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Reproductive Endocrinology     Open Access   (Followers: 2)
Journal Cover Reproductive Endocrinology
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  This is an Open Access Journal Open Access journal
   ISSN (Print) 2309-4117 - ISSN (Online) 2411-1295
   Published by Trilist Publishing Homepage  [1 journal]
  • Optimization of family planning service in Ukraine in the realization of
           modern strategy of woman health maintenance

    • Authors: Ю. Г. Антипкін, В. В. Камінський, Т. Ф. Татарчук
      Pages: 7 - 16
      Abstract: The primary objective of the reproductive health services system and its individual institutions are, namely: to implement the strategy of women management starting from their fetal life to the old age and ensure quality of life in adolescence, reproductive and postmenopausal periods. Maternal and child death rates are above respectives rates in European countries, and utilization rate of modern contraceptive methods in Ukraine remains low. This can be explained by both, poor awareness of women and insufficient training of medical personnel. In this context, the top priority still is awareness-raising and further implementation of the strategy on reliable contraception means and methods along with effective preconception care as a potent component of family planning.Taking into account modern global trends, the principal goal of Family Planning Service in Ukraine is to improve women’s quality of life and time of active ageing, which achievement can be facilitated by the implementation of 3 priority tasks:• continued realization of the strategy on reliable contraception use and implementation of effective preconception care to abortions prevention and maternal and newborns mortality rates reduction;• reduction cardiovascular and oncological diseases incidence rate in women through development and implementation of respective screening programs, informational and preventive measures;• implementation of best international practices with respect to Family Planning Service efficacy, review and update of family planning clinical protocol with further implementation of such practices at the national and regional levels.Considering this, the Resolution of Advisory Board outlines the main tasks for the implementation of modern international experience and its further implementation at the national level, and amendments to clinical protocol of primary, secondary (specialized) and tertiary (highly specialized) medical care (approved by the order of MOH of Ukraine No. 59 dated January 21, 2014) “Family Planning”. The main additions and comments touched upon the issues of micronutrient status and reproductive health of women, contraceptive methods for women in perimenopause, counseling and selection of contraceptive methods for HIV-positive women. Particular attention was paid to counseling and selection of contraceptive methods for women military personnel.
      PubDate: 2017-06-21
  • Modern concept of prevention of tumor breast pathology

    • Authors: Ю. П. Вдовиченко, В. А. Потапов
      Pages: 17 - 30
      Abstract: In the article the data on the genetic and molecular and epigenetic mechanisms of carcinogenesis, shows the evolution of phenotypic similarity benign hyperplastic processes of mammary glands and breast cancer (BC). With critical positions represented a modern strategy for the prevention and treatment of breast cancer, benign breast disease, conducted an analysis of a number of pharmacological efficacy of drugs for these purposes are disclosed benefits of targeted therapy with phytonutrients.From the standpoint of evidence-based discussion about onkoprotection properties mediating most of the major pathogenetic links hyperproliferation and tumor growth in mammary glands, fitocomposition Epigalin Brest, active ingredients which are natural dopamine agonist – Vitex agnus-castus extract usual and the two most famous fitoprotection targeted 3,3-Diindolymethane and epigallocatechin-3-gallate, as well as the possibility of using Epigalin Brest as multitargeted therapy benign breast disease and prevention of carcinogenesis in women at risk for breast cancer.It is concluded that Epigalin Brest is unique fitoresources as an additional component to the diet daily diet in order to maintain the normal state of function of cells and natural deterministic genetic mechanisms onkoprotection as in patients with benign breast disease, and in healthy women who want to make informed choices in relation to the safe the prevention of breast cancer, the risk of developing that over the life of each woman has.
      PubDate: 2017-06-21
  • Endometrial hyperplasia: there are more questions than answers

