Vol 18, No 6 (2016)
Articles
Stress-related menstrual disorders
Abstract
In this systematic review of scientific literature on stress-related menstrual disorders we summarize the results presented in papers, published in course of last 15 years and indexed in Pubmed. We describe contemporary theories considering the mechanism of psychogenic menstrual disorders development and review their specific features. We identify certain characteristics of sensitivity to stress and personality traits in women, reacting on stress with menstrual disorder. We also describe certain non-pharmacologic psychotherapeutic approaches to the management of these disorders.
Consilium Medicum. 2016;18(6):8-13



Non-hormonal correction of vasomotor symptoms in peri - and postmenopausal women
Abstract
Frequency of climacteric symptoms in menopausal reaches 40-60%. One of the main reasons of neurovegetative reactions that develop during menopause, is a change in the functional state of hypothalamic centers and violation of neurotransmitter secretion. A prospective study including 30 patients with autonomic manifestations of climacteric syndrome was held. Within 3 months of therapy based on melatonin (Melaxen) in a daily dose of 3 mg was used. Dynamics of psycho-emotional state of self-assessed by a specialized scales: Spielberger-Khanin, A.M.Wayne questionnaire and modified menopausal index by Cooperman. Hormonal study was carried out before treatment and at 3 months. Subjective assessment of the quality of life and the level of anxiety in patients allow them to carry a high risk of developing the syndrome of autonomic dysfunction. Against the background of the 3-month course of the use of melatonin showed improvement of quality of life of patients.
Consilium Medicum. 2016;18(6):14-19



Prediction of osteoporotic changes in women during the menopausal transition
Abstract
The aim of this study was to evaluate bone mineral density (BMD) changes depending on the performance of follicle stimulating hormone and identification thresholds of the hormone, the formation of osteoporotic changes in women during the menopausal transition. The results showed a negative correlation between the levels of follicle stimulating hormone and lumbar spine BMD in women during the menopausal transition (r=-0.44; p=0.001). In assessing BMD fluctuations depending on the level of follicle stimulating hormone was determined classification threshold of this hormone, amounting to 34.7 mIU/ml in which the increased risk of osteoporotic changes. The odds ratio for the formation of these disorders in menopausal transition period amounted to 3.063 (1.558-6.022).
Consilium Medicum. 2016;18(6):20-23



Efficacy and safety of alphacalcidol for treatment of deficient states and functional impairments in postmenopausal women (literature review)
Abstract
Benefits of active metabolite of vitamin D (alfacalcidol) over native vitamin D as well as its biological and clinical effects mediated via activity of 1,25(ОН)2D3 and discussed, which determine a rationale for its use in treatment of osteoporosis in postmenopausal women. It is demonstrated that use of alfacalcidol (Alpha D3-Teva®) is among important links in prophylaxis of falls and fractures in such patients.
Consilium Medicum. 2016;18(6):24-28



Heartburn pregnant therapy: focus on alginate
Abstract
Heartburn is one of the most common complaints during pregnancy. In a number of heartburn pregnant studies it is isolated as a separate symptom that appears on the background of pregnancy and due to it. The urgency of the problem of heartburn among pregnant women is due to its high prevalence, the close relationship with the subsequent development of gastroesophageal reflux disease and with reduced quality of life. Due to the proven efficacy, safety and lack of side effects alginate-containing drugs such as Gaviscon Forte are the drugs of choice for the treatment of heartburn during pregnancy. Indicators of efficiency and safety of the drug Gaviscon Forte are confirmed by numerous clinical and toxicological studies that can be recommended for use in pregnant and lactating women.
Consilium Medicum. 2016;18(6):29-34



Pregravid training for women with chronic cervicitis associated with HPV infection
Abstract
Pregravid training 43 women with chronic cervicitis associated with HPV, included a comprehensive treatment with an immunostimulatory drug with antiviral effect Isoprinosine (inosine pranobex). Patients were taken through 3 courses of drug administration in a daily dose of 3000 mg with 10 days intervals. Treatment efficacy was evaluated on the basis of clinical data, the PAP-test, colposcopy and HPV PCR determination 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59 after 6 and 12 months of starting treatment. Prior to the combination therapy significantly more often in patients was observed an abnormal colposcopic picture (p<0,001). Against the background of a complex therapy, including the use of the drug Isoprinosine high oncological risk HPV elimination occurred in 93,02% of patients.
Consilium Medicum. 2016;18(6):35-37



