Pub Date : 2024-06-10DOI: 10.26442/20795696.2024.2.202800
O. Gizinger, Y. Sorokin, V. Radzinskiy
Aim. To determine local features of lipoperoxidation processes, antioxidant defense, state of matrix metalloproteinases in chronic endometritis. Materials and methods. Eighty women aged 29.33±6.71 (min-max [24–36]) with histologically and immunohistochemically confirmed chronic endometritis and a history of reproductive losses were examined (group 1). The control group consisted of 30 patients without chronic endometritis confirmed by the results of a histochemical study and no history of reproductive losses, suffering from infertility of tubal-peritoneal origin at the age of 30.11±6.9 years (min-max [24–37]; group 2). All 130 patients underwent transvaginal echography of the pelvic organs, and histological and immunohistochemical examination of endometrial samples was performed. The activity of lipid peroxidation factors was analyzed: primary, secondary and final products of lipid peroxidation in heptane and isopropanolol fractions of uterine cavity aspirate, enzymes of the antioxidant system: superoxide dismutase, catalase, glutathione peroxidase, deoxyribonuclease I (DNase), by spectrophotometric method, remodeling factors – matrix metalloproteinases MMP-2, -9 by flow fluorimetry. Results. In patients of group 1, according to transvaginal echography of the pelvic organs, M-echo was 6.29±1.22 mm, in group 2 – 9.10±1.15 mm. In chronic endometritis, disruption of pro-oxidant and activity of antioxidant factors in the endometrium in women with chronic endometritis and a history of reproductive losses. In the heptane fraction of the phenolic extract, the concentration of primary products of lipid peroxidation (diene conjugates) was 12.98% higher than in the control, the content of secondary products of lipid peroxidation (ketodienes) was higher by 15.45%, conjugated trienes by 18.67% higher than the values in the control group, which indicates increased lipid peroxidation of endometrial cell membranes during CE. In the isopropanol phase, the products of lipid peroxidation of phospholipid acyl residues are detected. In the isopropanol fraction of the lipid extract, the amount of diene conjugates was higher, ketodienes by 24.32% and conjugated trienes by 26.14%. An increase in the activity of the enzymes superoxide dismutase by 23.98%, catalase by 14.34%, glutathione peroxidase by 12.39%, and DNase by 2.9 times was recorded compared to the indicators of group 2. Conclusion. Chronic endometritis is accompanied by changes in the system of pro-oxidant and antioxidant factors, the content of tissue remodeling products. The pathogenetic changes underlying oxidative stress in the endometrium may be increased leukocyte infiltration, imbalance of primary, secondary and end products of lipid peroxidation, enzymes superoxide dismutase, catalase, glutathione peroxidase, deoxyribonuclease I (DNase), expression of matrix metalloproteinases-2, -9.
{"title":"Chronic endometritis. Local prooxidant, antioxidant and immunometabolic disorders. An open-label, prospective, randomized study","authors":"O. Gizinger, Y. Sorokin, V. Radzinskiy","doi":"10.26442/20795696.2024.2.202800","DOIUrl":"https://doi.org/10.26442/20795696.2024.2.202800","url":null,"abstract":"Aim. To determine local features of lipoperoxidation processes, antioxidant defense, state of matrix metalloproteinases in chronic endometritis. \u0000Materials and methods. Eighty women aged 29.33±6.71 (min-max [24–36]) with histologically and immunohistochemically confirmed chronic endometritis and a history of reproductive losses were examined (group 1). The control group consisted of 30 patients without chronic endometritis confirmed by the results of a histochemical study and no history of reproductive losses, suffering from infertility of tubal-peritoneal origin at the age of 30.11±6.9 years (min-max [24–37]; group 2). All 130 patients underwent transvaginal echography of the pelvic organs, and histological and immunohistochemical examination of endometrial samples was performed. The activity of lipid peroxidation factors was analyzed: primary, secondary and final products of lipid peroxidation in heptane and isopropanolol fractions of uterine cavity aspirate, enzymes of the antioxidant system: superoxide dismutase, catalase, glutathione peroxidase, deoxyribonuclease I (DNase), by spectrophotometric method, remodeling factors – matrix metalloproteinases MMP-2, -9 by flow fluorimetry. \u0000Results. In patients of group 1, according to transvaginal echography of the pelvic organs, M-echo was 6.29±1.22 mm, in group 2 – 9.10±1.15 mm. In chronic endometritis, disruption of pro-oxidant and activity of antioxidant factors in the endometrium in women with chronic endometritis and a history of reproductive losses. In the heptane fraction of the phenolic extract, the concentration of primary products of lipid peroxidation (diene conjugates) was 12.98% higher than in the control, the content of secondary products of lipid peroxidation (ketodienes) was higher by 15.45%, conjugated trienes by 18.67% higher than the values in the control group, which indicates increased lipid peroxidation of endometrial cell membranes during CE. In the isopropanol phase, the products of lipid peroxidation of phospholipid acyl residues are detected. In the isopropanol fraction of the lipid extract, the amount of diene conjugates was higher, ketodienes by 24.32% and conjugated trienes by 26.14%. An increase in the activity of the enzymes superoxide dismutase by 23.98%, catalase by 14.34%, glutathione peroxidase by 12.39%, and DNase by 2.9 times was recorded compared to the indicators of group 2. \u0000Conclusion. Chronic endometritis is accompanied by changes in the system of pro-oxidant and antioxidant factors, the content of tissue remodeling products. The pathogenetic changes underlying oxidative stress in the endometrium may be increased leukocyte infiltration, imbalance of primary, secondary and end products of lipid peroxidation, enzymes superoxide dismutase, catalase, glutathione peroxidase, deoxyribonuclease I (DNase), expression of matrix metalloproteinases-2, -9.","PeriodicalId":36505,"journal":{"name":"Gynecology","volume":" 49","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141365411","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 : 2024-06-10DOI: 10.26442/20795696.2024.2.202715
T. Belokrinitskaya, A.G. Sidorkina, V. Mudrov
Postpartum hemorrhage (PPH) is one of the leading causes of maternal mortality in Russia and worldwide. Accurate calculation of circulating blood volume (CBV) and personalized estimation of the extent of blood loss (EBL) play vital roles in the early diagnosis of PPH. Visual assessment of BL in childbirth is an available diagnostic method, but it has a high error rate compared to the gravimetric method. A dynamic assessment of the shock index (SI) as an indicator that reflects hemodynamic disorders early enough can be used as an additional diagnostic method for PPH and a test that allows predicting the need for transfusion of blood products. Aim. To review current literature on the assessment of BL in childbirth and the diagnosis of PPH. Materials and methods. The search for publications by Russian and foreign authors was carried out in the information electronic databases PubMed, PubMed Central, Scopus, MEDLINE, ScienceDirect, Cochrane Library, and eLibrary from 2016 to January 2024 using the keywords "obstetric blood loss," "PPH," and "SI." Results. When assessing the CBV, its correlation with the body mass index was revealed. Subjective methods for the PPH assessment have a large margin of error, which does not depend on the experience and seniority of the healthcare provider. The gravimetric method is more accurate, but it can underestimate the clinical situation when physiological blood loss is exceeded. Dynamic assessment of SI is an early marker of hemodynamic disorders and makes it possible to identify patients with a high risk of adverse outcomes more reliably than other parameters. Conclusion. In order to provide timely and adequate emergency medical care for excessive obstetric blood loss, a personalized approach should be used to calculate the EBL, taking into account the woman's body mass index, as well as a systematic assessment of the BL, including at least the extent of blood loss and monitoring of the SI.
