Pub Date : 2022-07-11DOI: 10.21886/2219-8075-2022-13-3-36-49
V. Malygin, E. A. Kutukova, A. S. Iskandirova, E. E. Pahtusova, Y. Merkurieva, Y. Malygin
Purpose: to study the formed images of sexual self-consciousness in persons who applied for permission to change their sex. Materials and methods: 80 people were examined, 40 of whom applied for permission to change their sex (20 people male and 20 people of the female biological sex). The comparison group — 20 men and 20 women, whose gender identity coincides with the biological sex. Methods — Sandra Bem's BSRI (Bem Sex-Role Inventory) test, V.V. Stolin's self-attitude questionnaire, O.L. Kustovoi's questionnaire. Results: it has been established that in the group of transsexuals with a female biological sex, images of a man and a woman are clearly distinguished, the self-image is closer to the desired image of a man, while the image of a woman is less achievable. The group of male transsexuals is closer to the image of the “Ideal Man” than to the image of the “Ideal Woman”. The key features that correspond to their self-determination as women are revealed: passivity, dependence on others, compromise, gullibility. According to the self-perception of all 4 groups, the “Ideal Woman” is happier than the “Ideal Man”. In the transsexuals’ group of male biological sex, were found no differences with the indicators of conditionally healthy groups of both sexes in the parameter “Love for children”, in contrast to the group of female transsexuals of the biological sex. Male transsexuals are looking for a radically new way to meet their needs without judgment from society. Summary: the indicators of self-relationship in the comparison groups are higher than in the groups of persons striving for a sex change.
{"title":"Self-consciousness features of persons with gender identity disorder","authors":"V. Malygin, E. A. Kutukova, A. S. Iskandirova, E. E. Pahtusova, Y. Merkurieva, Y. Malygin","doi":"10.21886/2219-8075-2022-13-3-36-49","DOIUrl":"https://doi.org/10.21886/2219-8075-2022-13-3-36-49","url":null,"abstract":"Purpose: to study the formed images of sexual self-consciousness in persons who applied for permission to change their sex. Materials and methods: 80 people were examined, 40 of whom applied for permission to change their sex (20 people male and 20 people of the female biological sex). The comparison group — 20 men and 20 women, whose gender identity coincides with the biological sex. Methods — Sandra Bem's BSRI (Bem Sex-Role Inventory) test, V.V. Stolin's self-attitude questionnaire, O.L. Kustovoi's questionnaire. Results: it has been established that in the group of transsexuals with a female biological sex, images of a man and a woman are clearly distinguished, the self-image is closer to the desired image of a man, while the image of a woman is less achievable. The group of male transsexuals is closer to the image of the “Ideal Man” than to the image of the “Ideal Woman”. The key features that correspond to their self-determination as women are revealed: passivity, dependence on others, compromise, gullibility. According to the self-perception of all 4 groups, the “Ideal Woman” is happier than the “Ideal Man”. In the transsexuals’ group of male biological sex, were found no differences with the indicators of conditionally healthy groups of both sexes in the parameter “Love for children”, in contrast to the group of female transsexuals of the biological sex. Male transsexuals are looking for a radically new way to meet their needs without judgment from society. Summary: the indicators of self-relationship in the comparison groups are higher than in the groups of persons striving for a sex change.","PeriodicalId":18314,"journal":{"name":"Medical Herald of the South of Russia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87925892","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-07-11DOI: 10.21886/2219-8075-2022-13-3-118-126
O. V. Arsenicheva
Objective: to study predictors of acute kidney injury (AKI) in patients with ST-segment elevation myocardial infarction (STEMI) complicated by cardiogenic shock (CS) who underwent percutaneous coronary intervention. Materials and methods: 109 patients with STEMI complicated by CS were studied after interventional intervention (mean age 63.1±10.1 years). The observation group included 33 patients with AKI, and the comparison group — 76 patients without AKI. AKI was diagnosed with an increase in plasma creatinine level by ≥26.5 mmol/l from the baseline level within 48 hours or by ≥1.5 times from its known or assumed basal level. To identify predictors of AKI, the method of simple and multiple logistic regression was used. Results: among patients with AKI, patients aged over 70 years (54.5% vs 15.8%, p<0.001), with concomitant chronic kidney disease (57.6% vs 26.3%, p=0.002), chronic heart failure with a low ejection fraction (69.7% vs 36.8%, p=0.001), an initial glomerular filtration rate of less than 60 ml/min/1.73 m2 (54.5% vs 22.4%, p=0.001) and a left ventricular ejection fraction below 40% (75.8% vs 51.3%, p=0.022) and a three-vascular lesion of the coronary arteries (63.6% vs 40.8%, p=0.028) were significantly more often observed. Conclusions: AKI in patients with STEMI complicated by CS after intracoronary intervention was associated with an age older than 70 years, the presence of a left ventricular ejection fraction of less than 40% and a glomerular filtration rate of less than 60 ml/min/1.73 m2.
