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Publisher: Trilist Publishing   (Total: 1 journals)   [Sort by number of followers]

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Reproductive Endocrinology     Open Access   (Followers: 3)
Journal Cover
Reproductive Endocrinology
Number of Followers: 3  

  This is an Open Access Journal Open Access journal
ISSN (Print) 2309-4117 - ISSN (Online) 2411-1295
Published by Trilist Publishing Homepage  [1 journal]
  • Correction of hormonal imbalance in patients with diffuse forms of
           mastopathy – the basis of pathogenetic therapy and oncoprophylaxis

    • Authors: Н. В. Косей
      Pages: 8 - 14
      Abstract: The physiological processes of cell division occurring in the tissues of the non-invading mammary gland (MG) are a response to the cyclic changes in the level of estrogens and progesterone released by the ovaries. Violation of the balance between estrogen and progesterone in women of reproductive age can cause dyshormonal hyperplasia of the mammary gland (DHMG). The cyclic form of mastalgia is dangerous not only for its manifestations, but also for the existence of a proven connection with an increased risk of breast cancer (BC).In particular, in a large cohort study in France, it was shown that women who had suffered from cyclic mastalgia for more than 3 years and who had not received treatment had a 5-fold increased risk of breast cancer compared to women who did not have it. In 2016, a meta-analysis of the numerous studies was confirmed that the use of estrogen with micronized progesterone is associated with a lower risk of breast cancer compared with synthetic progestogens. It has been established that progesterone deficiency creates conditions for uncontrolled proliferation in MG tissues and promotes the development of Fibro-cystic disease (FCD).The use of transdermal gel progesterone allows you to balance the excess effects of estrogens on MG, primarily eliminating the excess permeability of tissue capillaries, the mitotic activity of milk duct cells and the painful stretching of the MG tissue. Studies have shown that when using a gel with progesterone (Progestogel®), there is a decrease in mitotic activity in normal cells of the lobular epithelium of the MF. The antiproliferative effect of the Progestogel® is realized when it is used in a continuous mode – every day of the cycle, including the days of menstruation.A retrospective study of the effectiveness of the use of Progestogel® in monotherapy with FCD showed that against a background of local therapy with gel with progesterone there was a statistically significant decrease and disappearance of mastalgia, mastodynia, decrease average size and number of cysts. Progestogel® with course treatment reduces the mammographic density of MG, which is also considered as an independent and extremely significant risk factor for breast cancer. The local application of the gel with progesterone makes it possible to avoid many unnecessary surgical operations to remove cysts.
      PubDate: 2018-02-28
       
  • Modern methods of treatment of cervix inflammatory diseases in women of
           reproductive age. Literature review

    • Authors: А. Е. Дубчак, А. В. Милевский
      Pages: 16 - 20
      Abstract: The article describes contemporary views on the problem of inflammatory diseases of the cervix uterus – cervicitis with the presence of ectopia, erosion, ectropion or without them. The emphasis is placed on the fact that the development of the disease occurs due to two reasons: the persistent action (persistence) of the pathogen – the etiology of inflammation; increased concentration of proinflammatory cytokines – tumor necrosis factor and interleukin-1 – pathogenesis of inflammation. Cytokine-induced activation and output of leukocytes from the vascular bed leads to tissue damage, the development of clinical manifestations of inflammation, promotes chronization of the process and the occurrence of relapses. Therefore, rational treatment of inflammatory diseases of the cervix must be comprehensive and include an etiotropic and pathogenetic component.When choosing etiotropic therapy, it is necessary to take into account the increasing resistance of pathogens to major activated heric remedies. In this case, resistance to nitrofuran occurs very rarely. Nifuratel (Macmiror Complex) is a nitrofuran of the last generation, the only preparation of this group for local application in gynecology, has a pronounced bactericidal effect against a wide range of pathogens (bacteria, mushrooms, protozoa) and provides a reliable eradication of microorganisms. In the Macmiror Complex vaginal cream, the expressed bactericidal effect of nifuratel is combined with high fluidity and pronounced adhesive properties of the carbomeric basis of the cream, which provides a reliable coating of the cervix and a high concentration of the active substance in the focal point of the lesion.Benzodiamine hydrochloride (Tantum RosaR) is the only local non-steroidal anti-inflammatory agent in gynecology, which provides powerful suppression of the synthesis of proinflammatory cytokines, the tumor necrosis factor and interleukin-1, at the very earliest stages, as the recommended pathogenetic therapy of inflammation. Thus, the combination therapy of Macmiror Complex vaginal cream (nifuratel) and Tantum RosaR (benzidamine hydrochloride) has a comprehensive effect on the etiology and pathogenesis of the disease, provides a compelling clinical recovery and prevent relapse in inflammatory diseases of the cervix.
      PubDate: 2018-02-28
       
