СУЩЕСТВОВАНИЕ ИЗМЕРИМЫХ СОГЛАСОВАННЫХ СЕЛЕКТОРОВ МНОГОЗНАЧНЫХ ОТОБРАЖЕНИЙ

The present article is devoted to considering measurable set-valued random functions that are adapted to a fixed filtration of σ-algebras and the values of which are closed subsets of some complete separable metric space. For such functions, a criterion of measurability and adaptation is proved, which is analogous to Castain’s well-known criterion of measurability of set-valued functions. A theorem on existence of measurable and adapted selectors of set-valued random functions, which approximate some measurable adapted random function, is obtained. This theorem is improved in the case of set-valued functions with compact values. The generalization of Filippov’s theorem about the inverse function to the set-valued measurable random functions is proved. The obtained results can be useful both for proving the existence and for considering the properties of the solutions of stochastic differential inclusions.В настоящей статье рассматриваются измеримые многозначные случайные отображения, согласованные с заданным потоком σ-алгебр, значениями которых являются замкнутые подмножества некоторого полного сепарабельного метрического пространства. Для них установлен критерий измеримости и согласованности, аналогичный известному критерию Кастэна измеримости многозначных отображений. Доказана теорема о существовании у случайных многозначных отображений измеримых и согласованных селекторов, с заданной точностью аппроксимирующих некоторую однозначную измеримую и согласованную случайную функцию. Данная теорема усилена в случае, когда рассматриваемое многозначное отображение принимает компактные значения. Доказана теорема, обобщающая на многозначные измеримые случайные отображения теорему Филиппова об обратной функции. Полученные результаты могут быть использованы при доказательстве существования и исследовании свойств решений стохастических дифференциальных включений.

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

Streptococcus Group B contamination of the birth canal in pregnant women: the relevance of the introduction of screening programs

The aim of the study was to determine the frequency of occurrence of group B Streptococcus in women in labour and newborn babies. Materials and methods. prospective study included two groups: group 1 patients (n=35) with full-term pregnancy and term birth, group 2 patients (n=22) with preterm birth in the period from 34 to 37 weeks. All patients upon admission and all newborns was carried out rapid test for Streptococcus group B. Results. in the 1st group, the test was positive in 25.7% of women and 8.6% of newborns. In the 2nd group, the test was positive in 18.2% of women and 22.7% of newborns.a prospective study was conducted of contamination of the genital tract in pregnancy Streptococcus group B. We have formed 2 groups: group 1 patients (n=35) with full-term pregnancy and term birth, group 2 (n=22) patients with preterm birth in the period from 34 to 37 weeks. All patients upon admission and all newborns was conducted rapid test for Streptococcus group B. In the 1st group, the test was positive in 25.7% of women and 8.6% of newborns. In the 2nd group, the test was positive in 18.2% of women and 22.7% of newborns

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

THE EFFECT OF TREATMENT WITH MIFEPRISTONE ON THE QUALITY OF LIFE OF PATIENTS WITH UTERINE MYOMA

Purpose of the study: evaluation of the quality of life of patients with symptomatic uterine myoma up to 12 weeks of gestation against a background of mifepristone 50 mg daily continuously for 3 months.Material and methods. The prospective study involved 141 patients with uterine myoma who received treatment with mifepristone (Gynestril®) 50 mg continuously for 3 months. In order to evaluate changes in the volume of uterine bleeding, each patient kept a diary where she registered the number of sanitary napkins used. Sonographic examination was used to evaluate the size of the uterus and fibroids. The Visual Analogue Scale (10-point VAS scale) was used to assess the pain intensity. Quality of life of patients and their satisfaction with the therapy was also evaluated by a 10-point VAS scale. The complaints, physical examination data and results of sonographic studies were recorded before and immediately after the end of treatment (1st and 2nd visits).Study results. Drug therapy with Gynestril® (mifepristone 50 mg) for patients with uterine myoma for 3 months helped to obtain a statistically significant (p < 0.001) improvement across all the evaluated parameters: in a large majority of patients, control of menstrual blood loss was achieved (decreased duration and volume of bleeding), while 85 patients (60.3%) achieved reversible drug-induced amenorrhea, and 43 patients (30.5%) - oligomenorrhea; a large majority of patients achieved reduction of pain severity according to VAS, while in 118 (83.7%) patients the parameter was estimated as “slight pain/no pain” after the end of treatment. According to the ultrasound results, a statistically significant decrease was achieved in the number of displayable fibroids (from 2.1 to 1.9 at an average), the volume of the dominant myoma node (on average by 65% from 37.34 to 13.27 cm3) and of the uterus (an average of 35% from 182.71 to 118.09 cm3). In addition, a vast majority of patients - 99.9% - evaluated the quality of life and satisfaction with treatment as high.Conclusions. Therefore, the results of the study demonstrate that Gynestril® is highly effective, safe and promising in the pharmaceutical treatment of uterine fibroids

ROLE OF ULTRASOUND AND MAGNETIC RESONANCE IMAGING IN DIAGNOSIS OF OVARIAN AND DEEP ENDOMETRIOSIS

Endometriosis is common among women of reproductive age. Due to its nonspecific clinical picture, a correct diagnosis of endometriosis is especially important in developing an effective treatment plan. Ultrasound and magnetic resonance imaging with correct interpretation, and combined with differential diagnosis, is essential for determining the location and spread of endometriosis, which helps optimize the surgical treatment

Possible orthoor heterotopic transplantation of cryopreserved ovarian tissue

The article presents information on the possibilities for the cryopreservation of ovarian tissue with subsequent ortho - and heterotopic transplantation in patients receiving cytotoxic therapy

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