MODERN POSSIBILITIES OF RATIONAL VITAMIN THERAPY IN PREGNANT WOMEN

Insufficient nutrition is an urgent problem of modern healthcare. According to WHO, more than 2 billion people suffer from essential vitamin and mineral deficiencies, in particular vitamin A, iodine, iron and zinc [1]. The hypovitaminosis, as well as hypoelementosis pose the greatest threat to pregnancy and lactation, contributing to the development of miscarriages, intrauterine growth restriction, maternal mortality, labor complications, infectious pathology and adverse course of the neonatal period.Objective of the study: evaluation of the efficacy of the vitamin and mineral complex in correcting the nutritional status of patients during gestation.Materials and methods of the study: 33 pregnant women with threatened miscarriage of various genesis, who were admitted to the department of gynaecology, underwent a clinical and laboratory examination and treatment. In addition to the general clinical examination, all patients were assessed for plasma vitamin E and folic acid concentrations, which play a key role in embryogenesis. In addition to therapy aimed at prolonging pregnancy, all pregnant women received nutritional support in the form of a multivitamin drug.Results of the study: During the observation period, the condition of pregnant women improved significantly: signs of threatened miscarriage were eliminated, complaints of weakness, fatigue and sleep disturbance disappeared. All patients showed significantly higher plasma vitamin E and folic acid concentrations after the treatment

Vaginal hormonal ring: a modern method for prolonged contraception

Protection of women’s reproductive health and fertility is one of the priorities for the modern medicine. The prevention of an unintended pregnancy is critical for successful solving of this problem. Prevention of unwanted pregnancy and abortion, medical and social counselling are an integral part of the obstetrician-gynecologist activities. The effectiveness of preventing an unwanted pregnancy is a major factor in choosing a remedy, as well as the ease of use. The article presents information on the new modern contraception methods, including prolonged forms of combined hormonal contraception. A comparative analysis of oral and parenteral contraceptives is provided. The authors gave criteria of efficacy and principles for rational choice of contraceptives. The mechanism of action of a hormonal contraceptive drug containing etonogestrel and ethinyl estradiol is described. The article reviews the main advantages, indications for use and side effects of hormonal releasing systems, which contraceptive effect is provided by a combination of various factors. The suppression of ovulation is the most important of these factors. The researchers provided an analysis of the effect of the vaginal hormonal ring on the biocenosis of vagina and cervical mucosa, on the course of background cervix diseases and the possibility of preventing the development of pathogenic flora, as well as the benefits of its use in women with uncomplicated ectopia of the cervix: the effect on the epithelization of ectopia of columnar epithelium and the beneficial effect on endometrioid heterotopia. The article presents data on the frequency of adverse effects associated with the use of the contraceptive method, as well as risk factors that may become a contraindication to the use of the vaginal hormonal ring. Clear guidelines for postabortion contraception are provided

Anemia in elderly women. Rational prevention. Evidence base

Iron deficiency anemia is a frequent companion in postmenopausal women and those who have reached adulthood. Anemia in mild form in elderly women often occurs almost asymptomatically. Over time, iron deficiency progresses: severe complications occur, the quality of life decreases significantly, and the prognosis for life becomes unfavorable. A cross-section of the literature data in recent years shows that iron, folate, vitamin B12 deficiency, gastrointestinal diseases, pathologies in the processes of erythropoiesis and other somatic diseases come to the fore in terms of the etiological factors of anemia in elderly women. An important role in the development of anemia in older women is played by an irrational diet throughout life, which causes a lack of iron and folate in food. That is why therapy with a complex drug, which includes iron (II) fumarate in combination with folic acid is a rational choice in comparison with iron monotherapy for the prevention and treatment of anemia in elderly women. The administration of oral iron preparations for the correction of iron deficiency and for the purpose of selecting an effective pathogenetic therapy for anemia solves the problem of complications and improves the quality of life of older women. Iron (II) fumarate + folic acid - a tablet form of iron preparation in combination with folic acid for oral use, which has good tolerability, quickly replenishes iron reserves in the body of elderly patients, reducing mortality in this age group

Therapeutic approaches in the treatment of vulvovaginal candidiasis

According to world statistics, vulvovaginal candidiasis is a very common disease with a serious tendency to recurrence and chronic-ity, which makes it a fundamentally significant medical and social problem, the solution of which is becoming a priority task facing obstetricians and gynecologists. The attention of doctors should be focused on the search for optimal treatment regimens that meet all the requirements for therapeutic approaches, the introduction of which into clinical practice should lead to a significant decrease in the incidence of the disease and its chronicity in the population, and also on increase in the relapse interval, which will certainly be reflected in improving the quality of life of women. Analysis and comparison of the effectiveness of antifungal drugs on the modern pharmaceutical market, and the choice of the most effective and safe drug can be the key to success in combating the widespread prevalence of vulvovaginal candidiasis.The article presents the etiological aspects of vulvovaginal candidiasis, demonstrating an increase in the importance of Candida non-albicans in the pathogenesis of the disease, which is confirmed by high rates of disease prevalence, including chronic and recurrent forms. The mechanisms of vulvovaginal candidiasis development and diagnostic methods that allow to assess the state of vaginal microcenosis most adequately are considered. The negative impact of vulvovaginal candidiasis on the course of pregnancy and possible outcomes for both the mother and the fetus are also described. Special attention is paid to the ability of fungi of the genus Candida to form associations of microorganisms - biofilms, which create an obstacle to many antifungal drugs. The problem of resistance of Candida fungi to a number of antifungal drugs is highlighted. Data on the uniqueness of the composition and action of sertaconazole and the effectiveness of its use, which is confirmed by studies, including in a group of pregnant patients, are presented. The article analyses indicators of safety of sertaconazole and criteria of continuity

