Pub Date : 2023-09-29DOI: 10.18370/2309-4117.2023.69.80-88
О.А. Taran, D. Konkov, O. Bulavenko, T. V. Lobastova, O.B. Malinina, N.M. Homon, I.R. Pyvniuk
Research objectives: to study the clinical effectiveness of alternative complex therapy of vegetative syndrome in menopausal patients using L-arginine and xylitol drugs. Materials and methods. The clinical prospective study included 50 patients in the early postmenopausal period with natural menopause, neurovegetative and psychoemotional manifestations of the climacteric syndrome. According to the Life extension strategy, patients received intravenous L-arginine (Tivortin drug) and xylitol solution with electrolytes (Xylat drug) for endothelial protection and correction of insulin resistance in order to treat climacteric syndrome. Modified Kupperman menopausal index, serum triglyceride, cholesterol, high-density lipoprotein, low-density lipoprotein, and very-low-density lipoprotein levels were determined in all women. Examinations were performed before the start of therapy and 3 months after the end of treatment.Results. The Life extension therapeutic strategy as an alternative comprehensive therapy of the vegetative syndrome in menopausal patients contributed to a reliable reduction of the manifestations of the climacteric syndrome. The advantage of combined therapy involving L-arginine and xylitol was manifested in a significant decrease in diastolic blood pressure (p = 0.043); reduction of the Kupperman index (p = 0.002) and the average score of vasomotor symptoms (p = 0.02). There was also a significant decrease in the serum level of insulin (p = 0.00007), HOMA index (p = 0.01), low-density lipoproteins (p = 0.04), and triglycerides (p = 0.03). The selected therapy was well tolerated during the observation period.Conclusions. The combined therapy involving L-arginine and xylitol in the early postmenopausal period with neurovegetative and psychoemotional manifestations of the climacteric syndrome had a pronounced clinical effect, which consisted in a significant reduction of vegetative disorders and stabilization of carbohydrate and lipid metabolism. The given therapeutic strategy can be considered as an alternative therapy in patients with climacteric disorders when phytotherapy is ineffective and when there are contraindications or limitations to menopausal hormone therapy. The results of this study showed the safety of the Life extension strategy.
{"title":"Alternative therapy of menopausal vegetative disorders in women taking the metabolic status into account","authors":"О.А. Taran, D. Konkov, O. Bulavenko, T. V. Lobastova, O.B. Malinina, N.M. Homon, I.R. Pyvniuk","doi":"10.18370/2309-4117.2023.69.80-88","DOIUrl":"https://doi.org/10.18370/2309-4117.2023.69.80-88","url":null,"abstract":"Research objectives: to study the clinical effectiveness of alternative complex therapy of vegetative syndrome in menopausal patients using L-arginine and xylitol drugs. Materials and methods. The clinical prospective study included 50 patients in the early postmenopausal period with natural menopause, neurovegetative and psychoemotional manifestations of the climacteric syndrome. According to the Life extension strategy, patients received intravenous L-arginine (Tivortin drug) and xylitol solution with electrolytes (Xylat drug) for endothelial protection and correction of insulin resistance in order to treat climacteric syndrome. Modified Kupperman menopausal index, serum triglyceride, cholesterol, high-density lipoprotein, low-density lipoprotein, and very-low-density lipoprotein levels were determined in all women. Examinations were performed before the start of therapy and 3 months after the end of treatment.Results. The Life extension therapeutic strategy as an alternative comprehensive therapy of the vegetative syndrome in menopausal patients contributed to a reliable reduction of the manifestations of the climacteric syndrome. The advantage of combined therapy involving L-arginine and xylitol was manifested in a significant decrease in diastolic blood pressure (p = 0.043); reduction of the Kupperman index (p = 0.002) and the average score of vasomotor symptoms (p = 0.02). There was also a significant decrease in the serum level of insulin (p = 0.00007), HOMA index (p = 0.01), low-density lipoproteins (p = 0.04), and triglycerides (p = 0.03). The selected therapy was well tolerated during the observation period.Conclusions. The combined therapy involving L-arginine and xylitol in the early postmenopausal period with neurovegetative and psychoemotional manifestations of the climacteric syndrome had a pronounced clinical effect, which consisted in a significant reduction of vegetative disorders and stabilization of carbohydrate and lipid metabolism. The given therapeutic strategy can be considered as an alternative therapy in patients with climacteric disorders when phytotherapy is ineffective and when there are contraindications or limitations to menopausal hormone therapy. The results of this study showed the safety of the Life extension strategy.","PeriodicalId":21103,"journal":{"name":"Reproductive Endocrinology","volume":"33 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139334123","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 : 2023-06-30DOI: 10.18370/2309-4117.2023.68.30-35
V.V. Artyomenko, N.M. Nastradina, H.V. Kozhukhar
The gut microbiome (GM) is actively studied in terms of its impact on the development of oncological pathology, immune diseases, and metabolic disorders. Women with polycystic ovary syndrome (PCOS) have an imbalance of GM, which indirectly affects the intestinal mucosal barrier. Compared with non-obese patients and a healthy population, obese individuals with PCOS have increased numbers of Enterobacteriaceae, decreased numbers of Lactobacillus and Bifidobacterium, and changes in GM are associated with inflammation and insulin resistance.Fecal microbiota transplantation is a new method of treating inflammatory bowel diseases. GM regulation to improve the metabolism of PCOS may be one of the potential options for the future treatment of PCOS, but the specific mechanism of its action remains to be investigated.There is increasing evidence that probiotics, prebiotics, and synbiotics are effective treatment options for PCOS patients. Studies show that probiotics can restore the diversity of the GM of mice with PCOS, reduce the disruption of the flora and improve the reproductive function of the mice.The altered microbiome of the lower genital tract in PCOS can cause changes that are related to hormone levels during the menstrual cycle. Studies show that the vaginal microbiome of women with PCOS differs from healthy women due to the domination of Mycoplasma, Prevotella, Gardnerella, Actinomyces, Enterococcus, and Atopobium.The level of female sex hormones is associated with the composition of the oral cavity microbiome, which is associated with such oral pathology as periodontal disease. A study of periodontal pathogens and their prevalence in women with PCOS found that healthy women had higher levels of Peptostreptococcus and a higher percentage of women infected with Treponema denticola.New views on the management of women with PCOS indicate the importance of considering microbiome changes and open up new therapeutic opportunities. Research in this area is still ongoing, and additional studies are needed to clarify the microbial composition in women with PCOS.