目的:探讨经皮冠状动脉介入治疗st段抬高型心肌梗死(STEMI)合并心源性休克(CS)患者急性肾损伤(AKI)的预测因素。材料与方法:对经介入治疗的STEMI合并CS患者109例(平均年龄63.1±10.1岁)进行研究。观察组有AKI患者33例，对照组无AKI患者76例。AKI诊断为48小时内血浆肌酐水平较基线水平升高≥26.5 mmol/l，或较已知或假定的基础水平升高≥1.5倍。为了确定AKI的预测因素，采用了简单和多元逻辑回归的方法。结果:在AKI患者中，年龄超过70岁(54.5% vs 15.8%， p<0.001)，合并慢性肾脏疾病(57.6% vs 26.3%， p=0.002)，慢性心力衰竭伴低射血分数(69.7% vs 36.8%， p=0.001)，初始肾小球滤过率小于60 ml/min/1.73 m2 (54.5% vs 22.4%， p=0.001)，左心室射血分数低于40% (75.8% vs 51.3%， p=0.022)，冠状动脉三血管病变(63.6% vs 40.8%， p=0.001)。P =0.028)。结论:STEMI合并CS患者冠状动脉内介入治疗后AKI与年龄大于70岁、左室射血分数小于40%、肾小球滤过率小于60ml /min/1.73 m2相关。
{"title":"Predictors of acute kidney injury in patients with ST-segment elevation myocardial infarction complicated by cardiogenic shock who underwent percutaneous coronary intervention","authors":"O. V. Arsenicheva","doi":"10.21886/2219-8075-2022-13-3-118-126","DOIUrl":"https://doi.org/10.21886/2219-8075-2022-13-3-118-126","url":null,"abstract":"Objective: to study predictors of acute kidney injury (AKI) in patients with ST-segment elevation myocardial infarction (STEMI) complicated by cardiogenic shock (CS) who underwent percutaneous coronary intervention. Materials and methods: 109 patients with STEMI complicated by CS were studied after interventional intervention (mean age 63.1±10.1 years). The observation group included 33 patients with AKI, and the comparison group — 76 patients without AKI. AKI was diagnosed with an increase in plasma creatinine level by ≥26.5 mmol/l from the baseline level within 48 hours or by ≥1.5 times from its known or assumed basal level. To identify predictors of AKI, the method of simple and multiple logistic regression was used. Results: among patients with AKI, patients aged over 70 years (54.5% vs 15.8%, p<0.001), with concomitant chronic kidney disease (57.6% vs 26.3%, p=0.002), chronic heart failure with a low ejection fraction (69.7% vs 36.8%, p=0.001), an initial glomerular filtration rate of less than 60 ml/min/1.73 m2 (54.5% vs 22.4%, p=0.001) and a left ventricular ejection fraction below 40% (75.8% vs 51.3%, p=0.022) and a three-vascular lesion of the coronary arteries (63.6% vs 40.8%, p=0.028) were significantly more often observed. Conclusions: AKI in patients with STEMI complicated by CS after intracoronary intervention was associated with an age older than 70 years, the presence of a left ventricular ejection fraction of less than 40% and a glomerular filtration rate of less than 60 ml/min/1.73 m2.","PeriodicalId":18314,"journal":{"name":"Medical Herald of the South of Russia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85791870","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-07-11DOI: 10.21886/2219-8075-2022-13-3-50-58
N. V. Solovieva, S. A. Kremenitskaya, E. Makarova
Objective: to identify potentially reversible clinical and socio-demographic factors influencing the social adaptation of patients with gender incongruence (GI). Materials and methods: a retrospective analysis of 926 patient records with MtF and FtM GI was performed. Results: among the patients who applied, 44.38% were MtF, 55.62% were FtM. The mean age was 24.0 years (from 13 to 65 years). The educational level of patients is mainly represented by higher (44.2%) and specialized (22.3%) education, 43% of persons lived in the village, 57% - in urban areas. The majority of those who applied grew up in a complete family (82.02%). The first manifestations of GI started mainly in the prepubertal (26.4%) and parapubertal (61.6%) period (up to 13 years). The average age of accepting oneself as a transgender person was 17.0 years. Steps to reduce dysphoria and receive specialized care are usually taken after the age of 20. 83.1% of transgender patients had depressive episodes, and a third (38.5%) had autoaggression. Additional psychiatric diagnoses were present in 24.5% of patients and are represented by 3 groups of diseases: group 1 (6.2%) — potentially reversible neurotic disorders; group 2 (14.1%) — background mental illnesses that are not the cause of GI; group 3 (4.3%) — other mental states with “ideas of sex change”. Conclusions: improvement of social adaptation and prevention of emotional and psychological experiences in persons with GI, assistance is possible at several levels: family, educational institutions, medical community, patient organizations.
