A. Z. Khashukoeva, E. A. Markova, M. V. Burdenko, L. A. Nosova, A. M. Solovyova, E. A. Lukyanova
After the end of the reproductive period, women spend a third of their lives in menopause. During this period, they experience a range of predictable symptoms and conditions associated with changing levels of sex hormones and aging of the body. The menopausal transition precedes menopause by several years and is usually characterized by irregular menstrual cycles, hot flashes and night sweats. After menopause, genitourinary symptoms predominate, including vulvovaginal atrophy and dryness and complaints associated with urinary disturbances: increased urinary frequency, urgency, and nocturia. Menopausal hormone therapy is effective for vasomotor and genitourinary symptoms, but it is associated with the development of cardiovascular risks, cognitive impairment, depression, and a number of side effects. An alternative in the therapy of menopausal symptoms can be the prescription of biologically active supplement Happyclim®. The complex composition of the drug effectively fills the lack of its own estrogen in the female body. The preparation Happyclim® contains phytoestrogens (soy isoflavones, flavonoids) and auxiliary components (magnesium and B vitamins, vitamin C, extract of medicinal melissa), which with high efficiency affect the woman’s body during menopausal transition, alleviating the symptoms of menopause and improving the quality of life. This article presents a cross-section of the literature on the use of phytoestrogens and the dietary supplement Happyclim® during the perimenopausal transition to delay the administration of menopausal hormone therapy.
{"title":"Menopausal transition. Is it possible to delay the prescription of menopausal hormone therapy?","authors":"A. Z. Khashukoeva, E. A. Markova, M. V. Burdenko, L. A. Nosova, A. M. Solovyova, E. A. Lukyanova","doi":"10.21518/ms2023-342","DOIUrl":"https://doi.org/10.21518/ms2023-342","url":null,"abstract":"After the end of the reproductive period, women spend a third of their lives in menopause. During this period, they experience a range of predictable symptoms and conditions associated with changing levels of sex hormones and aging of the body. The menopausal transition precedes menopause by several years and is usually characterized by irregular menstrual cycles, hot flashes and night sweats. After menopause, genitourinary symptoms predominate, including vulvovaginal atrophy and dryness and complaints associated with urinary disturbances: increased urinary frequency, urgency, and nocturia. Menopausal hormone therapy is effective for vasomotor and genitourinary symptoms, but it is associated with the development of cardiovascular risks, cognitive impairment, depression, and a number of side effects. An alternative in the therapy of menopausal symptoms can be the prescription of biologically active supplement Happyclim®. The complex composition of the drug effectively fills the lack of its own estrogen in the female body. The preparation Happyclim® contains phytoestrogens (soy isoflavones, flavonoids) and auxiliary components (magnesium and B vitamins, vitamin C, extract of medicinal melissa), which with high efficiency affect the woman’s body during menopausal transition, alleviating the symptoms of menopause and improving the quality of life. This article presents a cross-section of the literature on the use of phytoestrogens and the dietary supplement Happyclim® during the perimenopausal transition to delay the administration of menopausal hormone therapy.","PeriodicalId":36137,"journal":{"name":"Meditsinskiy Sovet","volume":"27 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135513288","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}
Amiodarone has been used in clinical practice since 1964. The 2020 European guidelines note that amiodarone is recommended for long-term rhythm control in all patients with atrial fibrillation. However, due to its extracardiac toxicity, other antiarrhythmic drugs should be considered first. Information databases were searched for descriptions of amiodarone-induced blue man syndrome. Its pathogenesis is associated with accelerated physiological aging of dermal cells, leading to the accumulation of lipofuscin in lysosomes, or occurs as a result of the direct accumulation of amiodarone and its metabolites in the skin. As part of the review, brief descriptions of the 32 clinical cases found of the blue man syndrome are given. Most publications refer to various countries in Europe and the United States, which suggests that this syndrome develops more often in Caucasians. This syndrome is more common in people over 60 years of age, males predominate among patients. The development of the blue man syndrome is preceded by long-term use of amiodarone and the achievement of a certain cumulative dose. After the abolition of amiodarone, a gradual improvement is noted for 1 year or more. Other side effects of amiodarone are often detected in the presence of the blue man syndrome. Most publications describing the blue man syndrome belong to cardiologists and dermatologists. Given the variety of side effects of amiodarone, pulmonologists, endocrinologists, neurologists, ophthalmologists, gastroenterologists and doctors of other specialties may encounter a blue-gray skin color change.