{"title":"Modern methods for assessing blood loss in childbirth and diagnosing postpartum hemorrhage: A review","authors":"T. Belokrinitskaya, A.G. Sidorkina, V. Mudrov","doi":"10.26442/20795696.2024.2.202715","DOIUrl":"https://doi.org/10.26442/20795696.2024.2.202715","url":null,"abstract":"Postpartum hemorrhage (PPH) is one of the leading causes of maternal mortality in Russia and worldwide. Accurate calculation of circulating blood volume (CBV) and personalized estimation of the extent of blood loss (EBL) play vital roles in the early diagnosis of PPH. Visual assessment of BL in childbirth is an available diagnostic method, but it has a high error rate compared to the gravimetric method. A dynamic assessment of the shock index (SI) as an indicator that reflects hemodynamic disorders early enough can be used as an additional diagnostic method for PPH and a test that allows predicting the need for transfusion of blood products. \u0000Aim. To review current literature on the assessment of BL in childbirth and the diagnosis of PPH. \u0000Materials and methods. The search for publications by Russian and foreign authors was carried out in the information electronic databases PubMed, PubMed Central, Scopus, MEDLINE, ScienceDirect, Cochrane Library, and eLibrary from 2016 to January 2024 using the keywords \"obstetric blood loss,\" \"PPH,\" and \"SI.\" \u0000Results. When assessing the CBV, its correlation with the body mass index was revealed. Subjective methods for the PPH assessment have a large margin of error, which does not depend on the experience and seniority of the healthcare provider. The gravimetric method is more accurate, but it can underestimate the clinical situation when physiological blood loss is exceeded. Dynamic assessment of SI is an early marker of hemodynamic disorders and makes it possible to identify patients with a high risk of adverse outcomes more reliably than other parameters. \u0000Conclusion. In order to provide timely and adequate emergency medical care for excessive obstetric blood loss, a personalized approach should be used to calculate the EBL, taking into account the woman's body mass index, as well as a systematic assessment of the BL, including at least the extent of blood loss and monitoring of the SI.","PeriodicalId":36505,"journal":{"name":"Gynecology","volume":" 1285","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141363622","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 : 2024-05-09DOI: 10.26442/20795696.2024.1.202641
Y. Dobrokhotova, I. Lapina, A. Tyan, V. Taranov, T. G. Chirvon, N. V. Glebov, O. V. Kaykova, Anastasiya A. Malakhova, Valeriia M. Gomzikova, Ekaterina S. Mahonina, Mariya A. Olkhovskaya
Background. Colpoptosis combined with stress urinary incontinence is one of the most common conditions in postmenopausal women. Menopause is also associated with the risk of genitourinary syndrome due to estrogen deficiency. Despite the variety of options for surgical correction of genital prolapse and urinary incontinence, there is no universal technique. The use of vaginal approach in pelvic floor surgery is associated with several controversies regarding the rates of recurrence and mesh-associated complications. Studies of the state of the endothelium in menopause have demonstrated a close relationship between age-related features and the frequency of adverse clinical outcomes, which requires an optimal intervention not only on the hormonal status but also on the microcirculatory system. Aim. To improve the principles of complex treatment of pelvic organ prolapse and genitourinary syndrome in postmenopausal patients. Materials and methods. The study included 48 postmenopausal patients with genital prolapse of stage II and above according to the POP-Q classification. All patients received continuous menopausal hormone therapy (MHT) with a combined estrogen-progestogen agent. The patients in group 1 (n=24) received MHT according to clinical guidelines for managing patients with genitourinary syndrome. The patients in group 2 (n=24), in addition to MHT, received sulodexide containing glucurono-2-amino-2-deoxyglucoglucan sulfate before the intended surgical treatment and for 30 days after surgery. Correction of colpocystocele, proctocele and stress urinary incontinence was performed using anterior and posterior colporrhaphy, perineoplasty, and urethral sling placement in case of stress urinary incontinence. Results. Six months after surgical treatment, signs of genital prolapse recurrence were detected in 3 patients (12.5%) in group 1, and 1 patient (4.2%) showed signs of mesh-associated complications (implant extrusion) after urethral sling placement. In group 2, only 4.2% of patients (n=1) showed signs of recurrence of stage II cystocele. All patients who underwent urethral sling surgery reported improved urinary incontinence (n=10). During complex therapy, 3 months after surgery, a more significant improvement of endothelial dysfunction markers was noted in group 2 patients (homocysteine level in group 1 after treatment was 12.27±0.34, in group 2 – 8.34±0.24). Conclusions. Combination therapy of genitourinary syndrome and genital prolapse using MHT, endotheliotropic drugs and vaginal surgical approach in postmenopausal patients contributes to effective and safe treatment associated with minimal risk of complications and recurrence rate. Endothelial dysfunction correction is an essential step in planning surgical intervention in menopausal patients, which contributes to improving tissue repair in the postoperative period.