    • Authors: А. Н. Григоренко, А. Б. Гордийчук
      Pages: 31 - 43
      Abstract: Endometrial hyperplasia is a histological diagnosis. It refers to hormone-dependent diseases, which are treated with various hormonal drugs and surgical methods. At the same time, the method and timing of monitoring of the effectiveness of treatment depend on the initial morphological diagnosis.In recent years, there have been many changes in the classification, diagnosis and treatment of this disease. So, in 2014, a new international classification was developed by the International Agency for Research on Cancer and the World Health Organization, based on the identification of atypical cells in endometrial hyperplasia with modern molecular genetics and immunohistochemical methods. According to this classification, only two categories of endometrial hyperplasia are distinguished: with and without atypia. At the same time, the introduction of this classification in Ukraine is impossible without the involvement of morphologists and the development of a unified diagnostics strategy.The goal of the treatment of endometrial hyperplasia is the relief of symptoms (abnormal uterine bleeding, pain) and the prevention of relapses, and most importantly the timely detection of concomitant invasive endometrial cancer. During the diagnostic search for endometrial hyperplasia at any age, alertness for cancer must be present. Currently, the search for safer methods of timely detection of endometrial cancer early stages has been given great attention, but due to imperfect methods, there are still difficulties in diagnosing and predicting benign and malignant proliferative processes.An unfavorable outcome in the inadequate management of patients with benign tumors and uterine hyperplastic processes, especially when combined, is radical surgical treatment − hysterectomy. And only the mutual work of morphologists and gynecologists, which are aware of the difficulties in diagnosis and treatment, namely the presence of resistance to certain pharmacological groups of drugs in a number of women, will not allowed to lose time and review the strategy of management for that patients for applying the reasonable methods of treatment.
      PubDate: 2017-06-21
  • Optimization of treatment of endometrial hyperplastic processes in the
           late reproductive period by hysteroscopic сold loop technique

    • Authors: С. М. Корнієнко
      Pages: 44 - 49
      Abstract: The aim of the study was to evaluate the effectiveness of various methods of hyperplastic endometrium removing in late reproductive age women.Materials and methods. In the prospective cohort study 321 women 35–44 year aged with hyperplastic endometrium processes were selected by the continuous sample method. Depending on the method of treatment of this pathology, the patients were divided into two groups: the Ith group included 143 women whom, after hysteroscopic confirmation of the diagnosis, the hyperplastic endometrium was removed using the “cold loop” technique with the further complex scheme of treatment which included therapy by synthetic gestagens, sedative therapy and use of drugs of melatonin (in the presence of disorders of a dream and hypomelatoninemia). The II group included 178 women, whom after hysteroscopic confirmation of the diagnosis, curettage of a cavity of the uterus was performed, the subsequent hormonal therapy by synthetic gestagena was used according to the Clinical protocol “Endometrial Hyperplasia” (the order of the MOH of Ukraine No. 676 from 31.12.2004). The women of both groups did not differ significantly by age, menstrual cycle peculiarities, gynecological, reproductive, somatic anamnesis and complaints.Results and conclusions. Analisis of the long-term results of endometrial pathology treatment showed that among I-th group women recurrence of hyperplastic endometrium processes was observed several times less often (p <0.05). The author came to the conclusion that the removal of hyperplastic endometrium by the “cold loop” technique allows to significantly reduce the hyperplastic endometrium processes recurrence and newly detected intrauterine pathology level in comparison with endometrial curretage.
      PubDate: 2017-06-21
  • Incidence and spectrum of chromosomal abnormalities detected in married
           couples with early losses of pregnancy