{"title":"Amiodaron-induced skin lesion: focus on blue man syndrome","authors":"D. I. Trukhan","doi":"10.21518/ms2023-318","DOIUrl":"https://doi.org/10.21518/ms2023-318","url":null,"abstract":"Amiodarone has been used in clinical practice since 1964. The 2020 European guidelines note that amiodarone is recommended for long-term rhythm control in all patients with atrial fibrillation. However, due to its extracardiac toxicity, other antiarrhythmic drugs should be considered first. Information databases were searched for descriptions of amiodarone-induced blue man syndrome. Its pathogenesis is associated with accelerated physiological aging of dermal cells, leading to the accumulation of lipofuscin in lysosomes, or occurs as a result of the direct accumulation of amiodarone and its metabolites in the skin. As part of the review, brief descriptions of the 32 clinical cases found of the blue man syndrome are given. Most publications refer to various countries in Europe and the United States, which suggests that this syndrome develops more often in Caucasians. This syndrome is more common in people over 60 years of age, males predominate among patients. The development of the blue man syndrome is preceded by long-term use of amiodarone and the achievement of a certain cumulative dose. After the abolition of amiodarone, a gradual improvement is noted for 1 year or more. Other side effects of amiodarone are often detected in the presence of the blue man syndrome. Most publications describing the blue man syndrome belong to cardiologists and dermatologists. Given the variety of side effects of amiodarone, pulmonologists, endocrinologists, neurologists, ophthalmologists, gastroenterologists and doctors of other specialties may encounter a blue-gray skin color change.","PeriodicalId":36137,"journal":{"name":"Meditsinskiy Sovet","volume":"95 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135513289","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}
Introduction . Cervical intraepithelial neoplasias that have been recognized as a precursor of squamous cell carcinoma are subject to active detection for the purpose of eradication. Human papillomavirus (HPV) exposure of women is the major risk factor for carcinogenesis, which is a necessary part for the formation of a pre-tumour and malignant phenotype. Cervical intraepithelial neoplasias that precede the development of squamous cell carcinoma should be actively detected and treated early. The identification of patients with HPV is an important part of subsequent therapies. Inosine pranobex is used as one of the components of the treatment of HPV-associated diseases. Aim . To study the role of various diagnostic methods in patients with benign and neoplastic cervical processes. Materials and methods . The study included 311 women who were 21–64 years old. Colposcopy, cytological examination, HPV testing, preliminary biopsy, cervical excise with histological evaluation of tissue sampling were carried out. Results . HPV 16 was more often detected in a malignant tumour and CIN 3; HPV type 31 and 33 were more often detected in CIN 2 and CIN 3; HPV type 18 was detected in almost all patient with CIN, and malignant and benign neoplastic disorders in preliminary biopsy, that was not typical of results of the excision. In excision CIN 1 were confirmed in 17.07%, CIN 2 in 31.88%, CIN 3 in 66.67%. Preliminary results of benign process in 6.67% turned out to be CIN 1, and in 6.67% – CIN 2, that confirms the need for a comprehensive evaluation. Studies of prevalence of various types of HPV showed that the established sequence of recommended tests, which consists of extended colposcopy, cytology and identification of HPV types, if necessary, does not always correspond to the biopsy results and histological findings on cervical excision specimens. According to our sources, the final result can be determined after excision procedure of cervical tissue and histological examination of the tissue obtained. Conclusion . No strong correlations between examination methods and cervical pathology have been revealed. The final diagnosis is made after cervical biopsy. High prevalence of different types of HPV raises the question of need for complex therapy with inclusion the inosine pranobex.