{"title":"Combined treatment of postmenopausal patients with pelvic organ prolapse and genitourinary syndrome","authors":"Y. Dobrokhotova, I. Lapina, A. Tyan, V. Taranov, T. G. Chirvon, N. V. Glebov, O. V. Kaykova, Anastasiya A. Malakhova, Valeriia M. Gomzikova, Ekaterina S. Mahonina, Mariya A. Olkhovskaya","doi":"10.26442/20795696.2024.1.202641","DOIUrl":"https://doi.org/10.26442/20795696.2024.1.202641","url":null,"abstract":"Background. Colpoptosis combined with stress urinary incontinence is one of the most common conditions in postmenopausal women. Menopause is also associated with the risk of genitourinary syndrome due to estrogen deficiency. Despite the variety of options for surgical correction of genital prolapse and urinary incontinence, there is no universal technique. The use of vaginal approach in pelvic floor surgery is associated with several controversies regarding the rates of recurrence and mesh-associated complications. Studies of the state of the endothelium in menopause have demonstrated a close relationship between age-related features and the frequency of adverse clinical outcomes, which requires an optimal intervention not only on the hormonal status but also on the microcirculatory system. \u0000Aim. To improve the principles of complex treatment of pelvic organ prolapse and genitourinary syndrome in postmenopausal patients. \u0000Materials and methods. The study included 48 postmenopausal patients with genital prolapse of stage II and above according to the POP-Q classification. All patients received continuous menopausal hormone therapy (MHT) with a combined estrogen-progestogen agent. The patients in group 1 (n=24) received MHT according to clinical guidelines for managing patients with genitourinary syndrome. The patients in group 2 (n=24), in addition to MHT, received sulodexide containing glucurono-2-amino-2-deoxyglucoglucan sulfate before the intended surgical treatment and for 30 days after surgery. Correction of colpocystocele, proctocele and stress urinary incontinence was performed using anterior and posterior colporrhaphy, perineoplasty, and urethral sling placement in case of stress urinary incontinence. \u0000Results. Six months after surgical treatment, signs of genital prolapse recurrence were detected in 3 patients (12.5%) in group 1, and 1 patient (4.2%) showed signs of mesh-associated complications (implant extrusion) after urethral sling placement. In group 2, only 4.2% of patients (n=1) showed signs of recurrence of stage II cystocele. All patients who underwent urethral sling surgery reported improved urinary incontinence (n=10). During complex therapy, 3 months after surgery, a more significant improvement of endothelial dysfunction markers was noted in group 2 patients (homocysteine level in group 1 after treatment was 12.27±0.34, in group 2 – 8.34±0.24). \u0000Conclusions. Combination therapy of genitourinary syndrome and genital prolapse using MHT, endotheliotropic drugs and vaginal surgical approach in postmenopausal patients contributes to effective and safe treatment associated with minimal risk of complications and recurrence rate. Endothelial dysfunction correction is an essential step in planning surgical intervention in menopausal patients, which contributes to improving tissue repair in the postoperative period.","PeriodicalId":36505,"journal":{"name":"Gynecology","volume":" 14","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140997388","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 : 2024-05-09DOI: 10.26442/20795696.2024.1.202644
K. Pasenov, I. Ponomarenko, M. Churnosov
Aim. To assess the relationship of polymorphic gene variants associated with the level of sex hormone-binding globulin (SHBG) according to genome-wide association studies (GWAS) with the risk of stage I–II and stage III-IV breast cancer. Materials and methods. A comparative genetic analysis was carried out on samples of patients with breast cancer: 254 patients with stages I–II and 91 with stages III–IV, and 1140 females of the control group. The paper considers 4 single nucleotide substitutions associated with the level of circulating SHBG according to GWAS: g.107546375AG PRMT6 (rs17496332), g.27519736TC GCKR (rs780093), g.48419260TC PPP1R21 (rs10454142), g.98364050TA BAIAP2L1 (rs3779195). Results. Differences in the involvement of polymorphic variants of SHBG candidate genes in the development of stages I–II and III–IV breast cancer were revealed. The rs10454142 TC polymorphic variant in the PPP1R21 gene is associated with the risk of stage I–II breast cancer: women with an allelic variant of this locus have a higher risk of early-stage disease (T/T vs. T/C vs. C/C, odds ratio 1.35, 95% confidence interval 1.05-1.75; p=0.021; ppermutat=0.027). Also, an increase in the number of C alleles in the female genotype increased the risk of stage I–II breast cancer by 17–18% per allele. There were no associations of polymorphic variants of SHBG candidate genes with the risk of severe disease (stage III–IV). The single nucleotide substitution rs10454142 TC in the PPP1R21 gene and the single nucleotide polymorphisms strongly linked to it are functionally significant (located in the regions of enhancers and promoters) in the epithelial and myoepithelial cells of the mammary gland and liver, affect the level of genome methylation, and are associated with the level of GTF2A1L gene expression.