{"title":"Changes in the microbiome in women with polycystic ovary syndrome","authors":"V.V. Artyomenko, N.M. Nastradina, H.V. Kozhukhar","doi":"10.18370/2309-4117.2023.68.30-35","DOIUrl":"https://doi.org/10.18370/2309-4117.2023.68.30-35","url":null,"abstract":"The gut microbiome (GM) is actively studied in terms of its impact on the development of oncological pathology, immune diseases, and metabolic disorders. Women with polycystic ovary syndrome (PCOS) have an imbalance of GM, which indirectly affects the intestinal mucosal barrier. Compared with non-obese patients and a healthy population, obese individuals with PCOS have increased numbers of Enterobacteriaceae, decreased numbers of Lactobacillus and Bifidobacterium, and changes in GM are associated with inflammation and insulin resistance.Fecal microbiota transplantation is a new method of treating inflammatory bowel diseases. GM regulation to improve the metabolism of PCOS may be one of the potential options for the future treatment of PCOS, but the specific mechanism of its action remains to be investigated.There is increasing evidence that probiotics, prebiotics, and synbiotics are effective treatment options for PCOS patients. Studies show that probiotics can restore the diversity of the GM of mice with PCOS, reduce the disruption of the flora and improve the reproductive function of the mice.The altered microbiome of the lower genital tract in PCOS can cause changes that are related to hormone levels during the menstrual cycle. Studies show that the vaginal microbiome of women with PCOS differs from healthy women due to the domination of Mycoplasma, Prevotella, Gardnerella, Actinomyces, Enterococcus, and Atopobium.The level of female sex hormones is associated with the composition of the oral cavity microbiome, which is associated with such oral pathology as periodontal disease. A study of periodontal pathogens and their prevalence in women with PCOS found that healthy women had higher levels of Peptostreptococcus and a higher percentage of women infected with Treponema denticola.New views on the management of women with PCOS indicate the importance of considering microbiome changes and open up new therapeutic opportunities. Research in this area is still ongoing, and additional studies are needed to clarify the microbial composition in women with PCOS.","PeriodicalId":21103,"journal":{"name":"Reproductive Endocrinology","volume":"5 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136368859","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 : 2023-06-30DOI: 10.18370/2309-4117.2023.68.66-69
Vol. V. Podolskyi, V.V. Podolskyi, V.M. Znak
Research objectives: to determine the resistance index, pulsatile index and systolic-diastolic ratio in the fetal middle cerebral artery, fetal aorta and umbilical artery in women with gestational hypertension (GH).Materials and methods. The main group included 50 pregnant women with GH, the control group included 50 healthy pregnant women. Blood pressure level and ultrasound dopplerometric indicators of fetal blood flow were determined at the 20th, 25th, 30th, 35th, and 40th weeks of pregnancy.Results. Changes in Doppler blood flow indicators in the umbilical artery in women of the main group were observed earlier than changes in these indicators in the fetal aorta, namely from the 30th week of pregnancy: the resistance index was 0.46 ± 0.08, the pulsatility index was 0.8 ± 0.23, the systolic-diastolic ratio was 2 ± 0.19, and in women of the control group these indicators were 0.69 ± 0.17, 1.46 ± 0.21 and 3 ± 0.33, respectively.At the 35th week of pregnancy, the trend towards a decrease in dopplerometric indicators of blood flow in the umbilical artery in women of the main group continued, the value of these indicators was: resistance index – 0.42 ± 0.09, pulsatility index – 0.68 ± 0.23, systolic diastolic ratio – 1.8 ± 0.16, and in women of the control group these indicators were 0.68 ± 0.13, 1.43 ± 0.11 and 2.94 ± 0.24, respectively.The lowest Doppler parameters of blood flow in the umbilical artery in women of the main group were at 40th week: resistance index – 0.37 ± 0.07, pulsatility index – 0.63 ± 0.21, systolic-diastolic ratio – 1.6 ± 0.13, and in women of the control group these indicators were 0.67 ± 0.11, 1.4 ± 0.1, and 2.87 ± 0.21, respectively.Conclusions. Blood flow indicators in the aorta and umbilical arteries, as well as in the middle cerebral artery of the fetus in women with GH differ from such indicators in healthy women. Decreased blood flow may indicate a risk of hypoxia and neurological problems for fetus. Therefore, it is important to diagnose GH in time and monitor fetal blood flow indicators using ultrasound to prevent possible complications and preserve the fetus and mother health.