    • Authors: М. П. Веропотвелян, Л. Г. Шаповаленко, О. С. Саваровська
      Pages: 54 - 60
      Abstract: The aim of the study was to establish the incidence and spectrum of chromosomal abnormalities (CA) in married couples (MC) with sporadic and habitual early pregnancy losses (EPL) inhabiting south-east and central regions of Ukraine.Materials and methods: A cytogenetic study of 1869 women, 1788 men, and 1781 married couples (a total of 3657 individuals) with EPL was performed separately.Results: In 344 cases (9.4%), the patients’ karyotype contained various types of chromosomal rearrangements. Reciprocal translocations were found in 153 cases (48.3% of the total number of CA detected in women and men; in the case of couples with EPL the frequency of translocations was 4.1%), while in women – 84 (44.4% of all CA) cases, in men – 69 (44.5% of all CA), and in married couples – 6 (28.6%).Robertson’s translocations were found in 13 cases (9 in women and 4 in men), which amounted to 3.8% of all CA; their frequency in couples with EPL was 0.35%.Pericentric inversions were found in 159 cases (46.2% of the total number of CA), in couples with EPL their frequency made 4.3%, while in women – 82 (43.4% of all CA) cases and in men – 77 (49.7% of all CA).Pericentric inversion of chromosome 9 was detected in 65 cases, which is 40.89% of the total number of pericentric inversions and 18.89% of the total number of CA. Paracentric inversions in the karyotyped families with EPL are not detected by our study.Five cases with a mosaic karyotype of 45, Х/46, ХХ (1.5% of all CA), 4 cases with an isochromosome – 45,Х, i(Xq), 2 cases with a mosaic karyotype of polysomy in X (47, XXX / 46, XX), 3 cases of dysomia X – Klinefelter syndrome, 3 deletions of the terminal portion of short arm 46, X, del(X) (p21→pter).Conclusion: The frequency of CA in women with EPL was 8.5%, in men – 6.4%, and totally in all karyotyped parents – 7.5%, which does not differ from the incidence of CA in couples who have miscarried in other populations.
      PubDate: 2017-06-21
  • A study of plasma folate under the influence of [6S]-5-MTHF in women with
           677C→T polymorphism of mthfr with different types of inheritance

    • Authors: R. Prinz-Langenohl, S. Brämswig, O. Tobolski
      Pages: 62 - 66
      Abstract: Background and purpose: 5,10-Methylenetetrahydrofolate reductase is responsible for the synthesis of 5-methyltetrahydrofolate (5-MTHF). The 677C→T mutation of 5,10-Methylenetetrahydrofolate reductase reduces the activity of this enzyme. The aim of this study was, first, to compare pharmacokinetic parameters of [6S]-5-MTHF and folic acid in women with the homozygous (TT) and wild-type (CC) 677C→T mutation, and second, to explore genotype differences. The metabolism of [6S]-5-MTHF and folic acid was evaluated by measuring plasma folate derivatives.Experimental approach: Healthy females (TT, n = 16; CC, n = 8) received a single oral dose of folic acid (400 microg) and [6S]-5-MTHF (416 microg) in a randomized crossover design.Plasma folate was measured up to 8 h after supplementation. Concentration-time-profile (area under the curve of the plasma folate concentration vs. time), maximum concentration (Cmax) and time-to-reach-maximum (tmax) were calculated.Key results: Area under the curve of the plasma folate concentration vs. time and Cmax were significantly higher, and tmax significantly shorter for [6S]-5-MTHF compared with folic acid in both genotypes. A significant difference between the genotypes was observed for tmax after folic acid only (p < 0.05). Plasma folate consisted essentially of 5-MTHF irrespective of the folate form given. Unmetabolized folic acid in plasma occurs regularly following folic acid supplementation, but rarely with [6S]-5-MTHF.Conclusions and implications: These data suggest that [6S]-5-MTHF increases plasma folate more effectively than folic acid irrespective of the 677C→T mutation of the 5,10-Methylenetetrahydrofolate reductase. This natural form of folate could be an alternative to folic acid supplementation or fortification.
      PubDate: 2017-06-21
  • The combined use of various forms of micronized progesterone in the
           treatment of the threat of termination of pregnancy in multiple