The influence of a tuberculosis infection on pregnancy and fetal development
Abstract
Literary data on a problem of the influence of tuberculosis on pregnancy and its development, the course of childbirth and the early postnatal period, and also on development of the fetus and the newborn are presented in the article. Most of authors indicate negative influence of a specific infection, however this opinion isn't unambiguous. Absolute indications and contraindications for interruption of pregnancy at women with lung tuberculosis are listed, however the final decision on incubation of pregnancy depends on the mother. Therefore, phthisiatricians, obstetricians - gynecologists and pediatricians, recently, are even more often anxious about the problem of preservation of life of both the fetus and the mother with lung tuberculosis.
Consilium Medicum. 2016;18(6):38-42



Iodine deficiency during pregnancy
Abstract
Iodine deficiency disorders (IDD) are the most common non-infectious pathology in the world. The spectrum of disorders associated with a deficiency of iodine, is wide enough, but the most dangerous and socially significant changes relate to the period of fetal life and early childhood. Pregnant women are a part of a special group of IDD risk, that requires mandatory replenishment of iodine deficiency. In the absence of legislative measures of iodine deficiency elimination in pregnant women, the supplementation of iodine preparations in adequate physiological dosages is recommended.
Consilium Medicum. 2016;18(6):43-45



Hormonal contraception: evolution or revolution?
Abstract
June 27, 2016 the IX regional forum «Mother and Child», began its work in Sochi. In its framework, a symposium devoted to one of actual problems of obstetrics and gynecology - hormonal contraception and its role in the preservation of women's reproductive health took place.
Consilium Medicum. 2016;18(6):46-51



Nonalcoholic fatty liver disease in patients with polycystic ovary syndrome
Abstract
The article provides an overview of the current literature on the problem of polycystic ovary syndrome (PCOS) and non-alcoholic fatty liver disease (NAFLD). The prevalence of NAFLD in women with PCOS, substantially higher compared with the general population. Among the reasons for the high comorbidity of these disorders is common pathogenetic pathways, including insulin resistance, obesity, and metabolic syndrome. Formation of NAFLD in women with PCOS at a younger age and earlier progression of changes in the liver than in the general population are unfavorable prognostic factors. The presented results of authors own observations confirm the high prevalence of NAFLD in patients with PCOS, its association with obesity, lipid metabolism disorders and adipokines. The remedies of female sex steroid using in patients with PCOS and NAFLD is associated with the risk of drug liver injury therefore liver condition requires monitoring prior to and during the treatment period.
Consilium Medicum. 2016;18(6):52-58



Features of the immune system functioning during physiological pregnancy and their relationship with vaccination against influenza
Abstract
The changes in the consist of immune cells which are adaptive in the reproductive system during pregnancy are discussed. An insolvency of modulation of immune responses on the part of the mother's body if accompanied by bacterial or viral infection leads to a significant imbalance in the immune system of women, which is reflected in gestation and the postnatal development of the child. Studies concerning the prevention of respiratory infections with the help of inactivated influenza vaccines have proved their efficacy and safety but still it is has been discussing the possibility of the existence of different mechanisms of post-vaccination immune response after immunization with unadjuvanted and adjuvanted influenza vaccines depending on the trimester. However, the possibility of the existence of different mechanisms of post-vaccination immune response when administered adjuvanted and unadjuvanted influenza vaccines is still examining. An answer on this question will help to make the proper selection of vaccines according to the trimester of pregnancy.
Consilium Medicum. 2016;18(6):59-62



Fibrocystic disease of the breast. The modern approach to prevention and treatment
Abstract
Fibrocystic disease (FCD) is one of the most common diseases in the female population. The methods of its prevention and treatment does not lose its relevance, especially in the early women of reproductive age. Mamoklam - the drug of choice in the prevention of FCB and its complex therapy after Artificial abortion.
Consilium Medicum. 2016;18(6):63-66



Characteristics of the individual parameters of adaptive changes during treatment with hormonal contraception
Abstract
Relevance. Saving women's reproductive health and safe motherhood is a priority task of modern medicine throughout the world. Goal. The study of individual parameters, such as biochemical profile, characterized by the presence of adaptive changes in patients using hormonal contraceptives. Materials and methods. The article presents surveillance data for 220 female patients who used hormonal contraception. All patients were examined using clinical and laboratory diagnostic methods: the anamnestic, clinical, ultrasound (pelvic organs, mammary glands), biochemical blood tests. Results. The findings suggest that when taking combined oral contraceptives in the first 3 months in the body of patients adaptive changes occur, the reflection of which - statistically significant deviations of individual parameters biochemical profile (total blood protein, bilirubin, alanineaminotransferase, asparaginaminotransferaza, alkaline phosphatase). Using vaginal hormonal contraceptive does not lead to statistically significant changes in a number of biochemical parameters, which change the first 3 months of oral hormonal contraceptives. Conclusion. Hormonal contraceptive vaginal use is preferred in patients with gastrointestinal disease.
Consilium Medicum. 2016;18(6):67-70