{"title":"Characteristics of changes in fetal doppler blood flow parameters in women with gestational hypertension at different stages of pregnancy","authors":"Vol. V. Podolskyi, V.V. Podolskyi, V.M. Znak","doi":"10.18370/2309-4117.2023.68.66-69","DOIUrl":"https://doi.org/10.18370/2309-4117.2023.68.66-69","url":null,"abstract":"Research objectives: to determine the resistance index, pulsatile index and systolic-diastolic ratio in the fetal middle cerebral artery, fetal aorta and umbilical artery in women with gestational hypertension (GH).Materials and methods. The main group included 50 pregnant women with GH, the control group included 50 healthy pregnant women. Blood pressure level and ultrasound dopplerometric indicators of fetal blood flow were determined at the 20th, 25th, 30th, 35th, and 40th weeks of pregnancy.Results. Changes in Doppler blood flow indicators in the umbilical artery in women of the main group were observed earlier than changes in these indicators in the fetal aorta, namely from the 30th week of pregnancy: the resistance index was 0.46 ± 0.08, the pulsatility index was 0.8 ± 0.23, the systolic-diastolic ratio was 2 ± 0.19, and in women of the control group these indicators were 0.69 ± 0.17, 1.46 ± 0.21 and 3 ± 0.33, respectively.At the 35th week of pregnancy, the trend towards a decrease in dopplerometric indicators of blood flow in the umbilical artery in women of the main group continued, the value of these indicators was: resistance index – 0.42 ± 0.09, pulsatility index – 0.68 ± 0.23, systolic diastolic ratio – 1.8 ± 0.16, and in women of the control group these indicators were 0.68 ± 0.13, 1.43 ± 0.11 and 2.94 ± 0.24, respectively.The lowest Doppler parameters of blood flow in the umbilical artery in women of the main group were at 40th week: resistance index – 0.37 ± 0.07, pulsatility index – 0.63 ± 0.21, systolic-diastolic ratio – 1.6 ± 0.13, and in women of the control group these indicators were 0.67 ± 0.11, 1.4 ± 0.1, and 2.87 ± 0.21, respectively.Conclusions. Blood flow indicators in the aorta and umbilical arteries, as well as in the middle cerebral artery of the fetus in women with GH differ from such indicators in healthy women. Decreased blood flow may indicate a risk of hypoxia and neurological problems for fetus. Therefore, it is important to diagnose GH in time and monitor fetal blood flow indicators using ultrasound to prevent possible complications and preserve the fetus and mother health.","PeriodicalId":21103,"journal":{"name":"Reproductive Endocrinology","volume":"140 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136368974","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}
Research objectives: to assess the effectiveness of the developed treatment complex on the course of pregnancy and childbirth in obese women.Materials and methods. 135 pregnant women were examined depending on the degree of obesity and received treatment. The women were examined and treated in the Department of Pathology of Pregnancy and Childbirth, SI “O.M. Lukyanova Institute of Pediatrics, Obstetrics and Gynecology of the NAMS of Ukraine” during 2019–2021.The developed medical complex included: Miofolic 2 sachets/day 3 months before pregnancy and throughout the gestation period; in case of insufficiency or deficiency of vitamin D, this vitamin was prescribed in a dose of 4000 IU/day; magnesium citrate 250–300 mg/day during pregnancy; micronized progesterone vaginally 200–400 mg/day in the II phase of the menstrual cycle before conception and up to 34 weeks of gestation (if necessary); individual programs of prenatal psychological rehabilitation using psychophysical exercises were used depending on the psychosomatic disorders.Results. it was found that the number of pregnant women of older reproductive age is increasing. There was a decrease in pre-pregnancy weight (which was positively reflected in the subsequent course of pregnancy) at the 3 months before the onset of pregnancy in women with lifestyle modification (diet therapy, dosed physical activities) and who intake a developed treatment complex at the pre-gravid stage.A peculiarity of the somatic morbidity of pregnant women was the combination of various types of extragenital diseases. Significant differences were found between chronic diseases of the cardiovascular system and diseases of the gastrointestinal tract and liver compared to the control group. The course of pregnancy largely depended on the reproductive system status before fertilization – an increase in the frequency of infertility was noted with an increase in the woman’s body mass index.Pregnant women who received the developed treatment complex had fewer pregnancy complications, the frequency of which was not significantly different from the control group. At the same time, against the background of the treatment, their lipid profile and vitamin and mineral supply improved. All this had a positive effect on the pregnancy outcomes.Conclusions. Developed medical complex including myo-inositol, starting from the pre-gravid period and throughout pregnancy, helps to reduce insulin resistance in obese women, improve the lipid profile and normalize the leptin level, which has a positive effect on the course of pregnancy and childbirth and improves perinatal outcomes.