    • Authors: І. М. Нікітіна
      Pages: 68 - 73
      Abstract: The article highlights the data on the features of the etiology and pathogenesis of the threat of premature birth in a multiple pregnancy. The results of a clinical study of the effectiveness of combined therapy in the threat of termination of pregnancy in women with multiple pregnancies with sublingual and vaginal forms of micronized progesterone are presented.In the course of the study 120 twins pregnancies with signs of miscarriage in terms of 14–28 weeks were analyzed. The first group consisted of 40 women who were offered a sublingual form of natural micronized progesterone in combination with the vaginal form (drug Luteina) in the scheme of treatment and prophylactic measures. The second group included 40 women, who received a synthetic progesterone preparation (dydrogesterone) for treatment of the threat of termination of pregnancy. The control group consisted of 40 pregnant women, who were treated according to the current clinical protocols.The results of the study showed that the effect of the use of the sublingual form of micronized progesterone in the period of severe clinical symptoms of the threat of premature delivery in multiple pregnancy came out twice as fast compared to the oral form of synthetic dydrogesterone, what contributes the rapid elimination of clinical symptoms, regression of ultrasound markers of the threat of miscarriages and prevents further progression of cervix structural changes. The presence of sublingual and vaginal form of micronized progesterone allows, if necessary, to go from one form to another, and also combine both forms to quickly saturate the body of pregnant woman by progesterone in conditions of gestagen deficiency in order to eliminate the symptoms of the threat of pregnancy termination.Therefore, complex therapy of the threat of premature birth with the use of sublingual and vaginal forms of micronized progesterone has a significant therapeutic effect, contributes to a shorter period of inpatient stay, a reduction in the number of complications compared to other progestins and can be recommended for widespread use. The use of natural micronized progesterone in women with the threat of interruption of pregnancy in multiple pregnancies significantly reduces the risk of preterm labor and improves perinatal outcomes.
      PubDate: 2017-06-21
  • Железный щит репродуктивного здоровья.
           Терапевтические стратегии при
           железодефицитной анемии

    • Authors: В. Е. Радзинский, Т. В. Галина, Т. А. Добрецова
      Pages: 74 - 80
      Abstract: Удивительно, но организм человека не имеет механизмов активной экскреции железа, а потому всю «ответственность» за его количество на себя берут интестинальные клетки на этапе всасывания (теряется только десятая часть этого элемента с желчью и слущивающимися кишечными эпителиоцитами) [1].При падении концентрации железа в организме ниже критического уровня энтероциты ворсинок тонкого кишечника получают сигнал «бедствия», в результате чего стартует абсорбция железа. Из просвета двенадцатиперстной кишки железо попадает в цитоплазму энтероцита. Важно, что мембрана кишечных эпителиоцитов специализирована только на транспорт двухвалентного (гемового) железа [2], ионы которого тут же подхватываются белками-переносчиками, такими как дуоденальный металлотранспортер ДMT-1 [3]. Этот фермент, называемый переносчиком двухвалентных металлов, доставляет и другие ионы, например, цинка, поэтому при дефиците ДMT-1 захват железа может быть нарушен.
      PubDate: 2017-06-21
  • Livarol in the treatment of chronic vulvovaginal candidiasis

    • Authors: Т. С. Дивакова, Л. Д. Ржеусская
      Pages: 81 - 83
      Abstract: The article presents the results of the study of treatment of women with chronic vulvovaginal candidiasis by vaginal suppositories Livarol, which contain 400 mg of ketoconazole.Treatment was carried out according to two schemes. The main group (I) consisted of 22 women with chronic vulvovaginal candidiasis, who were prescribed treatment during the clinical manifestations of the disease in the form of Livarol in vaginal suppositories overnight during 10 days, then for three menstrual cycles in the same dosage during 5 days behind 7–10 days before the onset of menstruation. The comparison group (II) included 10 women with the same pathology, who were prescribed treatment only during the clinical manifestations of the disease in the form of Livarol in vaginal suppositories overnight during 10 days in one course. All patients were comparable in age and reproductive function and were treated on an outpatient basis.The efficacy of treatment was assessed based on the disappearance of clinical symptoms and complaints (itching, burning, pain, caseous vaginal discharge), the lack of positive laboratory tests for the presence of fungal and pathogenic flora after 3, 6, 12 days and 1–10 months from the start of treatment. Therapy in the first group, which in the first stage provided for the elimination of exacerbation of chronic candidiasis by 10-day appointment of vaginal suppositories with ketoconazole, and at the second stage – 3-fold antiretroviral treatment for 5 days through 1 month, was more effective (90.9%). A single course of local treatment of chronic vulvovaginal candidiasis by Livarol within 10 days is less effective (60.0%).The advantages of local use of ketoconazole are the rapid arresting of vulvovaginal candidiasis, a high concentration of antimycotic on the mucosa, the minimum frequency of side effects, the rapid normalization of the vaginal biocenosis, and the elimination of the effects of exo- and endocervicitis due to not only antimycotic but also antimicrobial action.
      PubDate: 2017-06-21
  • Level of thyroid-stimulating hormone as basic diagnostic marker and
           criterion of treatment success of thyroid diseases

