Risk factors for external genital endometriosis

One of the most common forms of violation of the reproductive system of a woman is endometriosis. It is assumed that the genetic predisposition and environmental factors are closely related to the development of endometriosis. However, despite the high prevalence of endometriosis among women of reproductive age, the risk factors or markers for the development of the disease remain largely unknown. The aim of the study was to identify risk factors for external genital endometriosis. Materials and methods. Study design: retrospective case-control. The study included 154 women. Group I included 77 women with histologically verified external genital endometriosis. Group II consisted of 77 women without endometriosis, who underwent endoscopic surgery due to various diseases of the pelvic organs. Results. The results of the study showed that the most significant risk factors for endometriosis are the early onset of menarche (< 11 years), a shortened menstrual cycle with prolonged menstruation, active and passive smoking, the presence of furnace heating and uterine fibroids, a family history of breast cancer. Typical complaints of patients with endometriosis are pelvic pain, dysmenorrhea and dyspareunia. Conclusions. Further studies are needed to study the significance of these factors in the diagnosis of endometriosis and the understanding of its etiology

Септический шок в акушерстве: клинические рекомендации Общероссийской общественной организации «Федерация анестезиологов и реаниматологов»

В статье отражены основные положения клинических рекомендаций по септическому шоку в акушерстве, утвержденных Общероссийской общественной организацией «Федерация анестезиологов и реаниматологов» в 2022 г. Актуальность проблемы связана с высокими показателями летальности и заболеваемости от сепсиса и септического шока в акушерстве. Последовательно представлены основные вопросы этиологии, патогенеза, клинической картины, методов лабораторной и инструментальной диагностики, особенности применения шкал qSOFA, SOFA, MOEWS, SOS, MEWC, IMEWS для верификации сепсиса. В статье представлена стартовая интенсивная терапия (первые 6–12 ч) лечения септического шока в акушерстве с учетом особенностей организма беременной женщины. Описана стратегия назначения вазопрессоров (норэпинефрин, фенилэфрин, эпинефрин), инотропных препаратов (добутамин), представлены антибиотики и оптимальные схемы антибактериальной терапии, особенности инфузионной и адъювантной терапии. Обсуждены вопросы хирургического лечения очага инфекции и показания к гистерэктомии, а также организация медицинской помощи и реабилитация пациенток, перенесших сепсис и септический шок. Описаны основные принципы профилактики развития сепсиса и септического шока в акушерстве. Представлены критерии качества оказания медицинской помощи пациенткам с септическим шоком и алгоритмы действий врача при диагностике и интенсивной терапии пациенток с септическим шоком в акушерстве

COVID-19 impacts the sexual function of women

Aim . Sexual function plays an important role in normal human life, along with sleep and food. As it is behind the main human motivations and can manifest itself in any phase of sexual activity or at any time of sexual life, the sexual function is considered as an important factor in determining the quality of life in adults. Here we aimed to estimate the influence of novel coronavirus disease (COVID-19) on the sexual function of women. Materials and Methods . Our study enrolled 364 women (17-59 years of age) who admitted to the gynecological units of Kemerovo (Russia). A Female Sexual Function Index (FSFI) questionnaire was used to assess the clinical manifestations of sexual dysfunctions. The key FSFI indicators include desire, arousal, lubrication, orgasm, and satisfaction before and during the COVID-19 pandemic, the number of sexual contacts, the age of the partner, the duration of the relationship and cohabitation, and the assumption to have sexual dysfunction. Results . The sample was divided into 6 age groups: < 17 years (n = 2), 18-29 years (n = 121), 30-39 years (n = 136), 40-49 years (n = 80), 50- 59 years (n = 25), and ≥ 60 years of age (n = 0). All examined parameters of sexual dysfunction have been impacted by the pandemic. In particular, we documented the reduced sexual arousal, lubrication, and satisfaction as well as increased pain during the sexual intercourse. Risk factors for the development of female sexual dysfunction were age of the sexual partner, the duration of the relationship, the frequency of sexual intercourse, and baseline psychological state. Conclusion . COVID-19 pandemic has been associated with the considerable impairment of the female sexual function