{"title":"New therapeutic opportunities in improving the antenatal management of obese women","authors":"I.A. Zhabchenko, O.R. Siudmak, I.S. Lishchenko, T.M. Kovalenko, O.M. Bondarenko","doi":"10.18370/2309-4117.2023.68.58-64","DOIUrl":"https://doi.org/10.18370/2309-4117.2023.68.58-64","url":null,"abstract":"Research objectives: to assess the effectiveness of the developed treatment complex on the course of pregnancy and childbirth in obese women.Materials and methods. 135 pregnant women were examined depending on the degree of obesity and received treatment. The women were examined and treated in the Department of Pathology of Pregnancy and Childbirth, SI “O.M. Lukyanova Institute of Pediatrics, Obstetrics and Gynecology of the NAMS of Ukraine” during 2019–2021.The developed medical complex included: Miofolic 2 sachets/day 3 months before pregnancy and throughout the gestation period; in case of insufficiency or deficiency of vitamin D, this vitamin was prescribed in a dose of 4000 IU/day; magnesium citrate 250–300 mg/day during pregnancy; micronized progesterone vaginally 200–400 mg/day in the II phase of the menstrual cycle before conception and up to 34 weeks of gestation (if necessary); individual programs of prenatal psychological rehabilitation using psychophysical exercises were used depending on the psychosomatic disorders.Results. it was found that the number of pregnant women of older reproductive age is increasing. There was a decrease in pre-pregnancy weight (which was positively reflected in the subsequent course of pregnancy) at the 3 months before the onset of pregnancy in women with lifestyle modification (diet therapy, dosed physical activities) and who intake a developed treatment complex at the pre-gravid stage.A peculiarity of the somatic morbidity of pregnant women was the combination of various types of extragenital diseases. Significant differences were found between chronic diseases of the cardiovascular system and diseases of the gastrointestinal tract and liver compared to the control group. The course of pregnancy largely depended on the reproductive system status before fertilization – an increase in the frequency of infertility was noted with an increase in the woman’s body mass index.Pregnant women who received the developed treatment complex had fewer pregnancy complications, the frequency of which was not significantly different from the control group. At the same time, against the background of the treatment, their lipid profile and vitamin and mineral supply improved. All this had a positive effect on the pregnancy outcomes.Conclusions. Developed medical complex including myo-inositol, starting from the pre-gravid period and throughout pregnancy, helps to reduce insulin resistance in obese women, improve the lipid profile and normalize the leptin level, which has a positive effect on the course of pregnancy and childbirth and improves perinatal outcomes.","PeriodicalId":21103,"journal":{"name":"Reproductive Endocrinology","volume":"36 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136368861","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 : 2023-06-30DOI: 10.18370/2309-4117.2023.68.36-42
T.F. Tatarchuk, L.V. Kalugina, T.I. Kvasha, R.O. Mnevets
Research objectives: to evaluate the effect of vitamin D supplementation (Olidetrim) in the complex anti-relapse therapy of bacterial vaginosis (BV) in women of reproductive age.Materials and methods. The study included 63 women of reproductive age with BV and with a level of 25-hydroxyvitamin D below 75 nmol/l, who were divided into groups: the main group included 32 women who were prescribed standard therapy (metronidazole 500 mg twice a day for 7 days) and cholecalciferol (Olidetrim) 4000 IU/day with subsequent continuation of its intake in a dose 2000 IU/day for up to 6 months; the comparison group included 31 women, who were not intake vitamin D preparation during the standard therapy and during the next 6 months of observation.After treatment, women provided completed questionnaires and self-collected vaginal swabs 1, 3, and 6 months after beginning of the study or before BV relapse. Evaluation of Gram-stained smears was carried out by microscopy according to Hay/Ison criteria, where BV corresponded to type III. The level of 25-hydroxyvitamin D in blood serum was determined by the chemiluminescent immunoassay method before the start of thestudy and at 3 and 6 months of follow-up.The primary endpoint was BV recurrence at any post-treatment interval; the patients were offered a second treatment in this case.Results. Vitamin D deficiency at the beginning of the study was detected in 12 (37.5%) patients of the main group and in 13 (41.94%) women of the comparison group, an insufficient level – in 20 (62.5%) patients of the main group and in 58.06% women of the comparison group.Patients complained of pathological vaginal discharge, itching, burning and dyspareunia lasting from 1 week to 2 months. At the seven-day course of basic BV therapy all participants noted the normalization of discharge and the absence of vaginal discomfort. Positive dynamics were also observed according to the gynecological examination.One month after the treatment, 4 (12.5%) participants of the main and 6 (19.36%) women of the comparison group noted the recovery of symptoms. Absence of BV recurrence after 3 months was noted by 25 (78.12%) women of the main group and 16 (51.61%) women of the comparison group (p = 0.054), that was confirmed by the laboratory tests. At the same time, the level of 25-hydroxyvitamin D in the main group increased by 43.37% (p = 0.05), and in the comparison group it did not differ from the initial level. There were no complaints in 24 (75.0%) patients after 6 months, however, a laboratory-confirmed normal state of the vaginal microbiome was observed in 22 (70.96%) participants of the main group and in 14 (45.16%, p = 0.07) women of the comparison group. Continuation of vitamin D intake at a dose of 2000 IU/day for the next 3 months demonstrated maintenance of the 25-hydroxyvitamin D level within normal values (81.7 ± 6.23 nmol/l in the main group vs. 38.51 ± 5.43 nmol/l in comparison group, p = 0.05).Conclusions. A decrease in the frequency of
{"title":"Vitamin D supplementation in bacterial vaginosis","authors":"T.F. Tatarchuk, L.V. Kalugina, T.I. Kvasha, R.O. Mnevets","doi":"10.18370/2309-4117.2023.68.36-42","DOIUrl":"https://doi.org/10.18370/2309-4117.2023.68.36-42","url":null,"abstract":"Research objectives: to evaluate the effect of vitamin D supplementation (Olidetrim) in the complex anti-relapse therapy of bacterial vaginosis (BV) in women of reproductive age.Materials and methods. The study included 63 women of reproductive age with BV and with a level of 25-hydroxyvitamin D below 75 nmol/l, who were divided into groups: the main group included 32 women who were prescribed standard therapy (metronidazole 500 mg twice a day for 7 days) and cholecalciferol (Olidetrim) 4000 IU/day with subsequent continuation of its intake in a dose 2000 IU/day for up to 6 months; the comparison group included 31 women, who were not intake vitamin D preparation during the standard therapy and during the next 6 months of observation.After treatment, women provided completed questionnaires and self-collected vaginal swabs 1, 3, and 6 months after beginning of the study or before BV relapse. Evaluation of Gram-stained smears was carried out by microscopy according to Hay/Ison criteria, where BV corresponded to type III. The level of 25-hydroxyvitamin D in blood serum