{"title":"Study of the role of various diagnostic methods in patients with benign and neoplastic cervical diseases","authors":"L. Yu. Karakhalis, V. S. Petrenko, S. I. Petrenko","doi":"10.21518/ms2023-335","DOIUrl":"https://doi.org/10.21518/ms2023-335","url":null,"abstract":"Introduction . Cervical intraepithelial neoplasias that have been recognized as a precursor of squamous cell carcinoma are subject to active detection for the purpose of eradication. Human papillomavirus (HPV) exposure of women is the major risk factor for carcinogenesis, which is a necessary part for the formation of a pre-tumour and malignant phenotype. Cervical intraepithelial neoplasias that precede the development of squamous cell carcinoma should be actively detected and treated early. The identification of patients with HPV is an important part of subsequent therapies. Inosine pranobex is used as one of the components of the treatment of HPV-associated diseases. Aim . To study the role of various diagnostic methods in patients with benign and neoplastic cervical processes. Materials and methods . The study included 311 women who were 21–64 years old. Colposcopy, cytological examination, HPV testing, preliminary biopsy, cervical excise with histological evaluation of tissue sampling were carried out. Results . HPV 16 was more often detected in a malignant tumour and CIN 3; HPV type 31 and 33 were more often detected in CIN 2 and CIN 3; HPV type 18 was detected in almost all patient with CIN, and malignant and benign neoplastic disorders in preliminary biopsy, that was not typical of results of the excision. In excision CIN 1 were confirmed in 17.07%, CIN 2 in 31.88%, CIN 3 in 66.67%. Preliminary results of benign process in 6.67% turned out to be CIN 1, and in 6.67% – CIN 2, that confirms the need for a comprehensive evaluation. Studies of prevalence of various types of HPV showed that the established sequence of recommended tests, which consists of extended colposcopy, cytology and identification of HPV types, if necessary, does not always correspond to the biopsy results and histological findings on cervical excision specimens. According to our sources, the final result can be determined after excision procedure of cervical tissue and histological examination of the tissue obtained. Conclusion . No strong correlations between examination methods and cervical pathology have been revealed. The final diagnosis is made after cervical biopsy. High prevalence of different types of HPV raises the question of need for complex therapy with inclusion the inosine pranobex.","PeriodicalId":36137,"journal":{"name":"Meditsinskiy Sovet","volume":"44 4","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135512856","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}
There is a clear and specific bidirectional relationship between diabetes mellitus and cardiovascular disease. It is known that cardiovascular disease in patients with diabetes occurs 2–5 times more often than in people without diabetes. CVD itself, and it is cardiovascular outcomes, are the main cause of death in patients with diabetes mellitus, both in men and women. In diabetes mellitus, there is a high risk of coronary heart disease, myocardial infarction, arterial hypertension, and acute cerebrovascular accident, and patients with diabetes may experience painless acute myocardial infarction associated with the presence of autonomic cardiac neuropathy. Much more often in diabetes mellitus there are various rhythm disturbances, including paroxysmal forms of atrial fibrillation, which increase the risk of death by 1.8–2 times. Currently, numerous international clinical studies have convincingly demonstrated that improved glycemic control causes a significant reduction in the risk of late macroand microvascular complications of diabetes mellitus. The concept of dysglycemia includes disorders of glycated hemoglobin (HbA1c), fasting glycemia, postprandial glycemia, hypoglycemia, and glycemic variability. Dysglycemia increases the risk of developing type 2 diabetes mellitus and cardiovascular diseases, and their poor prognosis. HbA1c is the “gold standard” for monitoring glycemic control, but this indicator does not provide complete information about daily and intraday changes in glucose levels. Variability (not level) of fasting glucose determines cardiovascular mortality in patients with type 2 diabetes mellitus. Achieving glucose stability may become an additional therapeutic goal for the management of this category of patients with diabetes mellitus, and low glycemic variability is currently assessed as an additional target. Algorithms of specialized medical care for patients with diabetes mellitus recommend that patients with type 2 diabetes mellitus carry out self-monitoring, depending on the type of treatment taken and the degree of carbohydrate metabolism compensation. An important aspect of the technical impact on the adherence of patients to self-control and treatment of diabetes mellitus is the availability of convenient communication between the patient and the doctor, in particular, the possibility of contact remotely via a computer and mobile phone. In conclusion, the possibilities of a new model of the Contour® glucometer line, the Contour® Plus One glucometer, are considered.