{"title":"Clinical and socio-demographic factors influencing social adaptation in individuals with gender incongruence","authors":"N. V. Solovieva, S. A. Kremenitskaya, E. Makarova","doi":"10.21886/2219-8075-2022-13-3-50-58","DOIUrl":"https://doi.org/10.21886/2219-8075-2022-13-3-50-58","url":null,"abstract":"Objective: to identify potentially reversible clinical and socio-demographic factors influencing the social adaptation of patients with gender incongruence (GI). Materials and methods: a retrospective analysis of 926 patient records with MtF and FtM GI was performed. Results: among the patients who applied, 44.38% were MtF, 55.62% were FtM. The mean age was 24.0 years (from 13 to 65 years). The educational level of patients is mainly represented by higher (44.2%) and specialized (22.3%) education, 43% of persons lived in the village, 57% - in urban areas. The majority of those who applied grew up in a complete family (82.02%). The first manifestations of GI started mainly in the prepubertal (26.4%) and parapubertal (61.6%) period (up to 13 years). The average age of accepting oneself as a transgender person was 17.0 years. Steps to reduce dysphoria and receive specialized care are usually taken after the age of 20. 83.1% of transgender patients had depressive episodes, and a third (38.5%) had autoaggression. Additional psychiatric diagnoses were present in 24.5% of patients and are represented by 3 groups of diseases: group 1 (6.2%) — potentially reversible neurotic disorders; group 2 (14.1%) — background mental illnesses that are not the cause of GI; group 3 (4.3%) — other mental states with “ideas of sex change”. Conclusions: improvement of social adaptation and prevention of emotional and psychological experiences in persons with GI, assistance is possible at several levels: family, educational institutions, medical community, patient organizations.","PeriodicalId":18314,"journal":{"name":"Medical Herald of the South of Russia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86647705","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-06-29DOI: 10.21886/2219-8075-2022-13-2-26-33
M. Khamoshina, I. S. Zhuravleva, E. Dmitrieva, M. Lebedeva
Due to the total aging of the population, within the framework of the concept of “active longevity”, age-related aspects of women’s health have been paid close attention in the last decade. The physiological features of the menopausal period of life are due to the consequences of estrogen deficiency, while the protective effect of menopausal hormone therapy (MHT) in relation to diseases associated with age and aging leaves no doubt. At the same time, in the context of the ongoing COVID-19 pandemic, there are many open questions related to the appointment of MHT, both in terms of possible additional mechanisms for protecting the vascular wall, and in terms of risks, including against the background of changes in the state of immunity and the coagulation system. New realities require the development and justification of often fundamentally different approaches to the management of patients in gynecological practice, both in connection with coronavirus infection and in the postcovid period. That is why the organization of gynecological care during a pandemic requires a personalized approach to the management of patients with hormone-dependent diseases and the risk of unplanned pregnancy, as well as the development of clear algorithms that can be relied on in the daily work of both a practitioner and health care organizers.
{"title":"Menopausal hormone therapy and postcovid syndrome: new realities","authors":"M. Khamoshina, I. S. Zhuravleva, E. Dmitrieva, M. Lebedeva","doi":"10.21886/2219-8075-2022-13-2-26-33","DOIUrl":"https://doi.org/10.21886/2219-8075-2022-13-2-26-33","url":null,"abstract":"Due to the total aging of the population, within the framework of the concept of “active longevity”, age-related aspects of women’s health have been paid close attention in the last decade. The physiological features of the menopausal period of life are due to the consequences of estrogen deficiency, while the protective effect of menopausal hormone therapy (MHT) in relation to diseases associated with age and aging leaves no doubt. At the same time, in the context of the ongoing COVID-19 pandemic, there are many open questions related to the appointment of MHT, both in terms of possible additional mechanisms for protecting the vascular wall, and in terms of risks, including against the background of changes in the state of immunity and the coagulation system. New realities require the development and justification of often fundamentally different approaches to the management of patients in gynecological practice, both in connection with coronavirus infection and in the postcovid period. That is why the organization of gynecological care during a pandemic requires a personalized approach to the management of patients with hormone-dependent diseases and the risk of unplanned pregnancy, as well as the development of clear algorithms that can be relied on in the daily work of both a practitioner and health care organizers.","PeriodicalId":18314,"journal":{"name":"Medical Herald of the South of Russia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84420676","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-06-29DOI: 10.21886/2219-8075-2022-13-2-7-17
Y. A. Boldyreva, V. Tskhay, A. Polstyanoy, O. Polstyanaya
In the practice of an obstetrician-gynecologist, the problem of pelvic organ prolapse is increasingly being raised. Symptoms of pelvic organ prolapse are noted from a young age, gradually progressing and reducing the patient’s quality of life. Various surgical methods of treatment also don’t solve the problem of prolapse. The recurrence rate after correction of prolapse with own tissues reaches 40%, and operations using mesh implants have a number of specific complications, the fight against which sometimes becomes more difficult than primary intervention. Despite the steady increase in the prevalence of the disease, effective methods of dealing with it have not yet been developed. Also, the tactics of managing patients at the initial stage of prolapse, when there are complaints, but they are not given enough attention, both by the doctor and the patient, are not defined. The main risk factors for the disease are: perineal ruptures during childbirth, episiotomy, menopause, repeated pregnancies and childbirth, polyhydramnios, multiple pregnancy, fetal macrosomia, conditions accompanied by a chronic increase in intraabdominal pressure, heavy physical labor, impaired innervation and circulation of the pelvic floor, genetic predisposition, hysterectomy and connective tissue dysplasia. The review is devoted to the causes and methods of prevention of pelvic organ prolapse at the present stage. Methods such as pelvic floor muscles training, including in the biofeedback mode using vaginal simulators, electrical impulse stimulation, high-intensity focused electromagnetic stimulation, and non-ablative Er:YAG laser therapy are considered. A systematic literature search was carried out using Scopus, web of Science, MedLine, PubMed and eLibrary data base system.