  • Hemostasis and female sex hormones

    • Authors: О. А. Ефименко, И. А. Родионова
      Pages: 21 - 26
      Abstract: The review considers modern concepts of the pathogenesis of coagulation disorders in women and the participation of endogenous and exogenous sex steroids in it. The analysis of the results of studies in recent years demonstrates significant contradictions on the influence of endogenous female sex steroids on the development of thrombotic events. In the context of thromboembolic complications association with the use of modern hormone containing medications, in particular combined hormonal contraceptives, genetically determined thrombophilia appears to be essential, but the possibility of their routine diagnostics to reduce risks is still not fully defined.To date, recent clinical studies support the early use of menopausal hormone therapy (MHT) to slow the rate of atherosclerosis development and primary prevention of cardiovascular disease in women in early menopause. At the same time, researchers put forward a temporary theory of the use of MHT (the early beginning of the use of MHT from the onset of menopause provides the best protective effect of hormones on the vascular wall) as a way of successful prevention of cardiovascular diseases.Correctly chosen tactics of preventive measures for a specific gynecologic patient can significantly reduce the risk of thromboembolic complications, prevent the development of disseminated intravascular coagulation syndrome or at least reduce its severity, shorten treatment time, and reduce morbidity and mortality caused by this pathology. Strict individual approach and targeted prevention, if it is carried out in all medical institutions and at all stages of management of pregnant and gynecological patients, can significantly reduce the frequency of these formidable complications.
      PubDate: 2018-02-28
       
  • New possibilities of correction of metabolic disorders in women with PCOS

    • Authors: Л. В. Калугіна, Т. Ф Татарчук
      Pages: 27 - 32
      Abstract: The aim of the study, the results of which are described in the article, was to study the possibilities of using a polycomponent drug containing D-kiro-inositol in the polycystic ovarian syndrome.A comparative prospective study was conducted with the participation of 60 patients of reproductive age suffering from polycystic ovarian syndrome (phenotype A). The criteria for participation in the study were: a confirmed diagnosis of polycystic ovarian syndrome with ovarian enlargement and oligo/anovulation and a raised level of ovarian androgens; body mass index from 26 to 30 kg/m2. Patients with severe endocrine and somatic pathology were excluded from the study.Women aged 18–35 years were on out-patient treatment in the Endocrine gynecology department of the SI “Institute of Pediatrics, Obstetrics and Gynecology of the NAMS of Ukraine”. By random sampling, the patients were divided into 2 groups of 30 people each. For 6 months, the patients of the main group received twice a day 1 Protalis complex drug containing D-kiroinositol, which is recommended for normalization of ovarian function and stimulation of spontaneous ovulation in polycystic ovarian syndrome, improvement of oocyte state, and also to promote reduction of oxidative and inflammatory stress, reducing the level of total testosterone and increasing fertility. Patients of the control group received recommendations on dietary nutrition and exercise.Analysis of the results of therapy showed a recovery in the main group of regular ovulatory menstrual cycles in 53.33% of cases, a decrease in the frequency of androgen-dependent dermatopathy by 50%, normalization of body weight and a reliable decrease in androgen levels. In addition, a positive effect on metabolic parameters such as HOMA index and homocysteine level was noted.The results of the study allow us to recommend the use of Protalis course therapy (D-kiro-inositol and synergists) to restore ovulatory menstrual cycles, and as a means of preventing metabolic disorders in women with polycystic ovarian syndrome and overweight.
      PubDate: 2018-02-28
       