The effect of diet therapy on the anthropometric and metabolic parameters in women with infertility and obesity

Aim: to monitor the anthropometric, hormonal and metabolic parameters in women of reproductive age with infertility and grade I gluteofemoral obesity during treatment with a balanced hypocaloric diet.Materials and methods. The study included 23 infertile women of reproductive age. All patients were prescribed a balanced, low-calorie diet (1200 kcal/day), exercise, and behavioral therapy. The anthropometric, metabolic and hormonal parameters were determined before and 12 months after the treatment. We measured the levels of leptin, total cholesterol, triglycerides, triglycerides, high-density and low-density lipoprotein cholesterol (HDL cholesterol and LDL cholesterol), fasting glycose. Following the measurements, the atherogenic and insulin resistance indices were calculated. In addition, the plasma concentrations of luteinizing hormone, follicle-stimulating hormone, prolactin, estrone, estradiol, testosterone, progesterone, and immunoreactive insulin were measured.Results. Twenty patients completed the study. A decrease in body weight (by average of 10.58 ± 5.70 kg) was found in 87 % of patients; in parallel, the body mass index decreased from 32.53 ± 1.40 to 28.55 ± 2.50 kg/m2 (p &lt; 0.001). The decrease in body weight was accompanied by a statistically significant decrease in the levels of leptin (p &lt; 0.001), estrone (p = 0.049), estradiol (p = 0.032), total cholesterol (p &lt; 0.001), triglycerides (p = 0.004), LDL cholesterol (p = 0.001), fasting glycose (p &lt; 0.001), insulin resistance index (p = 0.002), atherogenic index (p &lt; 0.001) and an increase in the level of progesterone (p = 0.030). The ovulatory menstrual cycle was restored in all women (p = 0.007); within one year, wanted pregnancy occurred in 1 woman.Conclusion. The use of a low-calorie diet for 12 months in infertile women with grade I gluteofemoral obesity leads to normalization of metabolic parameters, weight loss and, the restoration of the ovulatory menstrual cycle in 100 % of cases

ALTERNATIVE APPROACHES TO THERAPY FOR ENDOMETRIAL HYPERPLASTIC PROCESSES IN PERIMENOPAUSE

The study included 68 perimenopausal patients. Group 1 comprised 34 women with endometrial hyperplastic processes (a study group); Group 2 consisted of 34 women without endometrial pathology (a control group). The authors conducted physical examination, small pelvic ultrasonography, hysteroscopy with endometrial biopsy, measured the urinary estrogen metabolites 2-OHE1/16α-OHE1 ratio by enzyme immunoassay, and determined the levels of total estrogens. Statistically significantly increased 16α-OHE1 concentrations, a low 2-OHE1/16α-OHE1 ratio, and elevated levels of total estrogens were found in Group 1 women. No recurrent endometrial hyper- plasia, as well as lower levels of total estrogens and 16α-OHE1 and a higher 2-OHE1/16α-OHE1 ratio were observed after using indi- nol in a dose of 300 mg/day for 3 months in 20 patients from the study group

IMPACT OF MECHANICAL MYOCARDIAL INJURY PRODUCTS, LPS AND THEIR COMBINATION ON HUMAN UMBILICAL VEIN ENDOTHELIAL CELLS

Complicated systemic inflammatory response (SIR) often determines the outcome in patients after cardiac surgery. Systemic endothelial activation plays the most important role in SIR pathogenesis. We have studied the impact of mechanical myocardial injury products, LPS and their combination on human umbilical vein endothelial cells (HUVEC). We have found that HUVEC increase the production of proinflammatory cytokines in response tocardiomyocyte cytosolic fraction responsible for mechanical injury modeling. 2% cytosolic fraction containing 0.204 ng/mL of Hsp70 was a greater stimulus for endothelial cells to produce IL-6 and IL8 than moderateendotoxin concentrations