The modern concept of mastodynia
Abstract
Mastodynia is a condition characterized by painful sensations in the breasts. It is diagnosed in middle-aged women in the reproductive 50%, while in the older age group it is significant; y lower - 5%. Pain in the breast may be cyclic and non-cyclic in nature. Cyclical is associated with the hormonal changes of the menstrual cycle, bilateral, more pronounced in the upper outer quadrant of the breast. Non-cyclic is permanent or intermittent in nature, one-way. Their cause is stretching in the Cooper ligaments, smoking, ductal ectasia, mastitis, an inflammatory cancer, pregnancy, thrombosis, trauma, cysts, previous breast surgery and the use of drugs. Diagnosis mastalgia includes patient survey, physical examination, ultrasound scan, and mammography. Treatment consists in the normalization of diet, and symptomatic medication.
Consilium Medicum. 2016;18(6):74-76



The treatment of endometriosis. Pharmacological aspects of anti-adhesive activity
Abstract
Relevance. The search for optimal tactics of patients with endometriosis is one of the most urgent problems of modern gynecology. The basis of success in the treatment of this disease - well-chosen medical complex, including surgical approach, hormone therapy, means protivospaechnoy activity. Materials and methods. In a prospective study conducted a comprehensive examination and treatment of 126 patients with endometriosis. Conclusions. It is impossible to underestimate the contribution of minimally invasive endoscopic treatment and barrier adjuvants, however the use of pharmacological, etiology-based tools, including the enzyme preparation Longidaza® - an important link in the complex therapy of endometriosis.
Consilium Medicum. 2016;18(6):77-81



Pelvic pain in women: diagnosis and treatment issues
Abstract
The article presents the epidemiology and classification of pelvic pain in women, etiological factors, current concept of pathogenesis of chronic pelvic pain syndrome. To-date integrated approach to management of patients with pelvic pain, including extensive examination and multidisciplinary approach to treatment and rehabilitation is elucidated. The principles of surgical treatment, drug therapy, physiotherapy and psychological rehabilitation are covered.
Consilium Medicum. 2016;18(6):82-86



Recurrent mixed urogenital infections in women: correction strategy of mucosal immunity
Abstract
Currently, infectious diseases of the female genital organs are typical combined etiology, erased or asymptomatic clinical picture, the high frequency of mixed infections, a tendency to recurrence. Such clinical course of inflammatory diseases are largely caused by violations of certain parts of the immune system. In this regard, there is an active search of methods of influence on General and mucosal immunity to enhance the effectiveness of therapy of inflammatory diseases of the genitals and reduce the frequency of recurrence of the inflammatory process. Among drugs with immunomodulatory properties, the drug Polyoxidonium®, which is associated with the presence of immunomodulating, antioxidant, membrane-protective and antitoxic effects of the drug. The article provides an overview of data on the use of immunomodulator Polyoxidonium® in patients with chronic nonspecific diseases of the genital organs.
Consilium Medicum. 2016;18(6):87-93



Genital prolapse and urinary incontinence: therapy options
Abstract
In modern urogynecological practice around the world in addition to traditional surgical methods of treatment of genital prolapse and stress urinary incontinence, new, high-performance methods associated with the use of erbium lasers are used. These technologies make it possible to safely carry out the correction of this disease and its associated states without the rehabilitation period. Now the intimate problems of patients in the perimenopausal period can be solved, and post-natal rehabilitation carried out without mucosal damage to the vaginal canal in an outpatient setting.
Consilium Medicum. 2016;18(6):94-97



Evaluation of oncological safety of Magnerot on a model of lung carcinoma
Abstract
Compensation of prolonged magnesium deficiency is carried out with organic magnesium salts. Here, the results of experimental evaluation of the oncological safety of magnesium orotate in doses of 5 and 10 mg/kg (elemental magnesium) are presented. The high oncological safety of the Magnerot was tested on a standard model - Lewis lung carcinoma.
Consilium Medicum. 2016;18(6):98-102



Efficiency of assisted reproductive technology in patients with infectious, inflammatory and dysplastic cervical disease
Abstract
The authors conducted a study on the outcomes of assisted reproductive technology (ART) in patients with infectious - inflammatory and dysplastic cervical disease. The results indicate that the pathology of the cervix can be a co-factor for unfavorable outcome of ART protocols. In this connection, the authors put the task of improving the efficiency of ART programs, through in-depth examination and optimization methods and timing of the treatment of cervical pathology before the ART protocols.
Consilium Medicum. 2016;18(6):103-108


