Changes in vascular wall stiffness and central aortic pressure in women of early post-menopausal period and the possibilities of correction of the revealed disturbances

Measurement of the central aortic pressure and the augmentation may have additional benefits for characterizing the state of the cardiovascular system than the only stiffness of the vascular wall. The purpose of the study is to assess the changes of indicators of central aortic pressure and arterial stiffness in women of early postmenopausal period, against the background of the prolonged use of menopausal hormone therapy 1 mg E2 / 2mg DRSP. Material and Methods. The study included 162 women in early postmenopause. The subjects were divided into 2 groups: primary — 84 patients, which was appointed menopausal hormone therapy 1 mg E2 / 2mg of DRSP (drug "Angelique", Bayer), control group — 78 women who did not receive menopausal hormone therapy. The duration of observation is 5.2 years. ABPM was performed with the evaluation indicators of arterial stiffness (RWTT, Alx, ASI, AASI, (dP/dt) max.), central aortic pressure, aoPW. Results. Initial aoPW increase was detected in 15 (21.4%) women of the main group and in 19 (24.3%) control group patients (p=0,4). The women in both groups showed an increase to the end of the study aoPW more pronounced in women of control group. Increasing falls detected in 25 (29.7%) women of the main group and in 25 (32%) women of control group (p=0.84). It was noted that in women in both groups a significant decrease of central aortic pressure has been matched. In women of the main group to the end of the study there was a reduction in pulse pressure from 38,4±6,2 to 35,3±4,19mm Hg (p&lt;0,001) and the absence of changes in women drops the control group. It is noted a significant increase of Alxao in patients of control group and no change in women of the main group. ASI revealed a decrease in women of the main group with 132.0 (121.0; 142.0) to 127.0 (115.5; 137.0) to the end of the study, and an increase from 133.0 (111.0; 155.0) to 148.0 (134.2; 171.0) in women in the control group (p&lt;0.01). Decrease of AASI in women of the main group to 0.379 (0.320; 0.463) to 0.264 (0.203; 0.329), (p&lt;0.001)and no change in the control group of women has been detected. Conclusion. The measurement of the central aortic pressure and the augmentation may have additional benefits for characterizing the state of the cardiovascular system. The positive changes in arterial stiffness and reflected waves, determining the value of central aortic pressure, on the background of long-term menopausal hormone therapy combined 1 mg E2 / 2 mg DRSP.</p

CONTEMPORARY APPROACH TO TREATMENT OF GYNECOLOGIC DISEASES

The analysis of surgical treatment results of 42 patients with hysteromyoma without prolapsed genitals, operated by means of laparoscopic transvaginal supracervical hysterectomy, was conducted. Advantages of this operative treatment in comparison with classical laparotomic and endoscopic operations were noted. Curative effect of embolization of uterine arteries on hysteromyoma was analyzed on example of 30 patients-women. The advantage of roentgenoendovascular hemostasis was proved in 22 patients with neglected forms of cervical carcinoma

Modern Technologies In Ectopic Pregnancy Diagnostics On Hospital Stage

The present research provides analysis of results of preoperative examination of 680 patients with ectopic pregnancy depending on the range of surgical treatment. It has been shown that in case of progressive ectopic pregnancy the diagnostic significance of concentrations of human chorionic gonadotropin, transvaginal examination and laparos-copy depends on the duration of pregnancy. When the term of ectopic pregnancy is 3-4 weeks monitoring of p chorionic gonadotropin in blood serum (99.5%), transvaginal examination (58%) and laparoscopy (78.5%) are more informative. When the term of ectopic pregnancy is more than 4 weeks there is a high diagnostic value of monitoring p-subunit of chorionic gonadotropin (99.5%), transvaginal examination (68%) and laparoscopy (99,5%). The research has proved that pregnancy period of 3-4 weeks is optimal for laparoscopy and other operation

Empirical therapy for vulvovaginitis in reproductive-aged women in routine clinical practice

Objective. To evaluate the efficiency of empirical therapy with tergynan in reproductive-aged women in routine clinical practice. Subjects and methods. The TERRA multicenter post-registration observational study enrolled 430 reproductive-aged patients diagnosed with acute vulvovaginitis. Based on their complaints, clinical symptoms, and objective examination, the patients received empirical therapy with the combination antimicrobial drug Tergynan as a single vaginal tablet once daily for 10 days. Gynecological examination, pH-metry, and bacterioscopic and bacteriological examinations of discharge (Femoflor-16) were performed, and the time course of changes in clinical symptoms evaluated. Results. There was less vaginal discharge, a complete disappearance of unpleasant odor, and a feeling of vaginal itching and burning (74.5 and 67.1%, respectively). There were increases in the detection rate of Lactobacillus spp. by 2 times with a dissemination level of 106-107 CFU/ml, in the suppression of obligate anaerobic representatives (associations of Gardnerella vaginalis + Prevotella bivia + Porphyromonas spp., as well as Eubacterium spp.) by 5 times, facultative anaerobic bacteria (Enterobacteriaceae and Streptococcus spp.) by 3 times, and yeast-like fungi of the genus Candida by 2 times. Conclusion. This investigation demonstrated the high clinical (96.5%) and microbiological (97.3%) efficiency of empirical therapy with tergynan in 430 reproductive-aged women with acute nonspecific vulvovaginitis. © 2020, Bionika Media Ltd. All rights reserved