  • Prediction of development of severe forms of endometriosis in women of
           reproductive age

    • Authors: Н. Ф. Захаренко
      Pages: 34 - 37
      Abstract: The article describes the algorithm for predicting the development of severe forms of endometriosis and a mathematical model for predicting the severity of this pathology, used for the identification of risk groups and the timely conduct of preventive measures. The application of this method makes it possible to predict not only the fact of the pathology occurrence, but also the degree of probability of its occurrence.123 women of reproductive age were examined: 79 with severe forms of endometriosis and 44 healthy women. The method of step-by-step discriminant analysis has identified 8 of the 65 factors that most affected the occurrence of severe form of endometriosis: the chronic stress, especially in puberty, unfavorable ecological conditions of residence, early menarche, manifestations of dysmenorrhea, gastrointestinal tract diseases, abortions in anamnesis, surgical interventions and inflammatory diseases of the reproductive system.Sensitivity of the prediction algorithm for severe endometriosis in the research retrospective sample was 89.87%: out of 79 women with endometriosis 71 cases of its severe form were predicted with high or moderate probability. Accuracy for a high-risk group of severe endometriosis was 94.1%, mean form – 84.8%, and overall system accuracy was 83.75%: out of 80 women with severe or moderate probability of severe endometriosis it was actually observed in 67. Out of 43 patients whose endometriosis was not predicted, in 39 it did not really exist, i. e. for the low-risk group the accuracy of the prediction was 90.69%. Of the 87 women in the control group who were diagnosed with severe endometriosis, 80 (91.95%), according to the forecast, expected its occurrence with high or moderate probability, which confirms the high sensitivity of the prognostic system.The developed algorithm and the mathematical model of prediction of a severe form of endometriosis are highly informative and provide the opportunity to form risk groups of disease developing, taking into account the degree of its occurrence probability for the prior conduct of individualized preventive measures.
      PubDate: 2018-02-28
       
  • The modern strategies of clinical management of vitamin D deficiency in
           practices of the obstetrician gynecologist

    • Authors: О. В. Булавенко, Т. Ф. Татарчук, Д. Г. Коньков, О. В. Фурман
      Pages: 38 - 44
      Abstract: Low vitamin D concentrations were presented in a significant proportion of the population. Many diseases in people, both middle and old, were directly associated with vitamin D deficiency. The effect of vitamin D levels on reproductive function in both men and women has been proven. Low vitamin D concentrations have been associated with a wide range of adverse maternal and offspring health outcomes in observational epidemiological studies.Complications of pregnancy with a low level of vitamin D are pre-eclampsia, gestational diabetes and premature birth. It is proved that the appointment of vitamin D to women during pregnancy reduces the proportion of cesarean section in delivery. Numerous authors prove the role of vitamin D in the pathogenetic chain of the polycystic ovary syndrome. It was found that during the menopause due to the violation of steroidogenesis there is a loss of bone mass due to vitamin D deficiency. In addition, a decrease in the level of vitamin D is associated with the occurrence of uterine fibroids.However, despite a dearth of interventional evidence supporting supplementation/treatment of vitamin D in randomised controlled trial settings, it is generally accepted that supplementation/treatment is not harmful and may have some significant short- and long-term health benefits. In this regard, timely correction of vitamin D deficiency becomes very important in solving reproductive problems. This review focuses on the problem of correcting the level of vitamin D in different population groups. Treatment of vitamin D deficient women and vitamin D supplementation is safe and is recommended for all women who are pregnant or breastfeeding.
      PubDate: 2018-02-28
       
  • Prenatal diagnosis of cystic fibrosis in combination with herpetic
           infection in parents with uncompensated family history

