Ethnic difference of neuroendocrine regulation in women with reproductive disturbances associated with genital tuberculosis

Genital tuberculosis is an actual socially significant disease associated with tubal peritoneal infertility, as well as hormonal disorders of women of fertile age. Studies of the prevalence of genital tuberculosis among women with infertility in other countries and various ethnic groups have not been found, but ethnic factors must be taken into account when assessing epidemiology, causes, clinical characteristics of the course and outcomes of many diseases. The aim of the work was to establish the clinical and hormonal features of reproductive disorders associated with tuberculosis of the genital organs in women of the two main ethnic groups in the Republic of Buryatia. Hormonal features have been revealed in women with reproductive disorders and genital tuberculosis, which are characterized by a statically significant decrease in the levels of estradiol, progesterone and free testosterone in the blood serum compared to women in whom genital tuberculosis has not been verified. When analyzing ethnic characteristics, it is shown that for women with reproductive disorders associated with genital tuberculosis, a decrease in the level of ovarian hormones in the blood serum is characteristic, and also a higher level of free testosterone and a decrease in free T4 in serum for women in the Buryat ethnogroup with the Russians. Timely detection of a decrease in the level of ovarian hormones in women with reproductive disorders and genital tuberculosis will allow rational and effective correction of hypogonadism

Prognosis and diagnosis of reproductive disorders associated with genital tuberculosis in women

Diagnosis of tuberculosis of female genitalia is based on a complex of traditional and new diagnostic methods used in a certain sequence in outpatient and/or inpatient settings. Because of insufficiently effective diagnostic tests, genital tuberculosis is often detected in irreversible anatomical changes, when the prospects for restoring the reproductive function are unsatisfactory. The aim of the work was to identify socio-economic and biomedical risk factors for reproductive disorders associated with genital tuberculosis in order to create statistical models for the prediction and diagnosis of these disorders. To study the connection between the presence of genital tuberculosis and a number of prognostic and diagnostic features, the method of nonlinear regression analysis (logistic regression) was used. Statistical models of prognosis and diagnosis of reproductive disorders associated with genital tuberculosis (HT) in women at the outpatient stage are proposed. The forecast model included clinical and anamnestic predictors: prolonged subfebrile condition, weight loss, increase in inguinal lymph nodes, membership in the social group «female students», contact with tuberculosis patients, tuberculin specimen turnover, presence of pulmonary tuberculosis in the anamnesis. The statistical diagnostic model included the following important methods: enzyme immunoassay, laser fluorescence method, Diaskin-test, hysterosalpingography (segmented fallopian tubes), determination of progesterone, estradiol and testosterone levels in the blood serum (decrease of these hormones)

Basic mechanisms of primary infertility in reproductive age women with hypothalamic dysfunction in puberty

Hypothalamic dysfunction is the most common pathology of the puberty and is accompanied by obesity in 39 % of adolescent girls. Obesity is one of the main causes of reproductive function disorders leading to decrease infertility in women. The aim of the study is to assess the gynecological health of reproductive age women with hypothalamic dysfunction in puberty and to determine the mechanisms of the primary infertility formation. We conducted a prospective study of adolescent girls with hypothalamic dysfunction (n = 170) from 2000 to 2013 year. According to the screening criteria, fertility was assessed in 86 women of reproductive age, a comparative characteristic was performed in fertile women (n = 46) and in women with primary infertility (n = 21). PCOS (38.1 %), absence of ayellow body in one of the ovaries (71.4 %), a decrease in serum progesterone by 2 times, an increase in ERa/PGR by 2.3 times and activity of NF-kB by 1.4 times in the endometrium were detected significantly more often in women with primary infertility with hypothalamic dysfunction in puberty in comparison with fertile women. The level of ERa and PGR in the endometrium decreased with increasing activity of NF-kB and BMI. The relationship between the activity of NF-kB and BMI in both study groups was established

FREQUENCY OF INFLAMMATORY DESEASES OF UROGENITAL REGION IN MEN WITH CHRONIC TRICHOMONIASIS INFECTION AND PATHOSPERMIA

The article presents results of the examination of 39 males with chronic trichomoniasis. Revealed a high frequency of inflammatory diseases of urogenital region: in 72 % of cases was detected chronic prostatitis, in 5 % of cases — epididymitis, in 2,5 % of cases — vesiculitis. In 62 % of men with chronic trichomoniasis was detected patospermia. This results evidence suggests a possible participation of Trichomonas vaginalis in the development inflammatory diseases of urogenital region and disorder of reproductive function of men

Features of Chronic Endometritis in Women of Reproductive Age with Polycystic Ovary Syndrome

