POSSIBILITIES OF USING LOW-MOLECULAR-WEIGHT HEPARIN IN THE COMPLEX TREATMENT OF WOMEN WITH TUMORS OF THE REPRODUCTIVE SYSTEM

Benign and malignant tumors of the organs of the female reproductive system are the most common diseases requiring medical and surgical treatment. They are rarely the cause of acute complications. However, the thromboembolic disease is a serious illness, sometimes causing death due to acute the pulmonary embolism. Venous thromboembolism secondary to Benign and malignant tumors of the organs of the female reproductive system should be considered in a female presenting with abdominal mass and pelvic pressure. Thromboembolic disease secondary to large tumors should be treated with anticoagulation then hysterectomy. The article presents an analysis of modern literature on optimal prevention of the pulmonary thromboembolism in patients with tumors of the female reproductive system. There are analysis data of 17 (0.7 %) cases of the pulmonary thromboembolism that occurred of 2358 gynecological and oncogynecologic patients

The effect of a high-polyphenol Mediterranean diet (Green-MED) combined with physical activity on age-related brain atrophy: The Dietary Intervention Randomized Controlled Trial Polyphenols Unprocessed Study (DIRECT PLUS)

Background: The effect of diet on age-related brain atrophy is largely unproven. Objectives: We aimed to explore the effect of a Mediterranean diet (MED) higher in polyphenols and lower in red/processed meat (Green-MED diet) on age-related brain atrophy. Methods: This 18-mo clinical trial longitudinally measured brain structure volumes by MRI using hippocampal occupancy score (HOC) and lateral ventricle volume (LVV) expansion score as neurodegeneration markers. Abdominally obese/dyslipidemic participants were randomly assigned to follow 1) healthy dietary guidelines (HDG), 2) MED, or 3) Green-MED diet. All subjects received free gym memberships and physical activity guidance. Both MED groups consumed 28 g walnuts/d (+440 mg/d polyphenols). The Green-MED group consumed green tea (3-4 cups/d) and Mankai (Wolffia-globosa strain, 100 g frozen cubes/d) green shake (+800 mg/d polyphenols). Results: Among 284 participants (88% men; mean age: 51 y; BMI: 31.2 kg/m2; APOE-ε4 genotype = 15.7%), 224 (79%) completed the trial with eligible whole-brain MRIs. The pallidum (-4.2%), third ventricle (+3.9%), and LVV (+2.2%) disclosed the largest volume changes. Compared with younger participants, atrophy was accelerated among those ≥50 y old (HOC change: -1.0% ± 1.4% compared with -0.06% ± 1.1%; 95% CI: 0.6%, 1.3%; P Conclusions: A Green-MED (high-polyphenol) diet, rich in Mankai, green tea, and walnuts and low in red/processed meat, is potentially neuroprotective for age-related brain atrophy.This trial was registered at clinicaltrials.gov as NCT03020186

HERBAL MEDICINAL PRODUCTS IN A TREATMENT OF MASTALGIA IN GYNECOLOGIC PATIENTS

Implementation of breast cancer screening using digital mammography improved the diagnosis of primary proliferative regressive structural changes in the breast, manifested as diffuse or diffusely-nodal deformations of tissues. Currently, women are significantly more likely to seek medical consultation for damages of the breast that could not be evaluated earlier. This requires the development of special tactics for their treatment and follow-up. Nowadays, searching for prognostic markers and choosing adequate therapy for nodular and diffuse mastopathy are among the most discussed issues in mammology, because up to 25 % of all breast cancer cases are diagnosed during the in situ phase. In this article we try to reassess the problem of dyshormonal changes in the breast and develop an optimal approach to their treatment

PREOPERATIVE AND POSTOPERATIVE ANTIBIOTIC PROPHYLAXIS IN GYNECOLOGICAL PATIENTS DEPENDING ON INDIVIDUAL RISK FACTORS

Pelvic inflammatory diseases as complications of invasive diagnostics and surgical treatment occur often enough in patients with gynecological disorders. The risk of infectious complications is always individual and depends on many factors. The implementation of a personified approach and optimization of antibacterial prophylaxis can decrease the incidence of inflammatory reactions and reduce the risk of infectious complications. Objective: to estimate the efficacy and tolerability of combiflox (ornidazole 500 mg + ofloxacin 200 mg) in long-term antibiotic prophylaxis after gynecological and oncological surgeries. Materials and methods. We assessed the results of a 7-day oral course of combiflox after intravenous intraoperative antibiotic prophylaxis (ciprofloxacin 500 mg + metronidazole 500 mg) in 73 women that underwent gynecological or oncological surgeries. All patients were monitored for postoperative complications, including any wound inflammation, low-grade hyperthermia, symptoms of postoperative vaginitis, endometritis, limited peritonitis, adnexitis. Results. We found that 43.8 % of patients were at high risk of developing postoperative inflammatory complications; in most of the cases, it was associated with obesity (body mass index >30 kg/m2). Three out of 32 overweight patients (9.3 %) developed postoperative complications, whereas none of the 41 patients with minimal risk factors had such events. No combiflox-related adverse effects were observed during the study. All patients reported good tolerability and high convenience of the drug. Conclusion. The need for long-term antibiotic prophylaxis depends on the type of surgery and individual risks for infectious complications. Low-cost oral therapy with combiflox (ornidazole + ofloxacin) during the postoperative period reduces the risk of infectious complications, especially among patients with a body mass index >30 kg/m2, since they are particularly prone to wound complications

MOLECULAR PROFILES OF ENDOMETRIAL HYPERPLASIA AND ENDOMETRIAL INTRAEPITHELIAL NEOPLASIA

Objective: to assess molecular profiles of endometrial hyperplasia and endometrial intraepithelial neoplasia.Materials and methods. We conducted a retrospective study that included 77 patients with a morphologically verified hyperplastic process in the endometrium. Of them, 34 patients had endometrial hyperplasia and 33 patients had endometrial intraepithelial neoplasia. The control group comprised 30 women with no endometrial disorders according to the results of histological examination.Results. Patients with endometrial intraepithelial neoplasia are at high risk of developing cancer. High angiogenic activity, pronounced vascularization, and endometrial hypoxia are believed to be important risk factors contributing to tumor proliferation and transformation. The expression of inhibitors of apoptosis, such as survivin and Bcl-2, is usually increased in atypical cells, which may indicate their involvement in malignant transformation of cells and tumor invasive growth.Conclusion. Our findings confirm the important role of survivin and Bcl-2 in hyperplastic processes in the endometrium

Options for therapeutic treatment of proliferative diseases of the uterus

Increase in the incidence of hormone-dependent diseases of the female reproductive system (FRS) calls for the search of new efficient algorithms for early diagnosis of early endometriosis, endometrial hyperplasia and uterine fibroids, while combined pathology requires early treatment and patient-based approach