目的根据全基因组关联研究（GWAS），评估与性激素结合球蛋白（SHBG）水平相关的多态性基因变异与罹患 I-II 期和 III-IV 期乳腺癌风险的关系。材料与方法对乳腺癌患者样本进行了基因比较分析：254 名 I-II 期患者和 91 名 III-IV 期患者，以及 1140 名对照组女性。本文根据 GWAS 研究了与循环 SHBG 水平相关的 4 个单核苷酸置换：g.107546375AG PRMT6（rs17496332）、g.27519736TC GCKR（rs780093）、g.48419260TC PPP1R21（rs10454142）、g.98364050TA BAIAP2L1（rs3779195）。结果结果显示，SHBG 候选基因的多态性变异在 I-II 期和 III-IV 期乳腺癌发病中的参与程度存在差异。PPP1R21 基因中的 rs10454142 TC 多态变异与罹患 I-II 期乳腺癌的风险有关：该位点等位基因变异的女性罹患早期疾病的风险更高（T/T vs. T/C vs. C/C，几率比 1.35，95% 置信区间 1.05-1.75；p=0.021；ppermutat=0.027）。此外，女性基因型中 C 等位基因数量的增加会使罹患 I-II 期乳腺癌的风险增加 17-18%。SHBG候选基因的多态变异与严重疾病（III-IV期）的风险没有关联。PPP1R21 基因中的单核苷酸替换 rs10454142 TC 以及与之密切相关的单核苷酸多态性在乳腺和肝脏的上皮细胞和肌上皮细胞中具有重要功能（位于增强子和启动子区域），影响基因组甲基化水平，并与 GTF2A1L 基因表达水平相关。
{"title":"Polymorphic variants of the PPP1R21 gene associated with the level of sex hormone-binding globulin and the risk of various stages of breast cancer","authors":"K. Pasenov, I. Ponomarenko, M. Churnosov","doi":"10.26442/20795696.2024.1.202644","DOIUrl":"https://doi.org/10.26442/20795696.2024.1.202644","url":null,"abstract":"Aim. To assess the relationship of polymorphic gene variants associated with the level of sex hormone-binding globulin (SHBG) according to genome-wide association studies (GWAS) with the risk of stage I–II and stage III-IV breast cancer. \u0000Materials and methods. A comparative genetic analysis was carried out on samples of patients with breast cancer: 254 patients with stages I–II and 91 with stages III–IV, and 1140 females of the control group. The paper considers 4 single nucleotide substitutions associated with the level of circulating SHBG according to GWAS: g.107546375AG PRMT6 (rs17496332), g.27519736TC GCKR (rs780093), g.48419260TC PPP1R21 (rs10454142), g.98364050TA BAIAP2L1 (rs3779195). \u0000Results. Differences in the involvement of polymorphic variants of SHBG candidate genes in the development of stages I–II and III–IV breast cancer were revealed. The rs10454142 TC polymorphic variant in the PPP1R21 gene is associated with the risk of stage I–II breast cancer: women with an allelic variant of this locus have a higher risk of early-stage disease (T/T vs. T/C vs. C/C, odds ratio 1.35, 95% confidence interval 1.05-1.75; p=0.021; ppermutat=0.027). Also, an increase in the number of C alleles in the female genotype increased the risk of stage I–II breast cancer by 17–18% per allele. There were no associations of polymorphic variants of SHBG candidate genes with the risk of severe disease (stage III–IV). The single nucleotide substitution rs10454142 TC in the PPP1R21 gene and the single nucleotide polymorphisms strongly linked to it are functionally significant (located in the regions of enhancers and promoters) in the epithelial and myoepithelial cells of the mammary gland and liver, affect the level of genome methylation, and are associated with the level of GTF2A1L gene expression.","PeriodicalId":36505,"journal":{"name":"Gynecology","volume":" 12","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141129122","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 : 2024-05-09DOI: 10.26442/20795696.2024.1.202645
A. Kazakova, G. Santalova, Polina V. Kartashova, G. Poretskova, I. Dufinets
Rheumatoid arthritis is one of the most common and severe autoimmune diseases. The prevalence of rheumatoid arthritis among adults in different geographical areas of the world ranges from 0.5 to 2%. The prevalence of juvenile rheumatoid arthritis is approximately 6 per 10 thousand children. The disease occurs 2 times more often in girls than in boys. Some studies have demonstrated a possible effect of high cumulative doses of methotrexate on ovarian function in patients with systemic lupus erythematosus, but further studies are needed to confirm this effect. The analysis of literature data allowed us to identify prognostically significant factors in the development of autoimmune ovarian failure in patients of reproductive age with rheumatic pathology, and to note the fact that there is missing information about the state of the reproductive system in female patients with juvenile arthritis.
{"title":"Features of the reproductive function of girls and women with rheumatoid arthritis: A review","authors":"A. Kazakova, G. Santalova, Polina V. Kartashova, G. Poretskova, I. Dufinets","doi":"10.26442/20795696.2024.1.202645","DOIUrl":"https://doi.org/10.26442/20795696.2024.1.202645","url":null,"abstract":"Rheumatoid arthritis is one of the most common and severe autoimmune diseases. The prevalence of rheumatoid arthritis among adults in different geographical areas of the world ranges from 0.5 to 2%. The prevalence of juvenile rheumatoid arthritis is approximately 6 per 10 thousand children. The disease occurs 2 times more often in girls than in boys. Some studies have demonstrated a possible effect of high cumulative doses of methotrexate on ovarian function in patients with systemic lupus erythematosus, but further studies are needed to confirm this effect. The analysis of literature data allowed us to identify prognostically significant factors in the development of autoimmune ovarian failure in patients of reproductive age with rheumatic pathology, and to note the fact that there is missing information about the state of the reproductive system in female patients with juvenile arthritis.","PeriodicalId":36505,"journal":{"name":"Gynecology","volume":" 10","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140995761","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 : 2024-05-09DOI: 10.26442/20795696.2024.1.202432
E. O. Golubenko, M. I. Savelyeva, V.V. Korennaya
Background. Side effects of endocrine therapy with tamoxifen (TAM) reduce the quality of life of patients with breast cancer (BC) and adversely affect treatment compliance. Against the background of treatment of BC with TAM, the risk of developing endometrial hyperplasia (EH) increases. At the moment, algorithms for monitoring patients receiving TAM by an obstetrician-gynecologist have not been developed and approved. There are also divergent opinions of experts regarding the diagnosis and management of patients in the detection of EH. This article presents the results of the final stage of the study in 2017–2022 – a survey study. The purpose of this study was to assess adherence to endocrine therapy and satisfaction with observation by a gynecologist of women with BC after 5 years of observation and their relationship with the identified early associated polymorphisms of the CYP2D6, CYP3A5, CYP2C9 and ABCB1 genes. Materials and methods. 54 patients with BC, out of 120 who had previously passed the first pharmacogenetic stage of the study, were interviewed with specially designed questionnaire. Due to the small sample size, delta percentages (∆%) were used in each comparison group with a difference threshold of 5%. To assess associations with the studied genetic polymorphisms, previously obtained significant associations of adverse drug reactions with pharmacogenetics in the same patients were used. Results. The prevalence of all adverse drug reactions (ADRs), with the exception of EH, was higher in the group of patients who canceled TAM. Over 5 years of follow-up, 57.4% of patients were regularly observed by an obstetrician-gynecologist, 42.59% of patients visited a gynecologist less than once a year. Of all the respondents, 53.7% of patients are satisfied with the regularity and quality of dispensary observation by an oncologist, 33.33% of patients are satisfied with the regularity and quality of dispensary observation by an obstetrician-gynecologist. All studied ADRs (EH, hot flashes, asthenia, bone pain and dyspepsia) associated with various genetic polymorphisms, prevailed in the group of patients who stopped taking TAM due to drug intolerance (∆%: 25.72, 6.97, 4.81, 6.97 and 24.52 respectively) compared with the TAM-group. Conclusion. The results obtained confirm the role of the studied genetic polymorphisms in the development of ADRs of TAM, but only systemic (hot flashes, asthenia, bone pain and dyspepsia). With regard to endometrial hyperplasia, no significant differences were obtained, which requires more extensive studies.