was determined by the chemiluminescent immunoassay method before the start of thestudy and at 3 and 6 months of follow-up.The primary endpoint was BV recurrence at any post-treatment interval; the patients were offered a second treatment in this case.Results. Vitamin D deficiency at the beginning of the study was detected in 12 (37.5%) patients of the main group and in 13 (41.94%) women of the comparison group, an insufficient level – in 20 (62.5%) patients of the main group and in 58.06% women of the comparison group.Patients complained of pathological vaginal discharge, itching, burning and dyspareunia lasting from 1 week to 2 months. At the seven-day course of basic BV therapy all participants noted the normalization of discharge and the absence of vaginal discomfort. Positive dynamics were also observed according to the gynecological examination.One month after the treatment, 4 (12.5%) participants of the main and 6 (19.36%) women of the comparison group noted the recovery of symptoms. Absence of BV recurrence after 3 months was noted by 25 (78.12%) women of the main group and 16 (51.61%) women of the comparison group (p = 0.054), that was confirmed by the laboratory tests. At the same time, the level of 25-hydroxyvitamin D in the main group increased by 43.37% (p = 0.05), and in the comparison group it did not differ from the initial level. There were no complaints in 24 (75.0%) patients after 6 months, however, a laboratory-confirmed normal state of the vaginal microbiome was observed in 22 (70.96%) participants of the main group and in 14 (45.16%, p = 0.07) women of the comparison group. Continuation of vitamin D intake at a dose of 2000 IU/day for the next 3 months demonstrated maintenance of the 25-hydroxyvitamin D level within normal values (81.7 ± 6.23 nmol/l in the main group vs. 38.51 ± 5.43 nmol/l in comparison group, p = 0.05).Conclusions. A decrease in the frequency of ","PeriodicalId":21103,"journal":{"name":"Reproductive Endocrinology","volume":"5 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136368971","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}
Genital herpes (GH) is a common sexually transmitted disease caused by the herpes simplex virus (HSV). It is characterized by lifelong infection and periodic reactivation. Until recently, GH was more often caused by HSV type 2 (HSV-2), but now it very common infection cases by HSV type 1 (HSV-1) and in some countries are even more common than HSV-2. More than 400 million people currently have GH caused by HSV-2 in the world. In the United States nearly one in five adults (approximately 40 million people) are infected with HSV-2. About 1 million new infections occur every year.Recently, much attention has been paid to the issue of new approaches to GH therapy in women. The problem is extremely urgent, since this infection is very common in the world. The main causes of GH are HSV-1 and HSV-2.Approaches to the treatment of GH differ depending on the type of virus (HSV-1 or HSV-2), as well as the absence or presence of clinical manifestations. The analysis of literature data shows that is there are two ways of GH treatment: episodic antiviral therapy, when patients undergo short courses of antiviral therapy during GH relapse, or suppressive antiviral therapy, when patients take medication daily to prevent relapses.Our clinical experience allows us to recommend the ukrainian drug Virostat (manufacturer “Kyiv Vitamin Plant”) for the treatment of HSV infection in women. The scheme of treatment with the Virostat depends on whether these are the first manifestations of infection or its recurrence.There are no approved vaccines for the treatment and prevention of GH, therefore, active prevention and early diagnosis increase the chances of safe and effective treatment of GH in women of different age groups and at different stages of the disease.
{"title":"Modern approaches to the therapy of genital herpes in women","authors":"L.B. Markin, O.O. Matviіenko, O.O. Korytko, K.L. Shatylovych","doi":"10.18370/2309-4117.2023.68.94-98","DOIUrl":"https://doi.org/10.18370/2309-4117.2023.68.94-98","url":null,"abstract":"Genital herpes (GH) is a common sexually transmitted disease caused by the herpes simplex virus (HSV). It is characterized by lifelong infection and periodic reactivation. Until recently, GH was more often caused by HSV type 2 (HSV-2), but now it very common infection cases by HSV type 1 (HSV-1) and in some countries are even more common than HSV-2. More than 400 million people currently have GH caused by HSV-2 in the world. In the United States nearly one in five adults (approximately 40 million people) are infected with HSV-2. About 1 million new infections occur every year.Recently, much attention has been paid to the issue of new approaches to GH therapy in women. The problem is extremely urgent, since this infection is very common in the world. The main causes of GH are HSV-1 and HSV-2.Approaches to the treatment of GH differ depending on the type of virus (HSV-1 or HSV-2), as well as the absence or presence of clinical manifestations. The analysis of literature data shows that is there are two ways of GH treatment: episodic antiviral therapy, when patients undergo short courses of antiviral therapy during GH relapse, or suppressive antiviral therapy, when patients take medication daily to prevent relapses.Our clinical experience allows us to recommend the ukrainian drug Virostat (manufacturer “Kyiv Vitamin Plant”) for the treatment of HSV infection in women. The scheme of treatment with the Virostat depends on whether these are the first manifestations of infection or its recurrence.There are no approved vaccines for the treatment and prevention of GH, therefore, active prevention and early diagnosis increase the chances of safe and effective treatment of GH in women of different age groups and at different stages of the disease.","PeriodicalId":21103,"journal":{"name":"Reproductive Endocrinology","volume":"13 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136368975","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 : 2023-06-30DOI: 10.18370/2309-4117.2023.68.70-74
C. Breymann, C. Honegger, I. Hоsli, D. Surbek
Iron deficiency occurs frequently in pregnancy and can be diagnosed by serum ferritin-level measurement (threshold value < 30 μg/L). Screening for iron-deficiency anemia is recommended in every pregnant women, and should be done by serum ferritin-level screening in the first trimester and regular hemoglobin checks at least once per trimester. In the case of iron deficiency with or without anaemia in pregnancy, oral iron therapy should be given as first-line treatment. In the case of severe iron-deficiency anemia, intolerance of oral iron, lack of response to oral iron, or in the case of a clinical need for rapid and efficient treatment of anaemia (e.g., advanced pregnancy), intravenous iron therapy should be administered. In the postpartum period, oral iron therapy should be administered for mild iron-deficiency anemia (haemorrhagic anemia), and intravenous iron therapy for moderately severe-to-severe anemia (Hb < 95 g/L). If there is an indication for intravenous iron therapy in pregnancy or postpartum, ironcontaining drugs which have been studied in well-controlled clinical trials in pregnancy and postpartum such as ferric carboxymaltose must be preferred for safety reasons. While anaphylactic reactions are extremely rare with non-dextrane products, close surveillance during administration is recommended for all intravenous iron products.