{"title":"Glycaemic control in comorbid patients: an important element of CVD progression prevention","authors":"D. I. Trukhan, E. L. Davidov, G. Yu. Shevchenko","doi":"10.21518/ms2023-307","DOIUrl":"https://doi.org/10.21518/ms2023-307","url":null,"abstract":"There is a clear and specific bidirectional relationship between diabetes mellitus and cardiovascular disease. It is known that cardiovascular disease in patients with diabetes occurs 2–5 times more often than in people without diabetes. CVD itself, and it is cardiovascular outcomes, are the main cause of death in patients with diabetes mellitus, both in men and women. In diabetes mellitus, there is a high risk of coronary heart disease, myocardial infarction, arterial hypertension, and acute cerebrovascular accident, and patients with diabetes may experience painless acute myocardial infarction associated with the presence of autonomic cardiac neuropathy. Much more often in diabetes mellitus there are various rhythm disturbances, including paroxysmal forms of atrial fibrillation, which increase the risk of death by 1.8–2 times. Currently, numerous international clinical studies have convincingly demonstrated that improved glycemic control causes a significant reduction in the risk of late macroand microvascular complications of diabetes mellitus. The concept of dysglycemia includes disorders of glycated hemoglobin (HbA1c), fasting glycemia, postprandial glycemia, hypoglycemia, and glycemic variability. Dysglycemia increases the risk of developing type 2 diabetes mellitus and cardiovascular diseases, and their poor prognosis. HbA1c is the “gold standard” for monitoring glycemic control, but this indicator does not provide complete information about daily and intraday changes in glucose levels. Variability (not level) of fasting glucose determines cardiovascular mortality in patients with type 2 diabetes mellitus. Achieving glucose stability may become an additional therapeutic goal for the management of this category of patients with diabetes mellitus, and low glycemic variability is currently assessed as an additional target. Algorithms of specialized medical care for patients with diabetes mellitus recommend that patients with type 2 diabetes mellitus carry out self-monitoring, depending on the type of treatment taken and the degree of carbohydrate metabolism compensation. An important aspect of the technical impact on the adherence of patients to self-control and treatment of diabetes mellitus is the availability of convenient communication between the patient and the doctor, in particular, the possibility of contact remotely via a computer and mobile phone. In conclusion, the possibilities of a new model of the Contour® glucometer line, the Contour® Plus One glucometer, are considered.","PeriodicalId":36137,"journal":{"name":"Meditsinskiy Sovet","volume":"37 4","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135513165","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}
N. A. Buralkina, N. A. Chekeneva, S. V. Pavlovich, V. D. Chuprynin, E. I. Pilyugina
Anti-Mullerian hormone (AMH) is well known as one of the key factors in reproductive development and the formation of sexual characteristics in the embryonic period in both sexes. In women, AMH is produced by granulosa cells of the preantral and early antral follicles of the ovaries and is a key biochemical marker of ovarian reserve. Recently, the role of AMH and its transmembrane receptor AMHRII as possible pathogenetic links in a number of gynecological diseases has been actively studied. The ability of AMH to cause regression of the Müllerian duct in male embryos suggests its inhibitory role for a number of benign and malignant gynecological tumors, as well as endometriosis. In this connection, active scientific research in this direction is currently underway. A number of studies have shown that AMH causes apoptosis of human endometrial stromal cells and endometriosis cells in vitro, and is also involved in the development of autophagy processes in endometriosis. The above studies demonstrate the important role of AMH in cell apoptosis in endometriosis, and indicate its therapeutic potential for a wide range of gynecological diseases. It is important to note that AMH, as a representativemember of the TGF-β superfamily, has high affinity and specificity for the AMHRII receptor, which. This fact makes further study of the function of AMH and AMHRII relevant both for assessing their effectinfluence on the processes of folliculogenesis, and reproductive aging processes, and for developing new targeting targeted therapy strategies therapy for a wide range of gynecological diseases, including endometriosis.
{"title":"The role of anti-Mullerian hormone in the context of modern pathogenetic approaches to the treatment of endometriosis (literature review)","authors":"N. A. Buralkina, N. A. Chekeneva, S. V. Pavlovich, V. D. Chuprynin, E. I. Pilyugina","doi":"10.21518/ms2023-354","DOIUrl":"https://doi.org/10.21518/ms2023-354","url":null,"abstract":"Anti-Mullerian hormone (AMH) is well known as one of the key factors in reproductive development and the formation of sexual characteristics in the embryonic period in both sexes. In women, AMH is produced by granulosa cells of the preantral and early antral follicles of the ovaries and is a key biochemical marker of ovarian reserve. Recently, the role of AMH and its transmembrane receptor AMHRII as possible pathogenetic links in a number of gynecological diseases has been actively studied. The ability of AMH to cause regression of the Müllerian duct in male embryos suggests its inhibitory role for a number of benign and malignant gynecological tumors, as well as endometriosis. In this connection, active scientific research in this direction is currently underway. A number of studies have shown that AMH causes apoptosis of human endometrial stromal cells and endometriosis cells in vitro, and is also involved in the development of autophagy processes in endometriosis. The above studies demonstrate the important role of AMH in cell apoptosis in endometriosis, and indicate its therapeutic potential for a wide range of gynecological diseases. It is important to note that AMH, as a representativemember of the TGF-β superfamily, has high affinity and specificity for the AMHRII receptor, which. This fact makes further study of the function of AMH and AMHRII relevant both for assessing their effectinfluence on the processes of folliculogenesis, and reproductive aging processes, and for developing new targeting targeted therapy strategies therapy for a wide range of gynecological diseases, including endometriosis.","PeriodicalId":36137,"journal":{"name":"Meditsinskiy Sovet","volume":"106 11","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135512726","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}