在妇产科医生的实践中，盆腔器官脱垂的问题越来越多地被提出。盆腔器官脱垂的症状从年轻时开始就被注意到，逐渐发展并降低患者的生活质量。各种手术治疗方法也不能解决脱垂的问题。自体组织矫正脱垂后的复发率达到40%，使用网状植入物的手术有许多特定的并发症，与之斗争有时比初次干预更困难。尽管这种疾病的流行率稳步上升，但尚未制定出有效的治疗方法。此外，在脱垂的初始阶段，当有抱怨，但医生和患者都没有给予足够的重视时，管理患者的策略也没有明确规定。该疾病的主要危险因素是:分娩时会阴破裂、会阴切开术、更年期、反复怀孕和分娩、羊水过多、多胎妊娠、胎儿巨大、伴有腹内压慢性升高的病症、繁重的体力劳动、盆底神经支配和循环受损、遗传易感性、子宫切除术和结缔组织发育不良。本文就现阶段盆腔器官脱垂的原因及预防方法作一综述。方法，如盆底肌肉训练，包括在生物反馈模式下使用阴道模拟器，电脉冲刺激，高强度聚焦电磁刺激和非烧蚀Er:YAG激光治疗。采用Scopus、web of Science、MedLine、PubMed和library数据库系统进行系统的文献检索。
{"title":"Modern possibilities for the prevention of pelvic organ prolapse","authors":"Y. A. Boldyreva, V. Tskhay, A. Polstyanoy, O. Polstyanaya","doi":"10.21886/2219-8075-2022-13-2-7-17","DOIUrl":"https://doi.org/10.21886/2219-8075-2022-13-2-7-17","url":null,"abstract":"In the practice of an obstetrician-gynecologist, the problem of pelvic organ prolapse is increasingly being raised. Symptoms of pelvic organ prolapse are noted from a young age, gradually progressing and reducing the patient’s quality of life. Various surgical methods of treatment also don’t solve the problem of prolapse. The recurrence rate after correction of prolapse with own tissues reaches 40%, and operations using mesh implants have a number of specific complications, the fight against which sometimes becomes more difficult than primary intervention. Despite the steady increase in the prevalence of the disease, effective methods of dealing with it have not yet been developed. Also, the tactics of managing patients at the initial stage of prolapse, when there are complaints, but they are not given enough attention, both by the doctor and the patient, are not defined. The main risk factors for the disease are: perineal ruptures during childbirth, episiotomy, menopause, repeated pregnancies and childbirth, polyhydramnios, multiple pregnancy, fetal macrosomia, conditions accompanied by a chronic increase in intraabdominal pressure, heavy physical labor, impaired innervation and circulation of the pelvic floor, genetic predisposition, hysterectomy and connective tissue dysplasia. The review is devoted to the causes and methods of prevention of pelvic organ prolapse at the present stage. Methods such as pelvic floor muscles training, including in the biofeedback mode using vaginal simulators, electrical impulse stimulation, high-intensity focused electromagnetic stimulation, and non-ablative Er:YAG laser therapy are considered. A systematic literature search was carried out using Scopus, web of Science, MedLine, PubMed and eLibrary data base system.","PeriodicalId":18314,"journal":{"name":"Medical Herald of the South of Russia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85662661","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-06-29DOI: 10.21886/2219-8075-2022-13-2-146-153
A. I. Kovalev
The review article gives a modern definition of the concept of agoraphobia. Different classification approaches in the typing of agoraphobia are presented. Its role as a factor aggravating the course of non-psychotic mental disorders is shown. The features of its manifestation depending on the nosological affiliation are analyzed. It was revealed that agoraphobia is a predictor of an unfavorable outcome in people with panic disorder. In turn, panic disorder often causes the development of agoraphobia. At the same time, gender and age aspects are noted. The comorbidity of agoraphobia and somato-vegetative type of generalized anxiety disorder is shown. Agoraphobia increases the risk of suicidal behavior in depression, has a high correlation with the severity of personality disorders, especially of the avoidant and dependent type. At the same time, some researchers dispute the point of view that these types of personality disorders are predisposing factors for panic disorder and agoraphobia, based on retrospective data on the premorbid personality structure of patients with anxiety disorders. The relationship between PTSD and panic disorder is emphasized in connection with the emergence of a circular model of the development of feelings of fear, which postulates a similar etiology of anxiety disorders. There is a comorbidity of agoraphobia with disorders of the hypochondriac spectrum: from the degree of fixation to obsessive nature. reduces the effectiveness of therapy for schizophrenic spectrum disorders and the quality of life of patients. The picture of the panic disorder itself with agoraphobia becomes heavier if the patient has chronic alcoholism (in particular, the frequency of seizures increases), while the presence of agoraphobic symptoms leads to a relapse of alcoholic illness, which is explained by taking alcohol to relieve symptoms, and also increases the likelihood of developing dependence on tranquilizers.