缺铁在妊娠期经常发生,可通过血清铁蛋白水平测定(阈值<30μg / L)。建议对所有孕妇进行缺铁性贫血筛查,并应在妊娠早期进行血清铁蛋白水平筛查,每三个月至少进行一次血红蛋白常规检查。在缺铁伴或不伴妊娠贫血的情况下,口服铁治疗应作为一线治疗。在严重缺铁性贫血、口服铁不耐受、对口服铁缺乏反应的情况下,或在临床需要快速有效治疗贫血的情况下(例如,晚期妊娠),应给予静脉注射铁治疗。在产后,轻度缺铁性贫血(出血性贫血)应口服铁治疗,中重度至重度贫血(Hb <95 g / L)。如果有妊娠期或产后静脉补铁的指征,则出于安全考虑,必须优先使用经妊娠期和产后临床对照良好的含铁药物,如三羧基麦芽糖铁。虽然非右旋糖酐产品的过敏反应极为罕见,但建议所有静脉注射铁产品在给药期间密切监测。
{"title":"Diagnosis and treatment of iron‑deficiency anaemia in pregnancy and postpartum","authors":"C. Breymann, C. Honegger, I. Hоsli, D. Surbek","doi":"10.18370/2309-4117.2023.68.70-74","DOIUrl":"https://doi.org/10.18370/2309-4117.2023.68.70-74","url":null,"abstract":"Iron deficiency occurs frequently in pregnancy and can be diagnosed by serum ferritin-level measurement (threshold value < 30 μg/L). Screening for iron-deficiency anemia is recommended in every pregnant women, and should be done by serum ferritin-level screening in the first trimester and regular hemoglobin checks at least once per trimester. In the case of iron deficiency with or without anaemia in pregnancy, oral iron therapy should be given as first-line treatment. In the case of severe iron-deficiency anemia, intolerance of oral iron, lack of response to oral iron, or in the case of a clinical need for rapid and efficient treatment of anaemia (e.g., advanced pregnancy), intravenous iron therapy should be administered. In the postpartum period, oral iron therapy should be administered for mild iron-deficiency anemia (haemorrhagic anemia), and intravenous iron therapy for moderately severe-to-severe anemia (Hb < 95 g/L). If there is an indication for intravenous iron therapy in pregnancy or postpartum, ironcontaining drugs which have been studied in well-controlled clinical trials in pregnancy and postpartum such as ferric carboxymaltose must be preferred for safety reasons. While anaphylactic reactions are extremely rare with non-dextrane products, close surveillance during administration is recommended for all intravenous iron products.","PeriodicalId":21103,"journal":{"name":"Reproductive Endocrinology","volume":"139 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136368854","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 : 2023-06-30DOI: 10.18370/2309-4117.2023.68.8-15
A.V. Serbeniuk
Research objectives: establishing an association between the state of mental health, the functional state of body systems, clinical and anamnestic data on reproductive health in female combat participants who suffered a concussion.Material and methods. The study included 487 women of reproductive age who took part in hostilities and suffered a concussion and who were divided into 2 groups – the main group (211 women with post-concussion syndrome) and a comparison group (246 women without the post-concussion syndrome). The control group included 30 healthy civilian women of reproductive age without any trauma episodes in the anamnesis. Concussion symptoms were determined by Cicerone K.D., PCL, Wein, Spielberger – Hanin, Beck questionnaires.Results. The participants of the main group and the comparison group were comparable in terms of age, social status, anthropometric data, parameters of menstrual, ovulatory and reproductive functions, gynecological, somatic and infectious diseases. Patients with post-concussion syndrome have a duration of menstruation 1.07 times (p < 0.001) longer compared to women without post-concussion syndrome; painful menstruation in 1.47 times more often (p < 0.0001), heavy menstruation in 1.64 times (p < 0.003) more often. The infertility duration in patients with post-concussion syndrome is 1.29 times longer (p < 0.0001) compared to women without post-concussion syndrome. 69.27% of women who took part in hostilities and suffered a concussion have a history of ureaplasmosis or bacterial vaginosis: chlamydia and bacterial vaginosis occur in every third patient, ureaplasmosis in 41.61% patients. Chlamydia trachomatis is detected in patients with post-concussion syndrome 1.64 times (p < 0.0007) more often than in patients without this syndrome.Conclusions. Women who suffered concussions during hostilities have significant problems with physical and mental health due to the impact of brain injury and stress factors associated with military actions. Solving this problem requires the development of a comprehensive program that will include medical and psychological support for female military personnel and creation of high-quality medical and psychological rehabilitation of female veterans aimed at their full adaptation to peaceful life.
