Endothelial function is an essential component of providing homeostasis, which allows controlling the state of the vascular bed and ensuring blood supply to organs both under physiological conditions and under the influence of various damaging factors. Endothelial dysfunction is associated with a wide range of pathological conditions and diseases, in the pathogenesis of which the vascular link is involved. Understanding the unifying role of endothelial dysfunction in the pathology of different fields of medicine allows, firstly, to predict the development of serious socially significant diseases, such as cardiovascular diseases, which remain the main cause of death among women. In particular, over the past decade, several cardiovascular risk factors specific to the female population have been identified, such as hypertensive pregnancy complications and menopausal vasomotor symptoms, which, in turn, are caused by endothelial dysfunction. Secondly, timely treatment of endotheliosis suspends or completely prevents both transient disorders associated with endothelial dysfunction and their serious consequences. In this regard, the drug group of glycosaminoglycans and its representative sulodexide are of interest.

When prescribing a vitamin‑mineral complex or a drug containing docosahexaenoic acid (DHA) to a pregnant, lactating mother and child, it is expected to receive the effect from the subsidy of this polyunsaturated fatty acid (omega‑3 PUFA). In the case when the preparation contains additional impurities, the magnitude and nature of the effect may differ from the expected ones. In this work, we conducted a comprehensive study of the composition of 11 omega‑3 PUFA preparations with chromatographic determination of more than 40 metabolites of fatty acids and other compounds. The obtained data on the composition of the extracts were analyzed using modern methods of intellectual analysis. As a result, quantitative markers were obtained that made it possible to separate preparations based on standardized omega‑3 PUFAs from less standardized ones based on chromatographic analysis of the fatty acid composition of the preparations: marker ‘EPA + DHA’, marker ‘ω6 + ω11’ and standardization coefficient evaluating the conformity of measured levels of omega‑3 PUFAs to manufacturer declared. Based on the data obtained, highly standardized (Elevit Feeding, Omacor), medium and low standardized preparations were selected. It is recommended to take these data into account when prescribing and choosing vitamin complexes for nursing women, preferring highly standardized ones.

The results of a retrospective analysis and a one‑stage study conducted among 352 teenage girls and 952 postmenopausal women demonstrate that pathology of the cardiovascular system (CVS) can be programmed in the antenatal period. Mass and growth indicators of the newborn are an important morphofunctional characteristic of a person and can be used not only to assess physical development throughout life, but also as a marker of risk of one or another somatic pathology. Timely identification of risk factors for adolescent health disorders and their adequate correction can significantly improve the results of cardiovascular prophylaxis. Equally important is the prevention of insufficient or excessive weight gain during fetal development, which can be achieved by prescribing vitamin‑mineral complexes to pregnant women.

The article discusses features manifestations of benign dysplasia remaining contralateral breast in patients with triple negative and Her2/neopositive breast cancer (BC) after a comprehensive treatment based on the results of mammography and ultrasound evaluation.

Materials and methods. A sample of 43 people was divided according to biological types of breast cancer into two groups: I (n = 17) and II (n = 26). All patients underwent mammography in two projections and an ultrasound with the calculation of the thickness glandular component and the echo density of the parenchyma.

Results. In all patients with breast cancer, benign changes in the remaining contralateral mammary gland of varying severity were noted: prevalence of cystic‑fibrous form — subgroup I (n = 17); subgroup II (n = 14) prevalence of the fibrocystic component; subgroup III (n = 12) was evaluated as a mixed glandular‑fibrous form of benign dysplasia remaining contralateral breast. An excess of the normal thickness of the glandular component was found: subgroup I Mc = 34.3 ± 2.1 mm; subgroup II M = 24.4 ± 3.3 mm; subgroup III M = 28.2 ± 1.7 mm. The echo density of the parenchyma of the remaining mammary contralateral gland also exceeded the reference values in all patients: subgroup I M = 34.1 ± 2.5 cu, subgroup II M = 42.3 ± 2.3 cu, subgroup III M = 37.5 ± 1.7 cu. After phytoprevention and phytotherapy with the herbal homeopathic medicine Mastopol®, 1 tablet 3 times a day under the tongue for 12 weeks, there was a positive dynamics in the antiproliferative status of the respondents. In all subgroups, a decrease in the mammographic density of the mammary gland was found. The glandular component and the echo density of the mammary parenchyma decreased according to the results of ultrasound. In the subgroup, the pancreatic component reached М = 23.4 ± 2.3 mm; in subgroup II М = 17.5 ± 2.4 mm; in subgroup III М = 20.3 ± 1.7 mm. Echo density: in the subgroup I М = 27.3 ± 3.1 cu; in subgroup II М = 31.6 ± 1.9 cu; in subgroup III М 21.4 ± 2.3 cu.

Conclusions. All breast cancer patients, regardless of the molecular subtype of the tumor, have benign changes in the contralateral mammary gland. The medicinal homeopathic complex can be considered a pathogenetically substantiated method for the prevention and treatment of DDM. The use of a herbal medicinal homeopathic remedy for the intended purpose (according to the instructions for the drug) of benign dysplasia remaining contralateral breast therapy for 12 weeks has a positive effect on the breast tissue, reducing mammorgafic density, reducing the glandular component of the mammary gland.

