Evaluation of the sucrosomial iron efficacy in the patient treatment with stage 1–2 iron deficiency anemia during heavy menstrual bleeding

I.N. Kononova1,2, Yu.E. Dobrokhotova1, E.N. Kareva1,3, N.A. Shmakova4, I.V. Graban5, T.A. Ogurtsova6 1Pirogov Russian National Research Medical University, Moscow, Russian Federation 2Transregional Center for Continuing Professional Education LLC, Moscow, Russian Federation 3I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russian Federation 4Medical Center "Angio Line plus" LLC, Yekaterinburg, Russian Federation 5Medical Center "Edelweiss", Yekaterinburg, Russian Federation 6Yekaterinburg Clinical Perinatal Center, Yekaterinburg, Russian Federation Aim: to evaluate the clinical efficacy of Sucrosomial® iron (SiderAL® Forte) in the treatment of stage 1–2 iron deficiency anemia (IDA) in patients with menorrhagia in the setting of ovulation disorders. Patients and Methods: a prospective randomized multicenter clinical case study of 110 patients with stage 1–2 IDA developed in the setting of menorrhagia as a result of ovulation disorders was conducted. Female patients of the main group (n=74) received Sucrosomial® iron 30 mg 2 times a day for 60 days. In the control group (n=36), a liposomal iron preparation of 30 mg 2 times a day was also prescribed for 60 days. Results: during Sucrosomial® iron ferrotherapy, an increase in Hb levels by more than 20 g/L was observed after 30 days of administration in 65 (87%) female patients, after 60 days in 73 (98.6%) female patients, which demonstrated higher therapeutic efficacy versus liposomal iron preparation (69.4 and 88.8%, respectively, p=0.0001). There was also a greater adherence to therapy (98.6%) during Sucrosomial® iron intake versus liposomal iron intake (86.1%, p=0.0001), due to fewer (1.4%) adverse events compared with the control group (5.5%, p=0.0002). Conclusion: oral ferrotherapy with Sucrosomial® iron is a reasonable option for the IDA treatment in patients with menorrhagia due to its higher efficacy versus the liposomal iron. The effect occurs after 30 days of drug intake with a minimum number of adverse events, due to the unique structural, physico-chemical and pharmacokinetic characteristics of the sucrosomial iron, thanks to which it is protected from the gastric juice action, does not contact with the gastrointestinal mucosa and is absorbed through special intestinal M-cells with further iron release in liver cells. Keywords: iron deficiency anemia, menorrhagia, ovulation disorders, Sucrosomial® iron, women, therapy. For citation: Kononova I.N., Dobrokhotova Yu.E., Kareva E.N., Shmakova N.A., Graban I.V., Ogurtsova T.A. Evaluation of the sucrosomial iron efficacy in the patient treatment with stage 1–2 iron deficiency anemia during heavy menstrual bleeding. Russian Journal of Woman and Child Health. 2023;6(4):332–339 (in Russ.). DOI: 10.32364/2618-8430-2023-6-4-2. <br

Minocycline (Minolexin®) clinical efficacy and tolerability evaluation in women with bacterial-associated chronic cervicitis