{"title":"Features of mental and reproductive health, functional state of the organism of female military servicemen who suffered concussion during combat actions","authors":"A.V. Serbeniuk","doi":"10.18370/2309-4117.2023.68.8-15","DOIUrl":"https://doi.org/10.18370/2309-4117.2023.68.8-15","url":null,"abstract":"Research objectives: establishing an association between the state of mental health, the functional state of body systems, clinical and anamnestic data on reproductive health in female combat participants who suffered a concussion.Material and methods. The study included 487 women of reproductive age who took part in hostilities and suffered a concussion and who were divided into 2 groups – the main group (211 women with post-concussion syndrome) and a comparison group (246 women without the post-concussion syndrome). The control group included 30 healthy civilian women of reproductive age without any trauma episodes in the anamnesis. Concussion symptoms were determined by Cicerone K.D., PCL, Wein, Spielberger – Hanin, Beck questionnaires.Results. The participants of the main group and the comparison group were comparable in terms of age, social status, anthropometric data, parameters of menstrual, ovulatory and reproductive functions, gynecological, somatic and infectious diseases. Patients with post-concussion syndrome have a duration of menstruation 1.07 times (p < 0.001) longer compared to women without post-concussion syndrome; painful menstruation in 1.47 times more often (p < 0.0001), heavy menstruation in 1.64 times (p < 0.003) more often. The infertility duration in patients with post-concussion syndrome is 1.29 times longer (p < 0.0001) compared to women without post-concussion syndrome. 69.27% of women who took part in hostilities and suffered a concussion have a history of ureaplasmosis or bacterial vaginosis: chlamydia and bacterial vaginosis occur in every third patient, ureaplasmosis in 41.61% patients. Chlamydia trachomatis is detected in patients with post-concussion syndrome 1.64 times (p < 0.0007) more often than in patients without this syndrome.Conclusions. Women who suffered concussions during hostilities have significant problems with physical and mental health due to the impact of brain injury and stress factors associated with military actions. Solving this problem requires the development of a comprehensive program that will include medical and psychological support for female military personnel and creation of high-quality medical and psychological rehabilitation of female veterans aimed at their full adaptation to peaceful life.","PeriodicalId":21103,"journal":{"name":"Reproductive Endocrinology","volume":"36 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136368973","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}
Abnormal vaginal discharge (AVD) is a common syndrome. Its management is addressed in many evidence-based guidelines: International Union of Sexually Transmitted Infections (IUSTI) and WHO Guidelines for management of vaginal discharge (2018); American College of Obstetrics and Gynecology (ACOG) Practice Bulletin No. 215 «Vaginitis in non-pregnant patients» (2020); U.S. Centers for Disease Control and Prevention (CDC) Guidelines for the treatment of sexually transmitted diseases (2021) etc. In December 2022, the Ministry of Health of Ukraine approved an adapted Clinical Guidelines and Standards of Medical Care “Abnormal vaginal discharge”.A special aspect of AVD management is frequent recurrence. Among the many hypotheses of the etiology of the recurrent course of vaginal infections the clinical aspect of difficulties of identifying all pathogens in case of mixed forms deserves special attention. Thus, there is need to presume the possibility of a mixed etiology of AVD or an atypical course of mono-infection at the stage of clinical examination.This review focuses on the role of vaginal discharge pH measuring both in the clinical stage of diagnosing the causes of AVD and in the interpreting laboratory results. Vaginal pH testing is an important component of the clinical stage in diagnostics of the AVD causes. This feasible and quick study allows objectifying the vaginal dysbiosis with a decrease in lactoflora and lactic acid value, which requires further laboratory diagnostics during the examination. Also it is an integral part of the Amsel criteria in the diagnostics of bacterial vaginosis, and vaginal health index to assess the degree of vaginal atrophy in menopause. Vaginal pH testing improves the diagnosis of difficult-to-detect infections and rare causes of AVD. Also, this method is useful for telemedicineto prevent unnecessary medical examinations, laboratory tests and self-treatment, or vice versa, to confirm the need for a specialist consultation.
