The role of prostate HistoScanning in detecting prostate cancer

Govorov A.V., Vasilyev A.O., Sadchenko A.V., Prilepskaya E.A., Kovylina M.V., Pushkar D.Y.


The early stage prostate cancer (PC) does not usually have clinical manifestations. The symptoms are usually associated with benign prostatic hyperplasia. The symptoms of infravesical obstruction, as well as the symptoms associated with the local tumor progression (tumor invasion into the neck of the urinary bladder, urethra, etc.) and during the tumor progression there is the occurrence of distant metastasis. Introduction of the program concerning the early PC diagnosis, including digital rectal examination (DRE), determination of the prostatic specific antigen level and performance of transrectal ultrasound made it possible to diagnosis PC at early stage and to offer the radical methods of PC treatment to patients. The appearance of new non-invasive method of PC visualization using HistoScanning showed the considerable potential in the diagnosis of prostate cancer and treatment selection, and during the planning of the surgical procedures and follow-up of patients. The modernization of existed technique has allowed perform target transrectal prostate biopsy under the control of HistoScanning using fewer injections and higher diagnostic value.
Consilium Medicum. 2015;17(7):8-11
pages 8-11 views

Principles of diagnosis and treatment of urogenital fistulas in women (literature review)

Loran O.B., Seregin A.V., Dovlatov Z.A.


Genitourinary fistulas in women most frequently (90% of all cases) occur after birth trauma and obstetric and gynecological operations. Currently the treatment of patients with genitourinary fistula is difficult and continuing problem. This is due to frequent recurrences of fistula after treatment, the lack of a common approach to determining the timing of the operation, the choice of surgical approach and methodology of intervention, management of post-operative period in these patients, as well as a significant influence on the results of the treatment level of technical equipment of institutions and training of medical personnel. Therefore, the implementation of the review of the world literature on the study of existing approaches to the diagnosis and treatment of genitourinary fistula seems urgent, as the basis of the analysis of the possible further development of measures to improve the effectiveness of treatment of this disease.
Consilium Medicum. 2015;17(7):12-15
pages 12-15 views

Male infertility. The use of antioxidants and zinc in the treatment of fertility disorders and inflammatory diseases of male genitalia (clinical lecture)

Borisov V.V.


This clinical lecture paper examines the current demographic problems of Russia, the dynamics of fertility and mortality, social aspects. The data on male infertility, its causes and consequences. Particular attention is paid to the health of the younger generation, its demographic prospects, as well as modern concepts of marriage and the family in terms of male infertility, complications during fertilization, pregnancy and childbirth is presented. In considering the problems associated with infections, sexually transmitted infections, and nonspecific inflammation male genitalia focuses on not only their frequency but also a significant role in the development of disorders of male infertility and infertile marriages. When considering the pathogenesis of male infertility focuses on the problems of oxidative stress and micronutrient deficiencies, possibilities of modern complex therapy with zinc, antioxidants and its prospects.
Consilium Medicum. 2015;17(7):16-23
pages 16-23 views

Erectile dysfunction: features of diagnostics and medical treatment of men with comorbidities

Korneev I.A.


Erectile dysfunction (ED) is common among the male population and is closely linked to the presence of comorbidities. Men with erectile dysfunction need a comprehensive examination and require a multidisciplinary approach for optimal results of therapy. Phosphodiesterase type 5 inhibitors, and in particular the drug sildenafil, are effective and safe 1st-line treatment drugs for men with ED of various etiologies, open up promising areas of use of these drugs in patients with concomitant urological diseases.
Consilium Medicum. 2015;17(7):24-28
pages 24-28 views

Cryosurgery for prostate cancer

Govorov A.V., Vasilyev S.O., Pushkar D.Y.


Cancer is the second most common cause of death only to cardiovascular diseases. In Russia, we marked the steady increase in the number of patients with malignant neoplasms last years, which were primarily due to increasing diagnostics and cancer overall survival rates. The development of the programme for the early prostate cancer screening in men older than 40 years lead to a significant incensement in the determination of the diseases at early stages. Prostate cancer (PC) frequency was higher in men over 60 years old, who often had intercurrent diseases, associated with severe course of the main disease during the radical methods of treatment. In such patients as well as in patients with life expectancies of less than 10 years, or in patients who had refused radical surgical treatment because of the possible complications, we had suggested the number of minimally invasive methods of treatment: cryoablation, HIFU treatment, photodynamic therapy, laser ablation, etc. The most studied PC treatment methods was cryoablation, which was recommended by the American and European Association of Urology as an alternative treatment. The received literature data, estimating the results of cryoablation showed the high recurrence-free survival rates.
Consilium Medicum. 2015;17(7):29-32
pages 29-32 views

Monitoring risk factors and microalbuminuria as methods of preventing the development of chronic kidney disease

Batrak G.A., Brodovskaya A.N.