背景。他莫昔芬（TAM）内分泌治疗的副作用会降低乳腺癌（BC）患者的生活质量，并对治疗依从性产生不利影响。在使用他莫昔芬治疗乳腺癌的背景下，患子宫内膜增生症（EH）的风险也在增加。目前，由妇产科医生对接受 TAM 治疗的患者进行监测的算法尚未制定和批准。专家们对发现 EH 患者的诊断和管理也存在不同意见。本文介绍了 2017-2022 年研究的最后阶段--调查研究的结果。本研究的目的是评估 BC 女性患者在观察 5 年后对内分泌治疗的依从性和对妇科医生观察的满意度，以及它们与已确定的 CYP2D6、CYP3A5、CYP2C9 和 ABCB1 基因早期相关多态性的关系。材料和方法使用专门设计的调查问卷对 120 名已通过第一阶段药物遗传学研究的 BC 患者中的 54 名患者进行了访谈。由于样本量较小，在每个比较组中使用德尔塔百分比（Δ%），差异阈值为 5%。为了评估与所研究的基因多态性之间的关联，还使用了之前在相同患者中获得的药物不良反应与药物遗传学之间的显著关联。研究结果在取消 TAM 的患者组中，除 EH 外，所有药物不良反应（ADR）的发生率都较高。在 5 年的随访中，57.4% 的患者定期接受妇产科医生的观察，42.59% 的患者每年看妇科医生不到一次。在所有受访者中，53.7% 的患者对肿瘤科医生的定期诊疗和诊疗质量表示满意，33.33% 的患者对妇产科医生的定期诊疗和诊疗质量表示满意。与 TAM 组相比，因不耐受药物而停止服用 TAM 的患者组（∆%：分别为 25.72、6.97、4.81、6.97 和 24.52）出现了与各种基因多态性相关的所有 ADR（EH、潮热、气喘、骨痛和消化不良）。结论研究结果证实了所研究的基因多态性在 TAM ADRs 发生中的作用，但只是全身性的（潮热、气喘、骨痛和消化不良）。在子宫内膜增生方面，没有发现明显差异，这需要进行更广泛的研究。
{"title":"Adherence to endocrine therapy with tamoxifen and satisfaction with follow-up of women with breast cancer by a gynecologist: A survey study","authors":"E. O. Golubenko, M. I. Savelyeva, V.V. Korennaya","doi":"10.26442/20795696.2024.1.202432","DOIUrl":"https://doi.org/10.26442/20795696.2024.1.202432","url":null,"abstract":"Background. Side effects of endocrine therapy with tamoxifen (TAM) reduce the quality of life of patients with breast cancer (BC) and adversely affect treatment compliance. Against the background of treatment of BC with TAM, the risk of developing endometrial hyperplasia (EH) increases. At the moment, algorithms for monitoring patients receiving TAM by an obstetrician-gynecologist have not been developed and approved. There are also divergent opinions of experts regarding the diagnosis and management of patients in the detection of EH. This article presents the results of the final stage of the study in 2017–2022 – a survey study. The purpose of this study was to assess adherence to endocrine therapy and satisfaction with observation by a gynecologist of women with BC after 5 years of observation and their relationship with the identified early associated polymorphisms of the CYP2D6, CYP3A5, CYP2C9 and ABCB1 genes. \u0000Materials and methods. 54 patients with BC, out of 120 who had previously passed the first pharmacogenetic stage of the study, were interviewed with specially designed questionnaire. Due to the small sample size, delta percentages (∆%) were used in each comparison group with a difference threshold of 5%. To assess associations with the studied genetic polymorphisms, previously obtained significant associations of adverse drug reactions with pharmacogenetics in the same patients were used. \u0000Results. The prevalence of all adverse drug reactions (ADRs), with the exception of EH, was higher in the group of patients who canceled TAM. Over 5 years of follow-up, 57.4% of patients were regularly observed by an obstetrician-gynecologist, 42.59% of patients visited a gynecologist less than once a year. Of all the respondents, 53.7% of patients are satisfied with the regularity and quality of dispensary observation by an oncologist, 33.33% of patients are satisfied with the regularity and quality of dispensary observation by an obstetrician-gynecologist. All studied ADRs (EH, hot flashes, asthenia, bone pain and dyspepsia) associated with various genetic polymorphisms, prevailed in the group of patients who stopped taking TAM due to drug intolerance (∆%: 25.72, 6.97, 4.81, 6.97 and 24.52 respectively) compared with the TAM-group. \u0000Conclusion. The results obtained confirm the role of the studied genetic polymorphisms in the development of ADRs of TAM, but only systemic (hot flashes, asthenia, bone pain and dyspepsia). With regard to endometrial hyperplasia, no significant differences were obtained, which requires more extensive studies.","PeriodicalId":36505,"journal":{"name":"Gynecology","volume":" 34","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140995689","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 : 2024-05-09DOI: 10.26442/20795696.2024.1.202569
N. Aganezova, S. Aganezov, K. E. Gogichashvili
Aim. To analyze the relationship between the expression of proteomic markers [estrogen (ER) and progesterone (PR) receptors, LIF, FOXA1, FOXA2] of endometrial receptivity and indicators of the levels of sex steroids [estradiol (E2) and progesterone (P)] in the peripheral blood during the “implantation window” in women with a history of reproductive dysfunction with “thin” endometrium (TE) and evaluate their significance for the therapeutic effect of using estradiol drugs. Materials and methods. The prospective cohort comparative study was conducted. The main group included 52 patients with TE (7 mm according to ultrasound on preovulatory days), the comparison group consisted of 62 women with normal endometrial thickness (≥7 mm according to ultrasound), women of both groups with reproductive dysfunctions of unknown reason; the control group included 16 healthy women. Aspiration biopsy of the endometrium was performed on the 6–8 days after ovulation (LH +6–8), as well as venipuncture to obtain a sample of peripheral blood to determine the E2, P levels. A combined histological and immunohistochemical study of endometrial samples was performed (ER, PR, LIF, FOXA1, FOXA2). The therapeutic effects of estradiol drugs were assessed in a cohort of women from the main group with TE (n=16 out of 26, those who have not changed their reproductive plans). Results. All women had ovulatory values of progesterone [P≥16.1 nmol/l (LH +6–8)] and normoestrogenemia in the blood (p0.05). According to the results of the correlation analysis, there were no associations between the E2, P levels and the value of M-echo, and no relationships were found between the E2, P levels and the expression of ER, PR, LIF, FOX-proteins. It was revealed that there are significant positive relationships between M-echo and FOXA2 expression in the endometrium (r=0.422; p0.001). Conditional threshold values for the ER, PR expression (LH +6–8) were determined, the excess of which is associated with abnormal expression of LIF, FOX-proteins: for PR in the glands – 105 and 285, for ER in glands – 145, for ER in the stroma – 155. It was found that usual doses of estradiol drugs (1–1.5 mg/day) are capable of increasing endometrial proliferation in women with TE, provided that the expression of ER, PR, LIF, FOX-proteins in their endometrium is similar to healthy women. Increased doses of estradiol drugs (4 mg/day) in women with TE had a significant effect in the form of an increase M-echo value and/or pregnancy in cases where the endometrial expression of LIF, FOX-proteins was comparable with healthy women, even in the presence of hormone-receptor interactions in the endometrium that are different from healthy women. Spontaneous pregnancy in participants of the main group with hypoplastic endometrium in our study occurred in 5 women in whom the expression characteristics of FOXA1 and/or FOXA2 in the endometrium were comparable to healthy women. Conclusion. TE is not the only marker of an imbala