Yu.E. Dobrokhotova1, I.N. Kononova1,2, E.N. Kareva1,3, N.A. Shmakova4, I.V. Graban5, T.A. Ogurtsova6 1Pirogov Russian National Research Medical University, Moscow, Russian Federation 2LLC "Interregional Center for Continuing Professional Education", Moscow, Russian Federation 3I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russian Federation 4LLC Medical Center "ANGIO LINE PLUS", Yekaterinburg, Russian Federation 5LLC Medical Center "Edelweiss", Aramil, Russian Federation 6Yekaterinburg Clinical Perinatal Center, Yekaterinburg, Russian Federation Background: bacterial-associated chronic cervicitis (CC) occupies a leading place in the cervical pathology structure. At the same time, the disease recurrence rate reaches 59–68% in the setting of resistance to antibacterial therapy, which determines the need to find new effective drugs. Aim: to evaluate the clinical efficacy, safety and compliance of therapy with minocycline in patients with bacterial-associated CC. Patients and Methods: a multicenter prospective observational clinical study was conducted in women's health clinics and medical centers in Yekaterinburg. The study included 60 female patients with a confirmed diagnosis of bacterial-associated CC. Group 1 (n=31) received the antibacterial drug minocycline (Minolexin®) 100 mg twice a day in the morning and evening, 10 days + antimycotic prebiotic 1 suppository once a day intravaginally for 6 days, starting from the 3rd day of antibiotic therapy. Group 2 (n=29) received doxycycline 100 mg twice a day for 10 days + antimycotic prebiotic 1 suppository once a day intravaginally for 6 days, starting from the 3rd day of antibiotic therapy. Clinical and laboratory efficacy (cervicitis signs, results of laboratory microbiome research methods) and drug tolerability were evaluated 10 and 30 days after the treatment initiation. Results: as a result of CC antibacterial therapy with minocycline, pathogen eradication was observed in 83.9% of female patients (group 2 — in 69.9%, p=0.0001), the original squamous epithelium 30 days after the minocycline was detected in 27 (87.1%) female patients (group 2 — in 19 (65.5±5.8%) female patients, p=0.0001), which indicates a higher efficacy of minocycline versus doxycycline. Patients of the minocycline group had more therapy adherence — 96.8% vs. 82.9% in the doxycycline group (p=0.0001) due to the minimal number of side effects (3.2% vs. 17.2%, respectively; p=0.0001). Conclusion: minocycline is a systemic antibiotic of the tetracycline group, which can be considered as the front-line drug for antibacterial therapy of patients with CC due to its high clinical efficacy, minimal risk of side effects and high compliance. Keywords: chronic cervicitis, antibacterial therapy, tetracyclines, minocycline, efficacy. For citation: Dobrokhotova Yu.E., Kononova I.N., Kareva E.N., Shmakova N.A., Graban I.V., Ogurtsova T.A. Minocycline (Minolexin®) clinical efficacy and tolerability evaluation in women with bacterial-associated chronic cervicitis. Russian Journal of Woman and Child Health. 2023;6(4):340–346 (in Russ.). DOI: 10.32364/2618-8430-2023-6-4-3. <br

The concept of enhanced recovery after surgery in gynecological oncology

The concept of enhanced recovery after surgery in gynecological oncology Dobrokhotova Yu.E.1, Ter-Ovanesov M. D.2, Borovkova E.I.1, Kukosh M. Yu.2, Zhelezkova T.A.1 1 Pirogov Russian National Research Medical University, Moscow 2 Peoples’ Friendship University of Russia, Moscow The proven and widely recognized advantage of using the concept of Enhanced recovery after surgery (ERAS) is an enhanced postoperative recovery of patients due to the rational preoperative preparation, reducing surgical stress and the number of postoperative complications, which in total reduces the length of hospital stay and treatment costs. Currently, the results of several prospective randomized trials have convincingly proven the effectiveness of the ERAS in gynecological oncology. The basic ERAS protocol consists of 21 items and includes measures aimed at informing the patient, a full preoperative examination, elimination of pre-operative fasting, optimization of the volume of infusional therapy, absence of mechanical preparation of bowels, use of multimodal analgesia, prevention of nausea and vomiting, rational antibiotic- and thromboprophylaxis, a personalized approach to the use of drains and probes, prevention of intraoperative hypothermia, as well as early activation of patients and their fast discharge from the hospital. Key words: gynecological oncology, surgery, ERAS, fast-track surgery, enhanced postoperative rehabilitation, nutritional and perioperative support. For citation: Dobrokhotova Yu.E., Ter-Ovanesov M.D., Borovkova E.I. et al. The concept of enhanced recovery after surgery in gynecological oncology // RMJ. 2018. № 5(I). P. 45–50.<br