Disorders of sexual function in postmenopausal patients

Introduction. Research in recent years has shown that sexual dysfunction is now common in post-menopausal women and that it has a significant impact on their quality of life.Aim: to identify the major causes of sexual dysfunction in postmenopausal women and their treatment options, by analysing different literature sources.Materials and methods. During the study of this problem, 25 sources of literature, both Russian and foreign, dating from 2007 to 2020 were analysed.Results and discussion. The main etiological aspects of sexual dysfunction in postmenopausal women, such as disorders of sexual desire, sexual pain disorders, orgasmic disorders are considered in this article. The role of physiological processes occurring in a woman’s organism during this age period in the formation of sexual dysfunction is presented, namely, the influence of insufficiency of sex hormones (In particular, estrogens) and genitourinary syndrome on disorders of the sexual sphere.The main methods of treatment are described, including hormone replacement therapy, the use of non-invasive laser technology, and surgical correction of the dysfunction and atrophy of the pelvic floor muscles. Particular attention is paid to the use of the synthetic steroid tibolone and flibanserin, a drug used to treat hypoactive sexual desire disorder, and the data concerning their high efficacy are presented.Conclusions. The predominant manifestation of sexual dysfunction are disorders of sexual desire and sexual pain disorders. Thus it is important to pay attention to this problem and to treat sexual dysfunction by treating its causes.Conclusion. The treatment of sexual dysfunction must address the causes. In many cases, psychotherapy is necessary. MHT has a positive effect on the sexual function of patients. Testosterone therapy is justified in this case, but is rarely used, as it has a number of side effects and contraindications. Synthetic steroids (Tibolone) have shown good results in the treatment of sexual dysfunction

The role of magnesium in the treatment of symptoms climacteric syndrome

According to epidemiological studies, about 30% of residents in Russia receive less than 70% of the daily magnesium intake, while magnesium deficiency manifests much more often in women than in men. The prevalence of magnesium deficiency is 1.3 times higher among the female population. Women are more sensitive to magnesium deficiency and normally have higher deposited concentrations of this element. Objective of the study: evaluate the effectiveness of magnesium in the management of menopausal syndrome symptoms. Materials and methods: 30 female patients, aged 47 to 57 years, with various menopausal syndrome symptoms underwent clinical and laboratory examination. In addition to the general clinical examination, all patients underwent atomic absorption spectroscopy to determine serum Mg2+ ions concentrations. All patients received menopausal hormone therapy in combination with magnesium supplement using Magnesium Diasporal 300. Results and discussions: The severe climacteric symptoms relief and an increase in the serum magnesium levels were recorded against the background of the therapy

Vitamin D deficiency in women of reproductive age, options for correction

Vitamin D deficiency is the pandemica for real in the modern world [1]. The role of vitamin D in the reproductive function regulation has been proven in light of the achievements over the past few years. Being a steroid hormone, this vitamin is essential for a wide range of normal physiologic functions. Vitamin D insufficiency as defined by serum 25(OH)D ≤ 30 ng/ml is widespread globally, with the frequency of registration of this condition among the population of Russia over 90% [2]. The elderly and pregnant women (especially in the presence of fat metabolism disorders, gestational diabetes and infectious pathology), who did not undergo a vitamin correction medication, is the main risk group for vitamin D deficiency. Objective of the study: Evaluate the efficacy of colcalciferol in vitamin D-deficient therapy in women of reproductive age. Material and methods of the study: clinical and laboratory examination and treatment of 31 patients with various reproductive system pathologies, aged 21 to 45 years who were hospitalized to the Department of Gynaecology. In addition to the general clinical examination, all patients had their vitamin D, total and ionized calcium levels in blood plasma assessed. In order to correct the vitamin D deficiency and insufficiency, the vitamin D supplementation by colcalciferol (vitamin D3) intake was prescribed to all examined patients in addition to the treatment of the underlying disease. Results of the study: all examined patients showed the decreased vitamin D concentration in the blood plasma below the reference indices. The vitamin D deficiency was discovered in 64.5% cases. At the same time, a significant increase in the concentration of 25(OH)D3 in blood plasma was noted against the background of therapy

Role of the Transcription Factor FOSL1 in Organ Development and Tumorigenesis

The transcription factor FOSL1 plays an important role in cell differentiation and tumorigenesis. Primarily, FOSL1 is crucial for the differentiation of several cell lineages, namely adipocytes, chondrocytes, and osteoblasts. In solid tumors, FOSL1 controls the progression of tumor cells through the epithelial–mesenchymal transformation. In this review, we summarize the available data on FOSL1 expression, stabilization, and degradation in the cell. We discuss how FOSL1 is integrated into the intracellular signaling mechanisms and provide a comprehensive analysis of FOSL1 influence on gene expression. We also analyze the pathological changes caused by altered Fosl1 expression in genetically modified mice. In addition, we dedicated a separate section of the review to the role of FOSL1 in human cancer. Primarily, we focus on the FOSL1 expression pattern in solid tumors, FOSL1 importance as a prognostic factor, and FOSL1 perspectives as a molecular target for anticancer therapy