{"title":"Characteristics of expression of proteomic markers in women with “thin” endometrium and their importance for the therapeutic effects of the use of exogenous estradiol: A prospective cohort comparative study","authors":"N. Aganezova, S. Aganezov, K. E. Gogichashvili","doi":"10.26442/20795696.2024.1.202569","DOIUrl":"https://doi.org/10.26442/20795696.2024.1.202569","url":null,"abstract":"Aim. To analyze the relationship between the expression of proteomic markers [estrogen (ER) and progesterone (PR) receptors, LIF, FOXA1, FOXA2] of endometrial receptivity and indicators of the levels of sex steroids [estradiol (E2) and progesterone (P)] in the peripheral blood during the “implantation window” in women with a history of reproductive dysfunction with “thin” endometrium (TE) and evaluate their significance for the therapeutic effect of using estradiol drugs. \u0000Materials and methods. The prospective cohort comparative study was conducted. The main group included 52 patients with TE (7 mm according to ultrasound on preovulatory days), the comparison group consisted of 62 women with normal endometrial thickness (≥7 mm according to ultrasound), women of both groups with reproductive dysfunctions of unknown reason; the control group included 16 healthy women. Aspiration biopsy of the endometrium was performed on the 6–8 days after ovulation (LH +6–8), as well as venipuncture to obtain a sample of peripheral blood to determine the E2, P levels. A combined histological and immunohistochemical study of endometrial samples was performed (ER, PR, LIF, FOXA1, FOXA2). The therapeutic effects of estradiol drugs were assessed in a cohort of women from the main group with TE (n=16 out of 26, those who have not changed their reproductive plans). \u0000Results. All women had ovulatory values of progesterone [P≥16.1 nmol/l (LH +6–8)] and normoestrogenemia in the blood (p0.05). According to the results of the correlation analysis, there were no associations between the E2, P levels and the value of M-echo, and no relationships were found between the E2, P levels and the expression of ER, PR, LIF, FOX-proteins. It was revealed that there are significant positive relationships between M-echo and FOXA2 expression in the endometrium (r=0.422; p0.001). Conditional threshold values for the ER, PR expression (LH +6–8) were determined, the excess of which is associated with abnormal expression of LIF, FOX-proteins: for PR in the glands – 105 and 285, for ER in glands – 145, for ER in the stroma – 155. It was found that usual doses of estradiol drugs (1–1.5 mg/day) are capable of increasing endometrial proliferation in women with TE, provided that the expression of ER, PR, LIF, FOX-proteins in their endometrium is similar to healthy women. Increased doses of estradiol drugs (4 mg/day) in women with TE had a significant effect in the form of an increase M-echo value and/or pregnancy in cases where the endometrial expression of LIF, FOX-proteins was comparable with healthy women, even in the presence of hormone-receptor interactions in the endometrium that are different from healthy women. Spontaneous pregnancy in participants of the main group with hypoplastic endometrium in our study occurred in 5 women in whom the expression characteristics of FOXA1 and/or FOXA2 in the endometrium were comparable to healthy women. \u0000Conclusion. TE is not the only marker of an imbala","PeriodicalId":36505,"journal":{"name":"Gynecology","volume":" 9","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140996469","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 : 2024-05-09DOI: 10.26442/20795696.2024.1.202615
Daria N. Senina, Saadat A. Pashaeva, Yuliya A. Kulakova, V. Chuprynin, A. Asaturova, Larisa S. Ezhova, N. A. Buralkina
Aim. To identify clinical and history features of patients with recurrent deep endometriosis (RDE). Materials and methods. A retrospective study of clinical and history data of 200 patients with DE undergoing surgical treatment at the Department of General Surgery of the Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology in 2020–2021. Group 1 included 80 patients with RDE, group 2 included 120 patients with newly diagnosed DE. All patients underwent surgical treatment followed by immunohistochemical examination and DE confirmation. Results. An association was found between the young age of the patient at the time of the first surgery and the type of endometriosis. It was found that women with a history of endometriosis surgery in early reproductive years (29.22±5.3 years) are at risk of recurrent endometriosis. Two or more surgeries were reported in 33.7% of RDE patients. In 90.2% of patients, endometriosis recurred with clinical manifestations; in 9.8%, it was asymptomatic and diagnosed on pelvic ultrasound. The group of RDE patients showed a longer period of infertility (5.432±3.53 years) than the group with newly diagnosed DE (2.953±1.29 years). It was found that the surgeries performed in RDE patients were longer, more complex, and associated with more blood loss. Intestinal resection, ureterolysis, adhesiolysis, and salpingectomy were significantly more common in the RDE group than in patients without a history of endometriosis surgery. Conclusion. In most cases, RDE is clinically manifested, rarely asymptomatic and diagnosed by visualization methods. Patients with a history of surgery at a younger age are at risk of RDE, and their surgical interventions are more complicated with more blood loss. Currently, surgical treatment of DE is the optimal method; however, it has serious disadvantages with severe and even life-threatening postoperative complications.