Objective: to compare the efficacy and safety of the use of three therapeutic regimens of Triogynal (vaginal capsules) for the treatment of atrophic vulvovaginitis in postmenopausal women.

Material and methods. The study included 201 women aged 46 to 65 years in postmenopause (at least 12 months after amenorrhea due to natural menopause, confirmed by laboratory determination of FSH concentration) with a diagnosis of atrophic vulvovaginitis. After screening, patients were randomized into three groups. The first one (n = 67) received Triogynal intravaginally, two capsules once a day for 20 days, then a capsule per day for 9 weeks, The second group (n = 67) received the drug intravaginally, two capsules one time per day for 20 days, then a capsule per day for 2 weeks, then a capsule two times a week for 7 weeks. The third group (n = 67) received the drug intravaginally, two capsules one time per day for 20 days, then a capsule two times a week for 9 weeks. The study evaluated changes in the vaginal maturation index (VIS), i. e. the primary endpoint, the dynamics of the vaginal health index, pH of the vagina, the severity of symptoms of atrophic vulvovaginitis on a five‑point Barlow scale, and the achievement of normal vaginal biocenosis after treatment.

Results. By the end of the course of therapy, the change in VIS was 23.94 ± 18.72 %, in patients of group 2 was 25.42 ± 21.84 %, in patients of group 3 was 25.52 ± 18.64 % (p > 0.05). The proportion of patients with a vaginal health index of 5 points did not differ at the end of the course of therapy (p > 0.05). As a result of a comparative analysis of the vaginal pH values, the severity of symptoms of atrophic vulvovaginitis on a five‑points Barlow scale in patients at the end of the course of therapy, data on similar efficacy were obtained (p > 0.05). Vaginal normocenosis was achieved in 68.2 % of patients in the first group, 57.6 % of patients in the second one, 60.0 % of patients in the third (p > 0.05).

Conclusion. All three therapeutic regimens for the use of Triogynal (vaginal capsules) for the treatment of atrophic vulvovaginitis have shown similar efficacy. The use of the drug in the regimen with the lowest course dosage according to the scheme two capsules once a day for 20 days, then one capsule twice a week for 9 weeks is most preferable due to the lower drug intervention, economic benefits and the convenience of therapy for the patient.

Identification of the genetic variants underlying the heredity of pelvic organ prolapse helps to identify useful markers for assessing clinical risk, prognosis and response to treatment. An association of polymorphisms in the ADRB 3 gene with an overactive bladder and in the COL1A1 gene with PTO was detected. AA mutation of the COL3A1 rs1800255 genotype increases the probability of VET by 4.8 times. There is evidence of involvement in the development of PTO genes of the extracellular matrix degradation group (ECM), which includes genes encoding matrix metalloproteinases. During the study of diseases of the connective tissue, their syntropy was revealed, which is genetically determined as a common risk haplotype of the FBLN 5 gene. The significance of epigenetic mechanisms for the development of VET is shown in the form of lysyl oxidase (LO) gene suppression. So far, the role of factors that induce changes in epigenetic regulation and lead to the appearance of clinical symptoms of prolapse is not clear.

The interpretation of thyroid function tests should be cautiously made during the perimenopause and postmenopause period bearing in mind that physiologic changes do exist in this group of women in terms of secretion and metabolism of thyrotropin and thyroid hormones. Moreover the incidence of thyroid disorders increases in postmenopausal and elderly women. There is no consensus for screening postmenopausal women even though there is well‑known evidence about the effect of thyroid status on cognitive function, cardiovascular risk, bone turnover, and longevity. The diagnosis of any thyroid disorder is challenging in these patients because the symptoms are more subtle and attributed to menopausal symptoms. Management requires more attention in this population than that of younger groups, because high doses of L‑thyroxine can lead to cardiac complications and increased bone turnover. Furthermore radio‑iodine is preferred in treatment of hyperthyroidism in older patients. The risk of nodular thyroid disease and thyroid cancers increases in this group. Although the diagnostic approach is the same as for young patients, the risk of surgery is high and disease prognosis is worse. Decision for menopausal hormonal therapy should be individualized regardless of the concomitant presence of thyroid disorders.

A clinical case of successful management of a patient with recurrent miscarriage on the background of antiphospholipid syndrome, Asherman syndrome, high‑risk hereditary thrombophilia combined with hyperhomocysteinemia. The rationale for a personalized selection of pathogenetic therapy, starting with the stage of pregravid preparation and ending with the postpartum period are described in detail.

The originality of the profile of psychological defenses (c, LSY) of women suffering from borderline and benign ovarian tumors is considered. The concepts of constructive LSY profile and non‑constructive LSY profile are introduced. It is shown that the most pronounced tendency to constructive ego‑defenses is among patients with benign ovarian tumors, which is directly related to the process of restoration of their reproductive potential. In patients representing groups of borderline ovarian tumors, the complexity of the course of the disease, the insufficient success of reproduction is accompanied by subjectively reduced self‑esteem, frustration, which is reflected in the predominance of the non‑constructive profile of LSY.

Conclusion. The psychological portrait of patients with benign ovarian tumors, characterized by various types of protective behavior, it is advisable to consider when planning the management of this patient population.