Introduction. Currently, increased uric acid (UA) levels are considered an independent risk factor for the development of non-alcoholic fatty liver disease. Oxidative stress, chronic systemic inflammation, and insulin resistance characteristic of non-alcoholic fatty liver disease (NAFLD) may represent possible mechanisms for the association between the development of hyperuricemia and NAFLD. Aim. To clarify the meaning and nature of the relationship between an increase in the level of UA concentration and the development of NAFLD, as well as to evaluate the relationship between uric acid and the risk of cardiovascular complications in patients with hypertension and NAFLD. Materials and methods. A cross-sectional comparative study was conducted, which involved 120 patients aged from 45 to 65 with hypertension of 1–2 degrees, 1–2 stages (with and without NAFLD (FLI > 60). During the examination, a clinical examination was carried out: analysis of anamnesis data, anthropometry. Lipids and uric acid in blood plasma were also analyzed. Results. In the group of comorbid patients, there were significantly more patients with excess of the reference values of UA levels in the blood plasma (OR = 2.25: 95% CI 1.08–4.71). ROC analysis showed that with an uric acid level of 369.5 µmol/l, a high risk of developing NAFLD is predicted. The UA/Cr index in patients with hypertension and NAFLD was statistically significantly higher than in patients in the control group. Increase in the MK/Kr index by 1 USD increases the chances of developing NAFLD by 1.54 times (95% CI: 1.11–2.13). Also, an increase in the concentration of sUA level by 1 µmol/l increases the chances of an increase in the 10-year risk of cardiovascular events to 5.0% or more by 0.6%. Conclusions. With an uric acid level of 369.5 µmol/l, a high risk of developing NAFLD in the study group is predicted. Increase in UA/creatinine index by 1 USD increases the chances of developing NAFLD by 1.54 times. In addition, an increase in the concentration of sUA in the blood plasma by 1 µmol/l increases the chances of an increase in the 10-year risk of cardiovascular events to 5.0% or more by 0.6% in patients with hypertension and NAFLD.
{"title":"Uric acid as a predictor of the development of non-alcoholic fatty liver disease in patients with arterial hypertension","authors":"M. Е. Statsenko, A. M. Streltsova","doi":"10.21518/ms2023-310","DOIUrl":"https://doi.org/10.21518/ms2023-310","url":null,"abstract":"Introduction. Currently, increased uric acid (UA) levels are considered an independent risk factor for the development of non-alcoholic fatty liver disease. Oxidative stress, chronic systemic inflammation, and insulin resistance characteristic of non-alcoholic fatty liver disease (NAFLD) may represent possible mechanisms for the association between the development of hyperuricemia and NAFLD. Aim. To clarify the meaning and nature of the relationship between an increase in the level of UA concentration and the development of NAFLD, as well as to evaluate the relationship between uric acid and the risk of cardiovascular complications in patients with hypertension and NAFLD. Materials and methods. A cross-sectional comparative study was conducted, which involved 120 patients aged from 45 to 65 with hypertension of 1–2 degrees, 1–2 stages (with and without NAFLD (FLI > 60). During the examination, a clinical examination was carried out: analysis of anamnesis data, anthropometry. Lipids and uric acid in blood plasma were also analyzed. Results. In the group of comorbid patients, there were significantly more patients with excess of the reference values of UA levels in the blood plasma (OR = 2.25: 95% CI 1.08–4.71). ROC analysis showed that with an uric acid level of 369.5 µmol/l, a high risk of developing NAFLD is predicted. The UA/Cr index in patients with hypertension and NAFLD was statistically significantly higher than in patients in the control group. Increase in the MK/Kr index by 1 USD increases the chances of developing NAFLD by 1.54 times (95% CI: 1.11–2.13). Also, an increase in the concentration of sUA level by 1 µmol/l increases the chances of an increase in the 10-year risk of cardiovascular events to 5.0% or more by 0.6%. Conclusions. With an uric acid level of 369.5 µmol/l, a high risk of developing NAFLD in the study group is predicted. Increase in UA/creatinine index by 1 USD increases the chances of developing NAFLD by 1.54 times. In addition, an increase in the concentration of sUA in the blood plasma by 1 µmol/l increases the chances of an increase in the 10-year risk of cardiovascular events to 5.0% or more by 0.6% in patients with hypertension and NAFLD.","PeriodicalId":36137,"journal":{"name":"Meditsinskiy Sovet","volume":"43 10","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135513291","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}
Metabolic disorders that are progressive in nature most significantly influence the health of postmenopausal women. Osteoporosis and cardiovascular diseases are the most important long-term consequences and seriously affect the menopausal women’s quality of life. Hot flashes, a sudden feeling of heat or burning that begins in the face, neck, upper chest or back regions, is a common reason to see a doctor. Sometimes, hot flashes are accompanied by redness of the skin, red blotches, or rapid heartbeat. In some cases, rises in local skin temperature are observed. The above symptoms are the result of impaired functioning of thermosensitive neurons in the hypothalamic region. Menopausal hormone therapy is the gold standard for pharmacotherapy of various menopausal symptoms. However, it has different absolute and relative contraindications, as well as patients’ refusal of treatment mainly due to hormone phobia, that have resulted in a situation where 30% of menopausal women take hormone replacement therapy and only 15% continue to take it for a long period. Patients often insist on a natural approach to symptom relief and need evidence-based information about different hormonal and non-hormonal treatment options. Concerns about potential side effects of the hormone replacement therapy resulted in increased interest rates for phytoestrogens to manage menopausal symptoms. A rational fixed dose combination of phytoestrogens and micronutrients is a well-tolerated alternative preparation to support the health of perimenopausal women, which can be used with virtually no restrictions.