{"title":"Clinical features of the combination of agoraphobia and non-psychotic mental disorders","authors":"A. I. Kovalev","doi":"10.21886/2219-8075-2022-13-2-146-153","DOIUrl":"https://doi.org/10.21886/2219-8075-2022-13-2-146-153","url":null,"abstract":"The review article gives a modern definition of the concept of agoraphobia. Different classification approaches in the typing of agoraphobia are presented. Its role as a factor aggravating the course of non-psychotic mental disorders is shown. The features of its manifestation depending on the nosological affiliation are analyzed. It was revealed that agoraphobia is a predictor of an unfavorable outcome in people with panic disorder. In turn, panic disorder often causes the development of agoraphobia. At the same time, gender and age aspects are noted. The comorbidity of agoraphobia and somato-vegetative type of generalized anxiety disorder is shown. Agoraphobia increases the risk of suicidal behavior in depression, has a high correlation with the severity of personality disorders, especially of the avoidant and dependent type. At the same time, some researchers dispute the point of view that these types of personality disorders are predisposing factors for panic disorder and agoraphobia, based on retrospective data on the premorbid personality structure of patients with anxiety disorders. The relationship between PTSD and panic disorder is emphasized in connection with the emergence of a circular model of the development of feelings of fear, which postulates a similar etiology of anxiety disorders. There is a comorbidity of agoraphobia with disorders of the hypochondriac spectrum: from the degree of fixation to obsessive nature. reduces the effectiveness of therapy for schizophrenic spectrum disorders and the quality of life of patients. The picture of the panic disorder itself with agoraphobia becomes heavier if the patient has chronic alcoholism (in particular, the frequency of seizures increases), while the presence of agoraphobic symptoms leads to a relapse of alcoholic illness, which is explained by taking alcohol to relieve symptoms, and also increases the likelihood of developing dependence on tranquilizers.","PeriodicalId":18314,"journal":{"name":"Medical Herald of the South of Russia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86457378","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-06-29DOI: 10.21886/2219-8075-2022-13-2-113-121
A. V. Kamaev, S. A. Krivskaya, N. Lyashenko, I. Kamaeva, Y. Mizernitsky, N. Shaporova
Objective: to investigate correlation between thymic stromal lymphopoietin and bronchial asthma course and control in patients of different age groups. Materials and methods: one hundred and four patients were included in 1-year long open prospective study. There were three age groups: children (6 –11 y.o., n=38), adolescents (14–17 y.o., n=35) and adults (25 –50 y.o., n=31). we used asthma duration ≥12 months, uncontrolled asthma and acute respiratory infection absence for ≥14 days as inclusion criteria. Clinical history, validated questionnaires, spirometry, common blood count, serum and nasal material to evaluate thymic stromal lymphopoietin were obtained during first visit. Patient were consequently examined twice with 6 months intervals. Statistical analyses included ANOVA (Kruskal-wallis test) and Pearson’s correlation (r). Differences accepted significant with р<0,05. Resuts: prevalence of main risk factors of asthma control lost (poor compliance, obesity, non-atopic phenotype, fixed airway obstruction) was different in age groups. we didn’t find any thymic stromal lymphopoietin in nasal material. Thymic stromal lymphopoietin concentration correlate significantly with duration of uncontrolled asthma in previous 12 months (r=0,74). we have found greater serum thymic stromal lymphopoietin concentration in patients who demonstrated FEV1 below normal at Visit 3. Conclusion. Serum thymic stromal lymphopoietin level can be used as risk factor of asthma future exacerbation and spirometry results decline.