目的：确定复发性深部子宫内膜异位症（RDE）患者的临床和病史特征。确定复发性深部子宫内膜异位症（RDE）患者的临床和病史特征。材料和方法。对2020-2021年在库拉科夫国立妇产科和围产医学研究中心普通外科接受手术治疗的200名复发性子宫内膜异位症患者的临床和病史资料进行回顾性研究。第一组包括80名RDE患者，第二组包括120名新确诊的DE患者。所有患者都接受了手术治疗，随后进行了免疫组化检查和 DE 确认。结果显示首次手术时患者的年龄与子宫内膜异位症的类型有关。研究发现，育龄早期（29.22±5.3 岁）有子宫内膜异位症手术史的妇女有复发子宫内膜异位症的风险。33.7%的复发性子宫内膜异位症患者接受过两次或两次以上的手术。90.2%的患者复发子宫内膜异位症时有临床表现；9.8%的患者无症状，通过盆腔超声检查确诊。与新确诊的子宫内膜异位症患者（2.953±1.29 年）相比，复发性子宫内膜异位症患者的不孕时间更长（5.432±3.53 年）。研究发现，RDE 患者的手术时间更长、更复杂、失血更多。与无子宫内膜异位症手术史的患者相比，RDE 组患者中肠切除术、输尿管溶解术、粘连溶解术和输卵管切除术的发生率明显更高。结论在大多数情况下，RDE 有临床表现，很少无症状，可通过可视化方法诊断。年轻时有过手术史的患者有发生 RDE 的风险，而且他们的手术治疗更为复杂，失血量更多。目前，手术治疗 DE 是最佳方法，但其缺点是术后并发症严重，甚至危及生命。
{"title":"Clinical and history features of patients with recurrent deep endometriosis: A retrospective study","authors":"Daria N. Senina, Saadat A. Pashaeva, Yuliya A. Kulakova, V. Chuprynin, A. Asaturova, Larisa S. Ezhova, N. A. Buralkina","doi":"10.26442/20795696.2024.1.202615","DOIUrl":"https://doi.org/10.26442/20795696.2024.1.202615","url":null,"abstract":"Aim. To identify clinical and history features of patients with recurrent deep endometriosis (RDE). \u0000Materials and methods. A retrospective study of clinical and history data of 200 patients with DE undergoing surgical treatment at the Department of General Surgery of the Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology in 2020–2021. Group 1 included 80 patients with RDE, group 2 included 120 patients with newly diagnosed DE. All patients underwent surgical treatment followed by immunohistochemical examination and DE confirmation. \u0000Results. An association was found between the young age of the patient at the time of the first surgery and the type of endometriosis. It was found that women with a history of endometriosis surgery in early reproductive years (29.22±5.3 years) are at risk of recurrent endometriosis. Two or more surgeries were reported in 33.7% of RDE patients. In 90.2% of patients, endometriosis recurred with clinical manifestations; in 9.8%, it was asymptomatic and diagnosed on pelvic ultrasound. The group of RDE patients showed a longer period of infertility (5.432±3.53 years) than the group with newly diagnosed DE (2.953±1.29 years). It was found that the surgeries performed in RDE patients were longer, more complex, and associated with more blood loss. Intestinal resection, ureterolysis, adhesiolysis, and salpingectomy were significantly more common in the RDE group than in patients without a history of endometriosis surgery. \u0000Conclusion. In most cases, RDE is clinically manifested, rarely asymptomatic and diagnosed by visualization methods. Patients with a history of surgery at a younger age are at risk of RDE, and their surgical interventions are more complicated with more blood loss. Currently, surgical treatment of DE is the optimal method; however, it has serious disadvantages with severe and even life-threatening postoperative complications.","PeriodicalId":36505,"journal":{"name":"Gynecology","volume":" 24","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140996517","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 : 2024-05-09DOI: 10.26442/20795696.2024.1.202415
O. A. Danilina, V. G. Volkov
Aim. To evaluate the effectiveness of combined pelvic organ prolapse correction using the proposed modification of laparoscopic promontofixation of the uterus and vaginal walls using a mesh graft in women of reproductive age. Materials and methods. A prospective non-randomized study included 41 women of reproductive age (up to 49 years) with grade II–IV symptomatic combined pelvic organ prolapse. The main group (n=19) included women who underwent surgery using the proposed original method (invention patent No. RU2795649C1 dated October 27, 2022), the control group (n=22) included women who underwent conventional laparoscopic promontofixation of the uterus and vaginal walls and vaginal plasty with local tissues. The duration of surgery, intraoperative blood loss, anatomical result, effect on symptoms and sexual function were assessed using the Pelvic Floor Distress Inventory (PFDI-20), Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ-12). Results. The duration of surgery and intraoperative blood loss were significantly lower in the main group (p=0.043 and p0.001, respectively). Anatomical success was achieved in both groups and persisted throughout the follow-up period (without statistically significant differences). Analysis of the PFDI-20 questionnaire responses showed a significant improvement in both groups with no statistically significant differences. Analysis of the PISQ-12 questionnaire data showed a significant improvement in the quality of sexual life in both groups; however, after a year of follow-up, patients of the main group had a significantly better quality of sexual life (p0.05). Conclusion. The surgical correction of combined pelvic organ prolapse using the proposed method demonstrated a good anatomical result, a decrease in intraoperative blood loss and duration of surgery, as well as an improvement in sexual function in women of reproductive age.