{"title":"Naturally occurring compounds in relieving symptoms and reducing perimenopausal risks","authors":"E. V. Shikh, A. A. Makhova","doi":"10.21518/ms2023-352","DOIUrl":"https://doi.org/10.21518/ms2023-352","url":null,"abstract":"Metabolic disorders that are progressive in nature most significantly influence the health of postmenopausal women. Osteoporosis and cardiovascular diseases are the most important long-term consequences and seriously affect the menopausal women’s quality of life. Hot flashes, a sudden feeling of heat or burning that begins in the face, neck, upper chest or back regions, is a common reason to see a doctor. Sometimes, hot flashes are accompanied by redness of the skin, red blotches, or rapid heartbeat. In some cases, rises in local skin temperature are observed. The above symptoms are the result of impaired functioning of thermosensitive neurons in the hypothalamic region. Menopausal hormone therapy is the gold standard for pharmacotherapy of various menopausal symptoms. However, it has different absolute and relative contraindications, as well as patients’ refusal of treatment mainly due to hormone phobia, that have resulted in a situation where 30% of menopausal women take hormone replacement therapy and only 15% continue to take it for a long period. Patients often insist on a natural approach to symptom relief and need evidence-based information about different hormonal and non-hormonal treatment options. Concerns about potential side effects of the hormone replacement therapy resulted in increased interest rates for phytoestrogens to manage menopausal symptoms. A rational fixed dose combination of phytoestrogens and micronutrients is a well-tolerated alternative preparation to support the health of perimenopausal women, which can be used with virtually no restrictions.","PeriodicalId":36137,"journal":{"name":"Meditsinskiy Sovet","volume":"39 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135619819","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}
The article discusses the modern therapeutic approach to lowering blood triglyceride levels. The need to consider indications for the use of lipid-lowering therapy in patients with hypertriglyceridemia is caused by the emergence of new evidence-based information. The article describes how elevated blood TG levels are associated with the risk of developing cardiovascular (CV) complications, as well as pancreatitis. The mechanisms of TG metabolism that may regulate the relationship between elevated blood TG levels and the risk of developing CV complications are considered. The findings of large randomized clinical trials, including recent ones, which laid the foundation for the current clinical guidelines for the use of drugs to lower triglycerides levels, are discussed. Indications for fibrate therapy in patients with elevated blood TG levels in various clinical situations are considered. The article emphasizes that the icosapent ethyl ester drug is not currently available in the Russian Federation. According to the latest versions of international guidelines, it is considered a first-line drug to reduce the risk of developing CV complications in patients with an established diagnosis of CVD (i.e. for the purpose of secondary prevention). In this context, the significance of fenofibrate as a drug to lower blood triglyceride levels, specifically in secondary prevention of CV complications, can remain quite high in our country. The appearance of a rosuvastatin and fenofibrate combination drug on the pharmaceutical market of the Russian Federation will increase adherence to the therapy, if a fibrate is required to be added to statin therapy.