{"title":"Thymic stromal lymphopoietin in bronchial asthma patients of different age groups: correlation with other markers, lung function results and disease control","authors":"A. V. Kamaev, S. A. Krivskaya, N. Lyashenko, I. Kamaeva, Y. Mizernitsky, N. Shaporova","doi":"10.21886/2219-8075-2022-13-2-113-121","DOIUrl":"https://doi.org/10.21886/2219-8075-2022-13-2-113-121","url":null,"abstract":"Objective: to investigate correlation between thymic stromal lymphopoietin and bronchial asthma course and control in patients of different age groups. Materials and methods: one hundred and four patients were included in 1-year long open prospective study. There were three age groups: children (6 –11 y.o., n=38), adolescents (14–17 y.o., n=35) and adults (25 –50 y.o., n=31). we used asthma duration ≥12 months, uncontrolled asthma and acute respiratory infection absence for ≥14 days as inclusion criteria. Clinical history, validated questionnaires, spirometry, common blood count, serum and nasal material to evaluate thymic stromal lymphopoietin were obtained during first visit. Patient were consequently examined twice with 6 months intervals. Statistical analyses included ANOVA (Kruskal-wallis test) and Pearson’s correlation (r). Differences accepted significant with р<0,05. Resuts: prevalence of main risk factors of asthma control lost (poor compliance, obesity, non-atopic phenotype, fixed airway obstruction) was different in age groups. we didn’t find any thymic stromal lymphopoietin in nasal material. Thymic stromal lymphopoietin concentration correlate significantly with duration of uncontrolled asthma in previous 12 months (r=0,74). we have found greater serum thymic stromal lymphopoietin concentration in patients who demonstrated FEV1 below normal at Visit 3. Conclusion. Serum thymic stromal lymphopoietin level can be used as risk factor of asthma future exacerbation and spirometry results decline.","PeriodicalId":18314,"journal":{"name":"Medical Herald of the South of Russia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77239873","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-06-29DOI: 10.21886/2219-8075-2022-13-2-72-79
M. Esetov, A. M. Esetov
Objective: the purpose of this publication is to present the establishment of the implantation zone of the fetal egg during ultrasound diagnostics at 5-7 weeks to differentiate the types of cicatricial and isthmian pregnancies in women with a scar on the uterus after cesarean section. Materials and methods: the study included 11 women with low implantation of the fetal egg in the presence of a scar on the uterus. All underwent ultrasound with transabdominal and transvaginal approaches at 5–7 weeks of pregnancy to establish the place of implantation of the fetal egg relative to the scar on the uterus. Results: according to the results of ultrasound evaluation of the implantation zone of the fetal egg in 5–7 weeks were differentiated: type 1 of scar pregnancy (1 case); type 2 of scar pregnancy (7 cases) and low implantation along the posterior wall of the uterus at the level of the scar intact from it (2 cases). Conclusions: ultrasound at 5–7 weeks is a necessary method of examination in women with a scar on the uterus for the diagnosis of scar pregnancy. The establishment of the implantation zone of the fetal egg is a tool that allows differentiating the types of cicatricial and isthmic pregnancies.
{"title":"Implantation zone as an echographic criterion identification of types of cicatricial and isthmic pregnancies in women with a scar on the uterus","authors":"M. Esetov, A. M. Esetov","doi":"10.21886/2219-8075-2022-13-2-72-79","DOIUrl":"https://doi.org/10.21886/2219-8075-2022-13-2-72-79","url":null,"abstract":"Objective: the purpose of this publication is to present the establishment of the implantation zone of the fetal egg during ultrasound diagnostics at 5-7 weeks to differentiate the types of cicatricial and isthmian pregnancies in women with a scar on the uterus after cesarean section. Materials and methods: the study included 11 women with low implantation of the fetal egg in the presence of a scar on the uterus. All underwent ultrasound with transabdominal and transvaginal approaches at 5–7 weeks of pregnancy to establish the place of implantation of the fetal egg relative to the scar on the uterus. Results: according to the results of ultrasound evaluation of the implantation zone of the fetal egg in 5–7 weeks were differentiated: type 1 of scar pregnancy (1 case); type 2 of scar pregnancy (7 cases) and low implantation along the posterior wall of the uterus at the level of the scar intact from it (2 cases). Conclusions: ultrasound at 5–7 weeks is a necessary method of examination in women with a scar on the uterus for the diagnosis of scar pregnancy. The establishment of the implantation zone of the fetal egg is a tool that allows differentiating the types of cicatricial and isthmic pregnancies.","PeriodicalId":18314,"journal":{"name":"Medical Herald of the South of Russia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74726110","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-06-29DOI: 10.21886/2219-8075-2022-13-2-50-58
E. S. Nikitina, A. N. Rymashevsky, Y. L. Naboka, M. A. Rymashevsky, I. Gudima, E. G. Svirava