    • Authors: В. І. Паньків
      Pages: 84 - 88
      Abstract: In the article information is generalized on the aspects of early diagnostics of thyroid disorders. The value of thyroid-stimulating hormone is underlined as basic test for determination of the thyroid functional state and criterion of treatment success of thyroid diseases. Particular attention is paid to subclinical hypothyroidism, in which the clinical manifestations of the disease are very subtle. As emphasized in the article, in fact, the presence or absence of symptoms depends on the attention of the doctor who examines the patient, and the appropriate patient’s attitude even to minor changes in his body.In addition, one of the main tasks in the family doctor’s practice is the early diagnosis of subclinical hyperthyroidism and the appointment of appropriate treatment with thyreostatics, which allows to restore the normal activity of heart or prevents the progression of cardiovascular disorders into more severe forms of heart failure.Recommendations for diagnosing thyroid dysfunction of the American Thyroid Association recommend a screening test for the thyroid-stimulating hormone level in all adults over 35 years with an interval of 5 years.During the last three decades, laboratory methods used to diagnose thyroid diseases have been significantly improved. To date, the first level test, which is used at the initial stage of diagnostic search and screening for congenital hypothyroidism in newborns, is the determination of the thyroid-stimulating hormone concentration by a sensitive method.In Ukraine, under the conditions of iodine deficiency, the absence of a national program for the prevention of iodine deficiency disorders, an unfavorable ecological situation, it is recommended the determination of thyroid-stimulating hormone at the beginning of treatment of patients with cardiological, gynecological, gastroenterological, neurological, dermatological, and other pathologies. The success of treatment and the achievement of a state of compensation for thyroid pathology are also determined by the level of thyroid-stimulating hormone. Patients with nodular pathology of the thyroid gland should also be sure to determine the level of calcitonin, the high content of which in the blood is the most important diagnostic criterion of medullary thyroid cancer.
      PubDate: 2017-06-21
  • New features in the correction of dysbiosis in the family doctor’s

    • Authors: А. К. Дуда, Е. И. Дубровский
      Pages: 90 - 95
      Abstract: Today, the problem of intestinal dysbiosis is one of the most relevant in the work of doctors of many specialties.There are many reasons that can cause this state. The main and most common etiologic factor is the harmful effect of antibacterial drugs on the microflora. The question of the inexpedient and uncontrolled use of antibiotics is as relevant as ever. However, there are situations when chemotherapy can’t be avoided. Infectious diseases and their treatment in this list are on the first place. Meningitis, pneumonia, bronchitis, sinusitis (including their severe purulent complications), other bacterial lesions of various organs and systems require the appointment of a powerful and often prolonged antibiotic therapy. In addition, numerous intestinal infections, viral hepatitis and pancreatitis, gastritis, cholecystitis and other diseases that develop against their background, even without the use of chemotherapy, depress and suppress normal microflora.Thus, the main task of the doctor in prescribing an antibiotic is the timely prevention and treatment of dysbiosis. This is achieved by a set of measures, including the designation of useful microorganisms and substances.Promising in the treatment of this pathology is using of positive therapeutic effects of prebiotics, which create favorable conditions for the functioning of endogenous microflora, stimulate the growth of bifidobacteria, which are the obligate (basic) microflora of the human intestine.Among a large number of existing prebiotics, dietary fiber is widely used, the increased content of which contributes to an increase in the population of lactic acid microorganisms and the production of carboxylic acids having a laxative effect.The article describes the main principles of correction of dysbiosis with the use of modern domestic enterosorbent-prebiotic Bionorm. The experience of using Bionorm in patients with intestinal dysbiosis confirms the ability of the preparation to modulate the intestinal microbiota and restore its disturbed motor-evacuation function.The use of the Bionorm for the prevention and treatment of patients with dysbiosis is pathogenetically justified in the form of monotherapy and an effective supplement to standard treatment, which contributes to the rapid positive dynamics of the clinical picture, normalization of the stool, elimination of flatulence, discomfort in the abdomen and improvement of the quality of life of patients.
      PubDate: 2017-06-21
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