽

High Level

Aim. To analyze the psychological status indices in women with functional cysts of the ovaries. Materials and methods. The group of observation (group I) included 35 women with functional ovarian cysts (follicular and yellow body cysts), the group of comparison (group II) 34 patients with no cysts available and normal ovarian volume. The mean age of the patients examined was 28.7 5.2 and 29.3 4.8 years, respectively. The methods used included registration of complaints and anamnesis data, standard general clinical and gynecological studies, ultrasound scanning of pelvic organs using apparatus Sonoscape 6000, survey with Beck Depression Inventory, Spielberger-HaninScale, MOS SF-36. Results. Health status of women with functional cysts of the ovaries is characterized by abdominal pain syndrome (91.3 % and 14.7 6.0%; p 0.001), mastodynia in the second phase of cycle (37.1 % and 8.8 4.9 %; p 0.01), dysmenorrhea (37.1 % and 14.7 6.0 %; p 0.05) that undoubtedly influences the indices of psychoemotional status. It is worth noting that the prevalence of smoking among women of group I is high (26.5 % and 2.9 % respectively; p 0.01). The characteristic features of psychological status of group I patients are the following: high level of reactive anxiety (Spielberger-Hanin Anxiety Scale 45.7 1.9 and 35.8 0.9 scores; p 0.001), elevated level of depression (Beck scale 18.9 3.4 and 9.5 5.3 scores; p 0.01) and, as a result, decrease in the quality of life, especially with the Role Functioning Scale (25.71, 61.79 scores, p 0.01) and Social Functioning Scale (26.60 and 62.93 scores, p 0.05). Conclusions. Improvement of health among women with functional ovarian cysts should be complex and include modification of the way of life (refusal from smoking), anti-inflammatory therapy, correction of hypothalamic-pituitary dysfunction and psychological status.

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