{"title":"Changing perceptions about the role of combination therapy with statin and fibrate in patients with hypertriglyceridemia","authors":"S. R. Gilyarevskiy","doi":"10.21518/ms2023-268","DOIUrl":"https://doi.org/10.21518/ms2023-268","url":null,"abstract":"The article discusses the modern therapeutic approach to lowering blood triglyceride levels. The need to consider indications for the use of lipid-lowering therapy in patients with hypertriglyceridemia is caused by the emergence of new evidence-based information. The article describes how elevated blood TG levels are associated with the risk of developing cardiovascular (CV) complications, as well as pancreatitis. The mechanisms of TG metabolism that may regulate the relationship between elevated blood TG levels and the risk of developing CV complications are considered. The findings of large randomized clinical trials, including recent ones, which laid the foundation for the current clinical guidelines for the use of drugs to lower triglycerides levels, are discussed. Indications for fibrate therapy in patients with elevated blood TG levels in various clinical situations are considered. The article emphasizes that the icosapent ethyl ester drug is not currently available in the Russian Federation. According to the latest versions of international guidelines, it is considered a first-line drug to reduce the risk of developing CV complications in patients with an established diagnosis of CVD (i.e. for the purpose of secondary prevention). In this context, the significance of fenofibrate as a drug to lower blood triglyceride levels, specifically in secondary prevention of CV complications, can remain quite high in our country. The appearance of a rosuvastatin and fenofibrate combination drug on the pharmaceutical market of the Russian Federation will increase adherence to the therapy, if a fibrate is required to be added to statin therapy.","PeriodicalId":36137,"journal":{"name":"Meditsinskiy Sovet","volume":"17 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135618651","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}
S. V. Apresyan, A. E. Markarov, Ju. E. Dobrokhotova, S. A. Khlynova, V. I. Dimitrova, S. A. Papoyan, E. A. Markova, O. A. Slyusareva
Introduction . The relevance of studying the mechanisms underlying the development of adenomyosis is determined not only by its high prevalence reaching 40% among reproductive aged women, but also by its association with unexplained infertility (60%), as well as woman’s quality of life impairment. Aim . To enhance efficiency of therapy after surgical treatment of endometriosis and minimize the risk of disease recurrence. Materials and methods . In a cohort prospective comparative study conducted on the basis of the gynecological department of the Inozemtsev City Clinical Hospital, 80 patients of reproductive age who underwent organ-preserving treatment for external genital endometriosis and nodular adenomyosis were included. Dienogest (Zafrilla) was prescribed to 65 patients at a dose of 2 mg/day (1 tablet) from day 2 after surgical treatment continuously for 6 months, taking into account contraindications to its use, 15 patients refused to take the drug in the postoperative period, and made up the control group. Results . The results of the study showed that after surgical treatment of external genital endometriosis and the nodular form of adenomyosis and the appointment of suppressive therapy with Zafrilla, after 3 months, the intensity of the pain syndrome was transformed according to the VAS, NRS, B&B scales by one step, and after 6 months it decreased to a slight (p < 0.05), which contributed to the improvement of the quality of life of patients based on the EHP-30 questionnaire. The long-term results of the study allow us to recommend the drug Zafrilla, with high compliance, good tolerance, a favorable safety profile, in order to reduce pain, the intensity of menstrual flow, and prevent recurrence of the disease based on 24 months of observation. Conclusion . An integrated approach to the treatment of external genital endometriosis and nodular adenomyosis, including surgical treatment and suppressive therapy with Zafrilla, made it possible to realize reproductive function in 48% of patients. Taking dienogest for 24 weeks provided effective relief of pain, alleviated the symptoms of the disease, as well as improved the quality of life and realized reproductive plans.