{"title":"Evaluation of the effectiveness of a new surgical correction method for combined pelvic organ prolapse in women of reproductive age: A prospective non-randomized study","authors":"O. A. Danilina, V. G. Volkov","doi":"10.26442/20795696.2024.1.202415","DOIUrl":"https://doi.org/10.26442/20795696.2024.1.202415","url":null,"abstract":"Aim. To evaluate the effectiveness of combined pelvic organ prolapse correction using the proposed modification of laparoscopic promontofixation of the uterus and vaginal walls using a mesh graft in women of reproductive age. \u0000Materials and methods. A prospective non-randomized study included 41 women of reproductive age (up to 49 years) with grade II–IV symptomatic combined pelvic organ prolapse. The main group (n=19) included women who underwent surgery using the proposed original method (invention patent No. RU2795649C1 dated October 27, 2022), the control group (n=22) included women who underwent conventional laparoscopic promontofixation of the uterus and vaginal walls and vaginal plasty with local tissues. The duration of surgery, intraoperative blood loss, anatomical result, effect on symptoms and sexual function were assessed using the Pelvic Floor Distress Inventory (PFDI-20), Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ-12). \u0000Results. The duration of surgery and intraoperative blood loss were significantly lower in the main group (p=0.043 and p0.001, respectively). Anatomical success was achieved in both groups and persisted throughout the follow-up period (without statistically significant differences). Analysis of the PFDI-20 questionnaire responses showed a significant improvement in both groups with no statistically significant differences. Analysis of the PISQ-12 questionnaire data showed a significant improvement in the quality of sexual life in both groups; however, after a year of follow-up, patients of the main group had a significantly better quality of sexual life (p0.05). \u0000Conclusion. The surgical correction of combined pelvic organ prolapse using the proposed method demonstrated a good anatomical result, a decrease in intraoperative blood loss and duration of surgery, as well as an improvement in sexual function in women of reproductive age.","PeriodicalId":36505,"journal":{"name":"Gynecology","volume":" 19","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140996344","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 : 2024-05-09DOI: 10.26442/20795696.2024.1.202556
D. A. Stupin, L. I. Kolesnikova, A. Semendyaev, M. Darenskaya, Daria V. Tukhieva, Ekaterina S. Bystrova, Ksenia V. Kuryshova, A. I. Gus
Aim. To evaluate the clinical efficacy of complex antioxidant therapy (CAT) in the treatment of patients with pelvic varicose veins (PVV). Materials and methods. Patients with PVV (n=150) were divided into groups 1 and 2 of 75 subjects; the groups were comparable. Treatment in both groups included standard therapy with one of the venotropic agents (60 days). Patients of group 1 additionally received CAT for 30 days (1 course), in total 3 courses with 2-month intervals. Results. When assessing the parameters of the lipoperoxidation system (antioxidant protection) in group 1 during CAT combined with standard venotropic therapy, there was a statistically significant decrease in the levels of lipid hydroperoxides (p0.0001), diene conjugates (p=0.001), malonic dialdehyde (p0.0001), an increase in the levels of catalase (p0.0001), superoxide dismutase (p0.0001), glutathione peroxidase (p0.0001), glutathione reductase (p0.0001), glutathione-S-transferase (p=0.002) and the reduced glutathione content (p=0.032) compared to levels before treatment. The above group showed a decrease in the diameter of the pelvic varicose veins: internal iliac (p0.001), ovarian (p0.0001) and arcuate (p0.001), an increase in their blood flow velocity (p=0.003, 0.041, and 0.040, respectively), a decrease in the duration of retrograde flow to 0.3 cm. There was a decrease in pelvic pain (p0.0001), dysmenorrhea (p=0.024), dyspareunia (p=0.037), the frequency of irregular menstruation (p=0.031), an improvement in quality of life (p=0.047), pregnancy rate (p=0.013), the number of live births (p=0.004), and the duration of remission (p=0.047). Conclusion. The use of a combination of antioxidants superoxide dismutase 250 mg 2 times a day, acetyl-glutathione at 100 mg 2 times a day, and astaxanthin 400 mg/day for 30 days in 3 courses with 2-month intervals combined with venotropic therapy can significantly improve the treatment outcomes of patients with PVV.
{"title":"Clinical efficacy of complex antioxidant therapy for pelvic varicose veins in women: A prospective non-randomized controlled study","authors":"D. A. Stupin, L. I. Kolesnikova, A. Semendyaev, M. Darenskaya, Daria V. Tukhieva, Ekaterina S. Bystrova, Ksenia V. Kuryshova, A. I. Gus","doi":"10.26442/20795696.2024.1.202556","DOIUrl":"https://doi.org/10.26442/20795696.2024.1.202556","url":null,"abstract":"Aim. To evaluate the clinical efficacy of complex antioxidant therapy (CAT) in the treatment of patients with pelvic varicose veins (PVV). \u0000Materials and methods. Patients with PVV (n=150) were divided into groups 1 and 2 of 75 subjects; the groups were comparable. Treatment in both groups included standard therapy with one of the venotropic agents (60 days). Patients of group 1 additionally received CAT for 30 days (1 course), in total 3 courses with 2-month intervals. \u0000Results. When assessing the parameters of the lipoperoxidation system (antioxidant protection) in group 1 during CAT combined with standard venotropic therapy, there was a statistically significant decrease in the levels of lipid hydroperoxides (p0.0001), diene conjugates (p=0.001), malonic dialdehyde (p0.0001), an increase in the levels of catalase (p0.0001), superoxide dismutase (p0.0001), glutathione peroxidase (p0.0001), glutathione reductase (p0.0001), glutathione-S-transferase (p=0.002) and the reduced glutathione content (p=0.032) compared to levels before treatment. The above group showed a decrease in the diameter of the pelvic varicose veins: internal iliac (p0.001), ovarian (p0.0001) and arcuate (p0.001), an increase in their blood flow velocity (p=0.003, 0.041, and 0.040, respectively), a decrease in the duration of retrograde flow to 0.3 cm. There was a decrease in pelvic pain (p0.0001), dysmenorrhea (p=0.024), dyspareunia (p=0.037), the frequency of irregular menstruation (p=0.031), an improvement in quality of life (p=0.047), pregnancy rate (p=0.013), the number of live births (p=0.004), and the duration of remission (p=0.047). \u0000Conclusion. The use of a combination of antioxidants superoxide dismutase 250 mg 2 times a day, acetyl-glutathione at 100 mg 2 times a day, and astaxanthin 400 mg/day for 30 days in 3 courses with 2-month intervals combined with venotropic therapy can significantly improve the treatment outcomes of patients with PVV.","PeriodicalId":36505,"journal":{"name":"Gynecology","volume":" 24","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140996274","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}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：