Objective: to study the microbiota of the vagina, myomatous nodes, their bed in patients with fibroids. Materials and methods: a comprehensive examination of 83 patients aged 26 to 50 years with diagnosed interstitial, interstitial-subserous uterine myoma was carried out. By age, all women are divided into 3 groups. Standard clinical and clinical laboratory studies, colposcopy, microbiological examination of the detachable posterior vaginal fornix, biopsy specimens of myomatous nodes and their bed, as well as morphological examination of biopsy specimens of myomatous nodes and their bed were performed.Results: in the structure of clinical manifestations of uterine fibroids, pain syndrome was the leading one (p<0.05). The number of myoma nodes in patients varied from 1 to 22. The duration of the operation and the amount of blood loss did not differ significantly (p>0.05). According to the results of a bacteriological study of the detachable posterior vaginal fornix in patients in the 2nd group, a decrease in the frequency of detection and the number of lactobacilli was revealed compared to the 1st group, and in women in the 3rd group, these microorganisms were absent. Among the anaerobic microorganisms in the 1st and 2nd groups, Eubacterium spp. dominated, in the 3rd — Peptostreptococcus spp. In patients of group 3, the frequency of detection of Bacteroides spp. was significantly increased (p<0.05). Among the aerobic spectrum of microorganisms in all groups, coagulasenegative staphylococci predominated. In a bacteriological study of biopsy specimens, the absence of growth of microorganisms in myomatous nodes was observed in 7.2% of cases, in the tissue of the bed of myomatous nodes in 17.7%. The microbiota of myomatous nodes and their bed in most cases was represented by anaerobic taxa. According to the results of a morphological study of biopsy specimens, no inflammatory reaction of tissues was detected. Conclusions: In women with uterine myoma of different age groups, multidirectional changes in the vaginal microbiota were revealed. In most cases, the myomatous node (92.8%) and its bed (82.3%) are not sterile with the dominance of anaerobic microbiota taxa. Identified significant correlations in the loci «vagina – myomatous node – myomatous node bed» indicate their relationship. The detection of various taxa of microorganisms in the myomatous node and its bed, according to morphological studies, is not associated with the presence of infectious and inflammatory processes in the tissues.
{"title":"Microbiota of the vagina and myoma nodes in uterine myoma","authors":"E. S. Nikitina, A. N. Rymashevsky, Y. L. Naboka, M. A. Rymashevsky, I. Gudima, E. G. Svirava","doi":"10.21886/2219-8075-2022-13-2-50-58","DOIUrl":"https://doi.org/10.21886/2219-8075-2022-13-2-50-58","url":null,"abstract":"Objective: to study the microbiota of the vagina, myomatous nodes, their bed in patients with fibroids. Materials and methods: a comprehensive examination of 83 patients aged 26 to 50 years with diagnosed interstitial, interstitial-subserous uterine myoma was carried out. By age, all women are divided into 3 groups. Standard clinical and clinical laboratory studies, colposcopy, microbiological examination of the detachable posterior vaginal fornix, biopsy specimens of myomatous nodes and their bed, as well as morphological examination of biopsy specimens of myomatous nodes and their bed were performed.Results: in the structure of clinical manifestations of uterine fibroids, pain syndrome was the leading one (p<0.05). The number of myoma nodes in patients varied from 1 to 22. The duration of the operation and the amount of blood loss did not differ significantly (p>0.05). According to the results of a bacteriological study of the detachable posterior vaginal fornix in patients in the 2nd group, a decrease in the frequency of detection and the number of lactobacilli was revealed compared to the 1st group, and in women in the 3rd group, these microorganisms were absent. Among the anaerobic microorganisms in the 1st and 2nd groups, Eubacterium spp. dominated, in the 3rd — Peptostreptococcus spp. In patients of group 3, the frequency of detection of Bacteroides spp. was significantly increased (p<0.05). Among the aerobic spectrum of microorganisms in all groups, coagulasenegative staphylococci predominated. In a bacteriological study of biopsy specimens, the absence of growth of microorganisms in myomatous nodes was observed in 7.2% of cases, in the tissue of the bed of myomatous nodes in 17.7%. The microbiota of myomatous nodes and their bed in most cases was represented by anaerobic taxa. According to the results of a morphological study of biopsy specimens, no inflammatory reaction of tissues was detected. Conclusions: In women with uterine myoma of different age groups, multidirectional changes in the vaginal microbiota were revealed. In most cases, the myomatous node (92.8%) and its bed (82.3%) are not sterile with the dominance of anaerobic microbiota taxa. Identified significant correlations in the loci «vagina – myomatous node – myomatous node bed» indicate their relationship. The detection of various taxa of microorganisms in the myomatous node and its bed, according to morphological studies, is not associated with the presence of infectious and inflammatory processes in the tissues.","PeriodicalId":18314,"journal":{"name":"Medical Herald of the South of Russia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86182947","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-06-29DOI: 10.21886/2219-8075-2022-13-2-18-25
R. A. Karamyan, I. M. Ordiyats, V. Khorolskiy, D. R. Asatryan