{"title":"Prevention of endometriosis recurrence after surgical treatment","authors":"S. V. Apresyan, A. E. Markarov, Ju. E. Dobrokhotova, S. A. Khlynova, V. I. Dimitrova, S. A. Papoyan, E. A. Markova, O. A. Slyusareva","doi":"10.21518/ms2023-341","DOIUrl":"https://doi.org/10.21518/ms2023-341","url":null,"abstract":"Introduction . The relevance of studying the mechanisms underlying the development of adenomyosis is determined not only by its high prevalence reaching 40% among reproductive aged women, but also by its association with unexplained infertility (60%), as well as woman’s quality of life impairment. Aim . To enhance efficiency of therapy after surgical treatment of endometriosis and minimize the risk of disease recurrence. Materials and methods . In a cohort prospective comparative study conducted on the basis of the gynecological department of the Inozemtsev City Clinical Hospital, 80 patients of reproductive age who underwent organ-preserving treatment for external genital endometriosis and nodular adenomyosis were included. Dienogest (Zafrilla) was prescribed to 65 patients at a dose of 2 mg/day (1 tablet) from day 2 after surgical treatment continuously for 6 months, taking into account contraindications to its use, 15 patients refused to take the drug in the postoperative period, and made up the control group. Results . The results of the study showed that after surgical treatment of external genital endometriosis and the nodular form of adenomyosis and the appointment of suppressive therapy with Zafrilla, after 3 months, the intensity of the pain syndrome was transformed according to the VAS, NRS, B&B scales by one step, and after 6 months it decreased to a slight (p < 0.05), which contributed to the improvement of the quality of life of patients based on the EHP-30 questionnaire. The long-term results of the study allow us to recommend the drug Zafrilla, with high compliance, good tolerance, a favorable safety profile, in order to reduce pain, the intensity of menstrual flow, and prevent recurrence of the disease based on 24 months of observation. Conclusion . An integrated approach to the treatment of external genital endometriosis and nodular adenomyosis, including surgical treatment and suppressive therapy with Zafrilla, made it possible to realize reproductive function in 48% of patients. Taking dienogest for 24 weeks provided effective relief of pain, alleviated the symptoms of the disease, as well as improved the quality of life and realized reproductive plans.","PeriodicalId":36137,"journal":{"name":"Meditsinskiy Sovet","volume":"182 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135619820","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}
L. A. Sharonova, S. V. Bulgakova, Yu. A. Dolgikh, O. V. Kosareva
Primary hyperaldosteronism is the leading cause of secondary arterial hypertension of adrenal origin. Its prevalence is underestimated. This leads to late diagnosis, although a timely diagnosis can achieve a complete cure for the patient, ensure control of blood pressure and avoid the development of complications. The article discusses the prevalence of primary hyperaldosteronism, its etiology and pathogenesis, the mechanisms of formation of autonomous secretion of aldosterone, including with the combined production of cortisol. The main clinical effects of aldosterone hypersecretion, its role in the formation of complications in the cardiovascular system and metabolic control are discussed. The assessment of the main clinical effects of aldosterone hypersecretion and its role in the formation of complications from the cardiovascular system and metabolic control is given. The authors remind about risk groups in which screening should be carried out, about the stages of a diagnostic search for suspected primary hyperaldosteronism. For the primary test, a preliminary assessment of the level of plasma potassium is necessary, and if hypokalemia is detected, its correction. If the result of the primary test is false negative, retesting will be carried out with the transfer of patients to antihypertensive drugs with minimal effect on the renin-angiotensinaldosterone system. It is important to remember that confirmatory sodium loading tests are contraindicated in some patients. Computed tomography with contrast in combination with selective venous blood sampling in patients are the most significant methods for the topical diagnosis of primary hyperaldosteronism. The choice of treatment method and its effectiveness depend on their results.
{"title":"Problems in the diagnosis of secondary arterial hypertension of adrenal origin","authors":"L. A. Sharonova, S. V. Bulgakova, Yu. A. Dolgikh, O. V. Kosareva","doi":"10.21518/ms2023-270","DOIUrl":"https://doi.org/10.21518/ms2023-270","url":null,"abstract":"Primary hyperaldosteronism is the leading cause of secondary arterial hypertension of adrenal origin. Its prevalence is underestimated. This leads to late diagnosis, although a timely diagnosis can achieve a complete cure for the patient, ensure control of blood pressure and avoid the development of complications. The article discusses the prevalence of primary hyperaldosteronism, its etiology and pathogenesis, the mechanisms of formation of autonomous secretion of aldosterone, including with the combined production of cortisol. The main clinical effects of aldosterone hypersecretion, its role in the formation of complications in the cardiovascular system and metabolic control are discussed. The assessment of the main clinical effects of aldosterone hypersecretion and its role in the formation of complications from the cardiovascular system and metabolic control is given. The authors remind about risk groups in which screening should be carried out, about the stages of a diagnostic search for suspected primary hyperaldosteronism. For the primary test, a preliminary assessment of the level of plasma potassium is necessary, and if hypokalemia is detected, its correction. If the result of the primary test is false negative, retesting will be carried out with the transfer of patients to antihypertensive drugs with minimal effect on the renin-angiotensinaldosterone system. It is important to remember that confirmatory sodium loading tests are contraindicated in some patients. Computed tomography with contrast in combination with selective venous blood sampling in patients are the most significant methods for the topical diagnosis of primary hyperaldosteronism. The choice of treatment method and its effectiveness depend on their results.","PeriodicalId":36137,"journal":{"name":"Meditsinskiy Sovet","volume":"26 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135619822","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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