{"title":"Benefits and limitations of clinical assessment of abnormal vaginal discharge etiology","authors":"T.M. Tutchenko, T.F. Tatarchuk, L.О. Borysova, E.F. Chaikivska","doi":"10.18370/2309-4117.2023.68.48-56","DOIUrl":"https://doi.org/10.18370/2309-4117.2023.68.48-56","url":null,"abstract":"Abnormal vaginal discharge (AVD) is a common syndrome. Its management is addressed in many evidence-based guidelines: International Union of Sexually Transmitted Infections (IUSTI) and WHO Guidelines for management of vaginal discharge (2018); American College of Obstetrics and Gynecology (ACOG) Practice Bulletin No. 215 «Vaginitis in non-pregnant patients» (2020); U.S. Centers for Disease Control and Prevention (CDC) Guidelines for the treatment of sexually transmitted diseases (2021) etc. In December 2022, the Ministry of Health of Ukraine approved an adapted Clinical Guidelines and Standards of Medical Care “Abnormal vaginal discharge”.A special aspect of AVD management is frequent recurrence. Among the many hypotheses of the etiology of the recurrent course of vaginal infections the clinical aspect of difficulties of identifying all pathogens in case of mixed forms deserves special attention. Thus, there is need to presume the possibility of a mixed etiology of AVD or an atypical course of mono-infection at the stage of clinical examination.This review focuses on the role of vaginal discharge pH measuring both in the clinical stage of diagnosing the causes of AVD and in the interpreting laboratory results. Vaginal pH testing is an important component of the clinical stage in diagnostics of the AVD causes. This feasible and quick study allows objectifying the vaginal dysbiosis with a decrease in lactoflora and lactic acid value, which requires further laboratory diagnostics during the examination. Also it is an integral part of the Amsel criteria in the diagnostics of bacterial vaginosis, and vaginal health index to assess the degree of vaginal atrophy in menopause. Vaginal pH testing improves the diagnosis of difficult-to-detect infections and rare causes of AVD. Also, this method is useful for telemedicineto prevent unnecessary medical examinations, laboratory tests and self-treatment, or vice versa, to confirm the need for a specialist consultation.","PeriodicalId":21103,"journal":{"name":"Reproductive Endocrinology","volume":"44 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136368858","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}
Research objectives: to evaluate the activity of apoptosis and proliferation mechanisms of eutopic endometrium in patients with adenomyosis who had a history of papillary thyroid carcinoma (PTC).Materials and methods. 63 women of reproductive age were examined: group I – 31 patients with adenomyosis and PTC in history, group II – 32 patients with adenomyosis and normal thyroid status. The intensity of pelvic pain was assessed using a visual analog scale in all women. The material for morphological research was obtained with Pipelle biopsy of the endometrium in the secretory phase of the menstrual cycle. A morphological study was performed on 30 biopsies of eutopic endometrium (15 samples from patients of group I and 15 samples from patients of group II). An immunohistochemical study was performed using monoclonal antibodies to cell-specific markers Bcl-2 (DAKO, clone 124) and Ki-67 (DAKO, clone MIB-1).Results. High expression of Bcl-2 was detected in the endometrial glandular epithelial cells (EGECs) in 70% and 62.5% of samples in group I and II respectively (р > 0.05), the number of Bcl-2-positive cells was significantly higher in samples from group I (80.0 ± 13.1% versus 60.0 ± 15.2% in group І and ІІ respectively, р < 0.05). In endometrial stromal cells (ESCs) high expression of Bcl-2 was detected in 90% and 100% of samples from group I and II respectively (р > 0.05), no significant difference in the number of positive cells was found between groups (18.9 ± 12.2% and 12.6 ± 9.1% in group І and ІІ respectively, р > 0.05). Expression of Ki-67 was detected in the EGECs in 70% and 62.5% (р > 0.05) of samples in group І and ІІ respectively and in the ESCs in 100% of samples from groups I and II respectively. The immunocytochemical Ki-67 labelling index was much more prominent in group I (45.0 ± 11.4% versus 25.8 ± 16.7% EGECs (р < 0.05); 26.5 ± 10.2% versus 16.3 ± 8.9% ESCs (р < 0.05) for group I and II respectively).Conclusions. Altered proliferation of the eutopic endometrium with marked resistance to apoptosis was found in reproductive aged female with adenomyosis and PTC in history, that is can be considered as a marker of the aggressiveness of the disease course in this cohort of patients.
{"title":"Immunohistochemical markers of the activity of apoptosis and proliferation in women with adenomyosis who had papillary thyroid carcinoma","authors":"M.D. Tronko, A.O. Danylova, L.V. Kalugina, N.V. Kosei, T.M. Kuchmenko, Y.M. Bondarenko","doi":"10.18370/2309-4117.2023.68.16-21","DOIUrl":"https://doi.org/10.18370/2309-4117.2023.68.16-21","url":null,"abstract":"Research objectives: to evaluate the activity of apoptosis and proliferation mechanisms of eutopic endometrium in patients with adenomyosis who had a history of papillary thyroid carcinoma (PTC).Materials and methods. 63 women of reproductive age were examined: group I – 31 patients with adenomyosis and PTC in history, group II – 32 patients with adenomyosis and normal thyroid status. The intensity of pelvic pain was assessed using a visual analog scale in all women. The material for morphological research was obtained with Pipelle biopsy of the endometrium in the secretory phase of the menstrual cycle. A morphological study was performed on 30 biopsies of eutopic endometrium (15 samples from patients of group I and 15 samples from patients of group II). An immunohistochemical study was performed using monoclonal antibodies to cell-specific markers Bcl-2 (DAKO, clone 124) and Ki-67 (DAKO, clone MIB-1).Results. High expression of Bcl-2 was detected in the endometrial glandular epithelial cells (EGECs) in 70% and 62.5% of samples in group I and II respectively (р > 0.05), the number of Bcl-2-positive cells was significantly higher in samples from group I (80.0 ± 13.1% versus 60.0 ± 15.2% in group І and ІІ respectively, р < 0.05). In endometrial stromal cells (ESCs) high expression of Bcl-2 was detected in 90% and 100% of samples from group I and II respectively (р > 0.05), no significant difference in the number of positive cells was found between groups (18.9 ± 12.2% and 12.6 ± 9.1% in group І and ІІ respectively, р > 0.05). Expression of Ki-67 was detected in the EGECs in 70% and 62.5% (р > 0.05) of samples in group І and ІІ respectively and in the ESCs in 100% of samples from groups I and II respectively. The immunocytochemical Ki-67 labelling index was much more prominent in group I (45.0 ± 11.4% versus 25.8 ± 16.7% EGECs (р < 0.05); 26.5 ± 10.2% versus 16.3 ± 8.9% ESCs (р < 0.05) for group I and II respectively).Conclusions. Altered proliferation of the eutopic endometrium with marked resistance to apoptosis was found in reproductive aged female with adenomyosis and PTC in history, that is can be considered as a marker of the aggressiveness of the disease course in this cohort of patients.","PeriodicalId":21103,"journal":{"name":"Reproductive Endocrinology","volume":"239 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136368851","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}