Despite scientific progress, there is currently no sigle opinion about the cause of the occurrence and recurrence of uterine fibroids, but due to the high level of molecular medicine, progress is being made in the hormonal and molecular genetic mechanisms of initiation, formation and growth of the fibroisds. The issue of pathogenetic treatment and prevention of recurrence of uterine fibroids in reproductive age remains relevant. The aims of the review. The aim of this review is to summarize current data about microRNA in biology of uterine leiomyoma (LM). This information can improve our understanding of the broad molecular interaction of signaling pathways in the formation of LM, and further maintaining epigenetic regulation as an important mechanism in the pathogenesis of uterine leiomyoma. In leiomyomas, the expression of a number of non-proteincoding genes is altered, such as microRNAs (miRNAs), which target genes that code protein. Material and research methods. Original and review articles, book chapters in the PubMed database related to the study of the pathogenesis of uterine fibroids in the period from 2004 to 2022 were found and analyzed. Results and discussions. Based on an analytical review of the literature, it becomes obvious that as evidence should be considered: 1. Abnormal myometrial and fibroid stem cells show an increased response to estrogen and progesterone exposure, stimulating processes such as cell proliferation, inhibition of apoptosis, and extracellular matrix (ECM) formation. 2. A number of tumor suppressor genes are abnormally hypermethylated in the LM when compared to normal myometrium, genes that form and regulate collagen, and a subset of estrogen receptor genes. 3. Multiple studies using microarray analysis or sequencing have demonstrated the existence of dysregulation of a number of protein-coding genes involved in cell proliferation and apoptosis, which are critical for the growth and progression of uterine fibroids. There are no reliable evidence base and do not provide an opportunity for practical application of clinically significant risk factors, the possibility of mathematical prediction of the growth of uterine fibroids in women of reproductive age. Data on the effect of the expression of a number of microRNAs on the growth of uterine fibroids in vivo are rather contradictory. The epigenetic processes of regulation and pathogenesis of the growth of leiofibromyomas in reproductive age have not been fully studied and substantiated. There are practically no data on predicting the growth of uterine fibroids in reproductive age, which will allow us to assess the risk of growth and determine further treatment tactics. Conclusion. Further work on the identification of specific genes, miRNAs, that are involved in the pathogenesis of LM may inspire the creation of new pathogenetic treatments. Such treatment is especially relevant for those groups of patients of reproductive age for whom surgical treatment may be ine
{"title":"Uterine fibroids: a look at the problem","authors":"R. A. Karamyan, I. M. Ordiyats, V. Khorolskiy, D. R. Asatryan","doi":"10.21886/2219-8075-2022-13-2-18-25","DOIUrl":"https://doi.org/10.21886/2219-8075-2022-13-2-18-25","url":null,"abstract":"Despite scientific progress, there is currently no sigle opinion about the cause of the occurrence and recurrence of uterine fibroids, but due to the high level of molecular medicine, progress is being made in the hormonal and molecular genetic mechanisms of initiation, formation and growth of the fibroisds. The issue of pathogenetic treatment and prevention of recurrence of uterine fibroids in reproductive age remains relevant. The aims of the review. The aim of this review is to summarize current data about microRNA in biology of uterine leiomyoma (LM). This information can improve our understanding of the broad molecular interaction of signaling pathways in the formation of LM, and further maintaining epigenetic regulation as an important mechanism in the pathogenesis of uterine leiomyoma. In leiomyomas, the expression of a number of non-proteincoding genes is altered, such as microRNAs (miRNAs), which target genes that code protein. Material and research methods. Original and review articles, book chapters in the PubMed database related to the study of the pathogenesis of uterine fibroids in the period from 2004 to 2022 were found and analyzed. Results and discussions. Based on an analytical review of the literature, it becomes obvious that as evidence should be considered: 1. Abnormal myometrial and fibroid stem cells show an increased response to estrogen and progesterone exposure, stimulating processes such as cell proliferation, inhibition of apoptosis, and extracellular matrix (ECM) formation. 2. A number of tumor suppressor genes are abnormally hypermethylated in the LM when compared to normal myometrium, genes that form and regulate collagen, and a subset of estrogen receptor genes. 3. Multiple studies using microarray analysis or sequencing have demonstrated the existence of dysregulation of a number of protein-coding genes involved in cell proliferation and apoptosis, which are critical for the growth and progression of uterine fibroids. There are no reliable evidence base and do not provide an opportunity for practical application of clinically significant risk factors, the possibility of mathematical prediction of the growth of uterine fibroids in women of reproductive age. Data on the effect of the expression of a number of microRNAs on the growth of uterine fibroids in vivo are rather contradictory. The epigenetic processes of regulation and pathogenesis of the growth of leiofibromyomas in reproductive age have not been fully studied and substantiated. There are practically no data on predicting the growth of uterine fibroids in reproductive age, which will allow us to assess the risk of growth and determine further treatment tactics. Conclusion. Further work on the identification of specific genes, miRNAs, that are involved in the pathogenesis of LM may inspire the creation of new pathogenetic treatments. Such treatment is especially relevant for those groups of patients of reproductive age for whom surgical treatment may be ine","PeriodicalId":18314,"journal":{"name":"Medical Herald of the South of Russia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77426021","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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