Endometriosis is a common disease, the diagnosis and treatment of which is still a matter of debate. One of the main symptoms of endometriosis -pelvic pain is a particular problem due to the difficulties in identifying the cause and the lack of sufficient effect from surgical and medical treatment. The literature review presents current data on the prevalence, clinical characteristics and methods of individualized therapy in patients with pelvic pain established or presumably associated with endometriosis.
Nutrition during adolescence, pregravid and postpartum is a major public health challenge, as it affects not only the health of adolescents and women, but also the health of future generations. Therefore, the International Federation of Gynaecology and Obstetrics' guidelines aim to address a number of nutritional concerns for adolescents and young women before, during and after pregnancy. Health care providers should think about nutrition first, with a focus on optimizing the nutrition and health of adolescents and mothers from the pre-conception period. This approach will help to achieve significant positive results in ensuring the health of women and their children, as well as in ensuring the health, life expectancy and well-being of future generations. The main findings on the use of micronutrients (vitamins and minerals) are presented. It is known that the number of calories required for the development of a child during pregnancy does not increase significantly, while the requirements for vitamins and minerals increase significantly. Therefore, pregnant women should focus on increasing their micronutrient intake and try to limit their intake of empty calorie foods.
The purpose: to consider modern concepts of epidemiology, biological characteristics, pathogenesis, clinical manifestations, principles of therapy and prevention of human papillomavirus infection.
Basic provisions. In the last decade, there has been a steady increase in diseases associated with the human papillomavirus (HPV). The prevalence of human papillomavirus infection of the genitals in the world has increased more than 10 times, it is found in 13 % of the population. Cervical cancer remains one of the most common forms of HPV-associated malignancy in women. About 570 thousand new cases of cervical cancer are diagnosed in the world every year, while the increase in incidence over the past 10 years was 7.8 %, and mortality was 13.1 %. In recent years, scientists have paid close attention to the study of assessing the effect of HPV on the endometrium and the degree of its participation in the development of GGE. From the standpoint of the latest scientific data, the generality of the influence of HPV on any epithelium should be considered through the prism of squamous cell metaplasia. Currently, there are still many unsolved scientific and practical issues, primarily related to the regional characteristics of the prevalence of various types of HPV, which determines the direction of cervical screening, as well as clinical manifestations during coinfection, dictating the need for a differentiated approach to patient management tactics.
Conclusion. A review of modern literature data indicates that most studies on various aspects of the influence of HPV on the reproductive health of women remain the subject of discussion, which dictates the need for further research.
In recent years, the frequency of operations for genital prolapse and urinary incontinence has been steadily increasing. Neurogenic disorders of urination can be the first manifestations of the disease of extragenital pathology. Neurogenic bladder is bladder dysfunction (lethargy or spasticity) caused by neurogenic damage. Any disease in which the afferent or efferent innervation of the bladder is damaged can lead to a neurogenic bladder.
Purpose. To study the features of urinary disorders in women with severe extragenital diseases and to improve the methods of rehabilitation of patients after reconstructive plastic surgery for various types of urinary incontinence.
Materials and methods. 153 patients aged 50-70 years (mean age 55.1 ± 6.3 years) and duration of postmenopause from 2 to 5 years (7.6 ± 4.1 years) were examined at the outpatient department of the of Moscow Regional Research Institute of Obstetrics and Gynecology, Russian Federation, who applied for various manifestations of urination disorders. All patients were offered the method of biofeedback in combination with electrical stimulation of the pelvic floor muscles as a treatment. When overactive detrusor therapy was detected, therapy was combined with medicamentous (solifenacin 5 mg [Vesicar] or myrobegron 50 mg [Betmiga] in the morning) in combination with estriol (cream or suppositories) 0.5 mg intravaginally 2 times a week. In the presence of symptoms of climacteric syndrome in the absence of contraindications, menopausal hormonal therapy was prescribed.
Results. Subjectively, 150 (98.1 %) patients noted an improvement in their condition, 3 (1.9 %) patients did not notice the effect of treatment. The results showed a significant improvement in all OABSS and bladder diary scores, including frequency of urination during the day and at night, urgency and number of urge incontinence episodes, and urine volume. Analysis of the -hour pad test showed that the volume of urine lost, which averaged 16.5 g before treatment, was negative after treatment in patients who noted the effect. In 2 patients who did not notice the effect, no changes were found. Investigation of the intraurethral pressure profile in 23 (17.6 %) women before treatment revealed insufficiency of the internal sphincter of the urethra, leading to urinary incontinence during stress. After treatment, in 19 (82.6 %) patients, the insufficiency of the internal sphincter was not determined. In 3 (13.0 %) patients, intraurethral pressure remained in the range of 60 to 80 cm of water column and did not lead to urinary incontinence during stress. In 1 (4.3 %) patient, the insufficiency of the urethral closure persisted, which required repeated surgery.
Conclusions. In patients with severe extragenital diseases against the background of vulvovaginal atrophy, an overactive bladder and a mixed form of urinary incontinence prevail. Extragenital pathology of various origins, especially concerning various parts of the central nervous system, obesity and diabetes significantly worsens the course of urination disorders in both conservative and surgical and combined treatment and requires additional treatment methods: pelvic floor muscle training, biofeedback therapy in combination with electrical stimulation of the pelvic floor muscles, local hormonal therapy, the use of M-anticholinergics, B-adrenomimetics.
Introduction. Using cytochemical methods, the activity of myeloperoxidase (MPO), as well as the content of cationic proteins, glycogen and lipids in the blood neutrophils of pregnant women with diffuse toxic goiter (DTG) was studied in a comparative aspect.
Goal. To study the dynamics of changes in the cytochemical parameters of neutrophils in women's blood during physiological pregnancy, as well as in pregnant patients with DTG.
Material and methods. The study included 82 pregnant women aged 20-40 years old with Hashimoto's thyroiditis and graves' disease. The subject of the study was the determination of immunological indicators: the level of autoantibodies to TSH, TPO and TG; the content of populations and subpopulations of lymphocytes, and cytochemical indicators of blood: MPO activity; cationic protein content; glycogen content; lipid content. Results. The activity of MPO in the blood neutrophils of women with a physiological course of pregnancy (comparison group) is similar to that in the control group. In the first trimester of pregnancy, the percentage of neutrophils with a moderate to high content of colored granules tends to decrease, which is reflected in the value of the average cytochemical index.
Conclusion. It should be noted that significant shifts in the content of components of the phagocytic defense system were found in the blood neutrophils of pregnant women with thyrotoxicosis syndrome.
This literature review of articles devoted to the problem of abortion and pre-abortion counseling has been carried out. The legal features of the development of the right to abortion at the request of a woman are outlined. The main stages in the development of the concept of perinatal psychology and pre-abortion counseling are described. The procedure for conducting pre-abortion counseling in the Russian Federation has been studied. The effectiveness of the existing algorithm was assessed and the prospects for further research aimed at studying and improving the effectiveness of pre-abortion counseling were outlined.
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