    • Authors: Н. П. Веропотвелян, Ю. С. Погуляй, И. В. Суховицкая, О. А. Береза, А. М. Пелых
      Pages: 49 - 54
      Abstract: Cystic fibrosis (CF) is a chronic genetic disorder that affects the exosecretory glands responsible for the production of mucus and sweat; as well as respiratory, digestive and reproductive systems. The article describes a brief description of this disease, the features of intrauterine manifestations and differential diagnosis with other conditions.In most cases, prenatal diagnosis of CF is offered to a family that already has children with CF. Regarding the prospective prenatal diagnosis of CF in families without CF history, as well as in couples with established status of heterozygous carrier of mutations in the CFTR gene, it is presented mainly in sporadic cases. In all other cases, prenatal diagnosis of CF is based on ultrasound detection of increased intestinal echogenicity. The hyperechogenic intestine is observed in 50–75% fetuses with CF. The incidence of intrauterine infection in fetuses with the hyperechogenic intestine is varies from 0 to 10%. The spectrum of perinatal infections is more often represented by cytomegalovirus, herpes, syphilis, toxoplasmosis, rubella and parvovirus B19.The second trimester amniotic fluid contains two main enzymes (alkaline phosphatase and gamma-glutamyltranspeptidase), whose decline of level is a reliable marker for CF. The article presents a clinical case of prenatal diagnosis of CF in combination with intrauterine infection with herpes simplex virus in 20 weeks pregnancy in a fetus with a hyperechoic intestine. Whenthe amniotic fluid was investigated in a fetus with a normal karyotype are revealed decline of alkaline phosphatase and gamma-glutamyltranspeptidase levels, the mutation delF508 CFTR in the homozygous state and the DNA regions homologous HSV I, II types. Taking into account the unfavorable morbid prognosis, the fetus with CF was eliminated for 22 weeks pregnancy at the family’s request. At autopsy were found the typical manifestations of CF in the female abortus. The molecular gene study of both parents confirmed the heterozygous carrier state. The family received recommendations on the mandatory prenatal diagnosis in subsequent pregnancies.
      PubDate: 2018-02-28
       
  • Modern approaches to the pre-induction cervical ripening of mifepristone

    • Authors: О. В. Кравченко
      Pages: 55 - 58
      Abstract: The article deals modern approaches used of mifepristone in order to prepare the cervix for delivery. The results of a study of 222 patients in the gestation period of 37–42 gestation weeks which given orally administered 200 mg of mifepristone at intervals of 24 hours for 2 days are presented.The criteria for inclusion in the study: the age of the pregnant 18–40 years, the independent onset of pregnancy, singleton pregnancy, head presentation, the presence of intact fetal membranes; absence of contraindications to the use of mifepristone. Before the preparation of the cervix for delivery, an assessment was made of the condition of the mother and fetus, which included clinical examinations and cardiotocography before pre-induction, as well as cardiotocography control in dynamics.Before receiving mifepristone, the cervix was evaluated as “immature” in 60.3% of pregnant women, in 39.6% of patients it was “not mature enough”. After taking the first pill of mifepristone, 44.6% of pregnant women against the background of the already “mature” cervix of the uterus developed an independent labor activity. Development of labor activity occurred in 32.3% of pregnant women within 12 hours after taking the drug, in 26.3% in the interval from 12 to 24 hours, in 46.5% – later than in 24 hours. The remaining 55.4% of patients needed the appointment of a second tablet of mifepristone, after which the cervix became “mature” in 69.1% of patients, of which 90.6% of women developed independent labor.As a result of the research it was proved that the use of mifepristone is a highly effective method of preparing the body for pregnant women to delivery, the efficiency of labor is 79.3%. Pre-induction of mifepristone for more than 41 weeks is less effective in relation to cervical maturation and the development of regular birth activity, which makes it possible to characterize the gestational period of 40–41 weeks, as optimal for the cervical effacement and the induction of labor. The use of mifepristone does not lead to a negative effect of the fetal condition.
      PubDate: 2018-02-28
       
  • Predictors of the development of placental dysfunction and methods for its
           correction in patients with retrochoric hematoma in the I trimester of
           gestation