Relevance. Chronic kidney disease (CKD) - a progressive disease, which is comparable to the prevalence of diabetes mellitus, hypertension and obesity, leading to serious complications, high disability and mortality of patients. Epidemiological studies to identify risk factors for CKD are changing traditional notions of the relatively low incidence of kidney disease. Identification of risk factors for CKD and research microalbuminuria (MAU) are the available methods of prevention, allowing timely adjustments to lifestyle, physical activity, assign medical diet, nephroprotective therapy slows the progression of chronic kidney disease, reduce the risk of severe complications and treatment costs. Goal. To study the prevalence of risk factors for CKD and severity among MAU patients of Advisory Diabetes Center in Ivanovo city. Material and methods. To determine the prevalence and risk factors of CKD severity in 52 MAU women and 10 men 58-85 years old, average age 68.3±5.3 years, sought medical help in an advisory Diabetes Center conducts research and MAU survey using questionnaires created on the initiative of the Scientific Society of Nephrology Russia in 2011 to determine the risk factors for CKD analyzed questionnaires. MAU investigated using test strips "Mikroalbufan" (by Lachema) and diagnosed by the level of urinary protein excretion in the range of 30 to 300 mg/day, as well as the ratio of albumin/creatinine urine. The presence of MAU indicates the ratio albumin/creatinine urine in men - 2.5-25.0 mg/mmol in women - 3.5-25.0 mg/mmol. An interpretation of MAU research results is also stated. Main results. The majority of patients surveyed in the advisory Diabetes Center, were identified by the main risk factors for CKD. In 82% of patients on observation were diagnosed with 1st degreeobesity. More than half of surveyed patients had arterial hypertension (AH) I-II stage. One third of patients suffer from type 2 diabetes, another 14% of patients in the presence of hyperglycemic diabetes currently require clarification. It should be noted that the absolute majority of patients had family history of GB and other cardiovascular diseases. According to the analysis of questionnaires, created on the initiative of Russian Scientific Society of Nephrology, the kidney changes were revealed in less than 20% of the patients, but complaints of possible renal failure (swelling, pain in the lumbar region, frequent urination) were submitted by more than 1/3 of patients which will undoubtedly require further in-depth survey, followed by a pathogenetic therapy. The studied MAU patients who applied to the consultative Diabetes Center, the prevalence of MAU in patients with various risk factors for CKD was mixed. The highest severity and frequency of MAU (90%) have been reported with the combination of several of the most important risk factors for CKD - type 2 diabetes, obesity and hypertension (p<0.05). In patients with type 2 diabetes with hypertension compared with patients with type 2 diabetes without hypertension is 2 times higher absolute values of the MAU (102.1±36.1 and 53.7±23.8 mg/g, respectively; p<0.05) and the ratio of albumin/urinary creatinine (11.6±4.1 and 6,1±2,7 mg/mmol to 1l, respectively); p<0.05. Test conducted twice within 1 month of test strips "Mikroalbufan" by Lachema. Discussion. The majority of patients who applied to the consultative Diabetes Center, discovered the most important risk factors for CKD: obesity, type 2 diabetes and hypertension. In the presence of obesity in the overwhelming number of patients (82%), only 14% have a satisfactory physical activity, while 31% do not pay attention to her. More than half of surveyed patients have hypertension stage I-II, but of these only 57% receive regular antihypertensive therapy. Against the background of antihypertensive therapy in 56% of patients are not achieved target BP. It should be noted that 26% of the surveyed have a family history of diabetes and require in-depth examination to rule out disorders of carbohydrate metabolism. The studied MAU patients who applied to the consultative Diabetes Center, diagnosed MAU varying frequency and severity. The highest prevalence (90%) and severity of the MAU (p<0.05) were observed with a combination of major risk factors for CKD - type 2 diabetes, obesity and hypertension. Conclusion. Carrying out the survey using questionnaires, created on the initiative of the Scientific Society of Nephrology Russia in 2011, and the definition of MAU in patients seeking medical care in the Diabetes Advisory Centre, revealed the high prevalence of major risk factors for CKD (obesity, type 2 diabetes and hypertension), as well as the early stage of CKD. The study of the prevalence of the major risk factors for CKD according to the analysis of questionnaires allows the further prevention of the development of chronic kidney disease in the early stages of development and in a timely manner to assign low-protein diet and ketoanalogs of essential amino acids (Ketosteril), pathogenetic therapy and renal protection.
Consilium Medicum. 2015;17(7):33-36
pages 33-36 views

Role and position of antioxidants in complex therapy of male infertility

Trukhan D.I., Makushin D.G.


The article considers the influence of various antioxidants in the treatment of male infertility
Consilium Medicum. 2015;17(7):37-43
pages 37-43 views

Modern possibilities of pharmacotherapy papillomavirus infection

Babanov S.A., Agarkova I.A.


The article is devoted to human papilloma virus infection and genital displays, advanced capabilities in its diagnosis and drug therapy using a drug Isoprinosine - complex synthetic purine derivative having immunostimulatory activity and non-specific antiviral effect. The results of the most important studies evaluating the efficacy of Isoprinosine.
Consilium Medicum. 2015;17(7):44-49
pages 44-49 views

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