    • Authors: О. В. Кравченко, І. В. Бойко
      Pages: 60 - 64
      Abstract: The objective of study was to determine the predictors of the development of placental dysfunction and to develop methods for its prevention and treatment in patients with retrochoric hematoma in the first trimester of gestation.Patients and methods. Under observation, there were 58 pregnant women with retrochoric hematoma in the first trimester (main group) and 20 women with a physiological pregnancy (control group). All pregnant women underwent a standard clinical and laboratory examination. In the ultrasound study, the volume of the retrochoric hematoma, its localization, and also the coccygeal-parietal size of the embryo, the heart rate, the volume of the fetal egg, the mid-inner diameter of the yolk sac, the vascularization of the yellow body, the hemodynamics in the myometrium were assessed. In a transvaginal ultrasound study, a special three-dimensional VOCAL program was used to calculate the chorion volume and evaluate its vascular system.Results. Predictors of placental dysfunction in the detachment of the chorion in the I trimester of gestation are associated not only with the volume and localization of the retrochoric hematoma, but also, first of all, with the state of extraembryonic structures.Decreased vascularization of the chorion, its hypoplasia, pathological nature of the blood flow in the yellow body, and hemodynamic disturbances in the myometrium creates high risks of placental dysfunction and worsens the pregnancy prognosis. The developed preventive measures include the 3 stage of treatment, the medicament means are aimed not only at halting the bleeding, but also on the effective restoration of microcirculation and the provision of adequate conditions for the passage of the second wave of trophoblast invasion.Conclusion. The proposed three-step corrective therapy contributes to the normalization of uterine-chorionic blood flow, the restoration of effective embryochorial interrelations and significantly reduces the incidence of placental dysfunction in the future.
      PubDate: 2018-02-28
       
  • The role of the docosahexaenoic acid in nutrition of pregnant and feeding
           women

    • Authors: Н. М. Шилина
      Pages: 65 - 67
      Abstract: The article presents information about the properties and functions of the docosahexaenoic acid (DHA) – a long-chain polyunsaturated fatty acid belonging to the ω-3 fatty acid family. DHA, along with the arachidonic acid, is the basic building material for cell membranes of the brain and the visual analyzer. During an active growth of the fetus and baby – in the third trimester of gestation and during breastfeeding – DHA is a conditionally essential fatty acid for the baby and should be provided through the placenta and with maternal breast milk in adequate quantities, which is possible only if the organism of a pregnant and feeding woman has sufficient supply of this fatty acid.According to the recommendations of the international scientific community, women should consume not less than 200 mg of DHA daily during pregnancy and lactation. The evidence of research studies are given, confirming a positive effect of supplementary intake of DHA by pregnant and feeding women on the psychomotor development and visual function of their babies. Advantages of intake of ready forms of DHA by women during pregnancy and lactation have been substantiated.
      PubDate: 2018-02-28
       
  • New features in combined therapy of human papillomavirus infection

    • Authors: Л. С. Осипова, А. А. Суханова, Е. И. Соколова
      Pages: 68 - 75
      Abstract: The article presents the results of studying the eff ectiveness and experience with antiviral and immunomodulating drug Groprinozin (inosine pranobex) in treatment of human papillomavirus infection in women. The results of immunological studies. Based on the studies found that the inclusion of Groprinozin in the complex therapy of these patients contributes to immunological reactivity, improve the clinical course of the disease, a signifi cant reduction in relapses.
      PubDate: 2018-02-28
       
  • Premenstrual syndrome and quality of life of woman. Effectiveness of
           herbal drugs

    • Authors: В. Н. Прилепская, Э. Р. Довлетханова
      Pages: 76 - 80
      Abstract: The premenstrual syndrome (PMS) is a pathological symptom that significantly reduces the quality of a woman’s life. The etiology and pathogenesis to date have not been sufficiently studied, but the diagnosis, treatment and prevention that are to be complied with have been identified. The treatment of the PMS should be differentiated, taking into account the overall and reproductive health of the woman, the concomitant diseases, the degree of severity of ICP, the portability of therapy, etc.
      PubDate: 2018-02-28
       
 
 
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