Background. The prevalence of chronic endometritis among women of reproductive age reaches 68 %. Polycystic ovary syndrome (PCOS) is a common cause of reproductive disorders. Data on the characteristics of the manifestation of chronic endometritis in patients with PCOS are incredibly insufficient. PCOS is known as closely associated with metabolic syndrome and chronic systemic inflammation. However, there is no information on the role of chronic systemic inflammation in the pathogenesis of chronic endometritis in women with PCOS.The objective. Determination of the clinical and morphological features of chronic endometritis in women  with polycystic ovary syndrome and to establish the role of systemic inflammation and hormones of the  hypothalamic-pituitaryovarian axis in chronic endometritis associated with PCOS. Materials and methods. We performed a cross-sectional study from May 2017 to December 2019 and examined 198 women of reproductive age (33.71 ± 5.93 years) during annual preventive examinations. We used clinical, instrumental, and laboratory research methods, including hormonal, biochemical,  immunohistochemical techniques, and statistical analysis.Results. Of the 198 women examined chronic endometritis was diagnosed in 76 patients, including 15 patients with PCOS. Chronic endometritis in PCOS is characterized by a relative decrease in the duration of the menstrual cycle and less pronounced lymphoid infiltration of endometrial tissue. The risk of chronic endometritis in women of reproductive age is not associated with changes in gonadotropins, prolactin, and  manifestations of clinical and biochemical hyperandrogenism. Chronic endometritis is not accompanied by an increase in the concentration of C-reactive protein. At the same time, BMI, waist circumference, and leptin are considered «anti-risk» factors for chronic endometritis.Conclusion. The specific clinical manifestations of chronic endometritis in PCOS allows us to consider them as diagnostically significant. The revealed negative associations of chronic endometritis with BMI, waist  circumference, and leptin require further investigation of the role of adipose tissue products in the control of local and systemic inflammation

Uterine fibroid and its association with metabolic syndrome in women of reproductive age (literature review)

Uterine fibroid is one of the most common gynecological diseases in women of reproductive age and many aspects of this disease remain the subject of investigation. In particular, the role of the metabolic syndrome is of interest as a potential predictor of uterine fibroid or a comorbid condition that has pathogenetic significance.   The aim of this literature review is to systematize current data on the prevalence and associations of the metabolic syndrome and uterine fibroid in women of reproductive age.   Literature search was carried out using the scientific literature databases eLIBRARY, PubMed, NCBI, CyberLeninka, and the official IDF website for the period from 2010 to 2022. In PubMed search, we used the following terms: uterine fibroid, metabolic syndrome, uterine fibroid and metabolic syndrome, uterine myoma and metabolic syndrome, uterine myoma and metabolic disorders, uterine myoma and MetS. A total of 439 sources were analized, 32 sources met the search criteria.   Results. An analysis of the largest epidemiological studies conducted in recent years, both in non-selective populations and in hospital samples, demonstrates a significant prevalence of both uterine fibroid and metabolic syndrome among women. The results presented in the publications which were included in the review indicate that there is a relationship between the presence of uterine fibroid and the manifestations of the metabolic syndrome.   Conclusions. Uterine fibroid and metabolic syndrome are mutually aggravating conditions. Women with uterine fibroid have a worse risk profile for cardiovascular disease, and the presence of metabolic syndrome increases the risk of uterine fibroid. One of the ways to reduce the risk of occurrence and growth of uterine fibroid is the timely correction of the metabolic syndrome and its components. On the other hand, the presence of uterine fibroid should be considered as a basis for active detection of metabolic disorders and cardiovascular risks

Comprehensive rehabilitation of patients with movement disorders with spastic forms of cerebral palsy

Until now, there is no radical method of treating children with cerebral palsy, which allows us to consider scientific research in this direction reasonable and promising.The aim of the research: to study the effect of exercises on the mini-simulator “Kinesioplatform-swing” with biofeedback on the indicators of motor skills in children with spastic cerebral palsy.Materials and methods. We conducted an open, non-randomized, prospective, comparative, controlled study in pairs (each participant in the main group corresponds to a participant in the control group). The study involved 53 patients aged 4–12 years with cerebral palsy: the intervention group (group 1: n = 27 (13 boys, 14 girls)) and the control group (group 2: n = 26 (11 boys, 15 girls)), comparable in terms of gender, age and severity of movement disorders. Characteristics of the medical intervention: group 1 – botulinum toxin type A (BTA, for exercising against the background of relative muscular normotonus) + exercise therapy + exercises on the mini-simulator “Kinesioplatform-swing” with biofeedback (BFB); group 2 – BTA + exercise therapy. Duration of the study: 2019–2020. The difference between groups in terms of motor skills on the day of hospitalization and after completion of the training program (10 sessions each) was determined. Motor skills were assessed according to the GMFM-66/88 (Gross Motor Function Measure) table using the “Scales for measuring global motor functions”.Results. The inclusion of additional exercises on the mini-simulator “Kinesioplatformswing” with biofeedback in the rehabilitation of patients with movement disorders with spastic cerebral palsy (BTA + exercise therapy) in comparison with the control group. However, the question of the long-term effects of such training remains open and requires further study

Detection of genes of pathogenicity of symbiotic microflora in adjacent biotopes in women with chronic endometritis and reproductive disorders

Recent researches established microecological relationships between intestinal, vaginal and nasopharyngeal biocenoses in the composition of a macroorganism microbiome. This study included 57 women with chronic endometritis and 21 woman without it (control group). In women with chronic endometritis all studied pathogenicity genes (asal, cylA, stxl and stx2) were identified in representatives of symbiotic microflora in all three studied habitats - vaginal, intestinal and nasopharyngeal, which confirms the presence of a reservoir of potential pathogenicity. Studied genes of pathogenicity were diagnosed in women with CE in 8 cases of the bacteria of the species E. faecalis and E. faecium, which are "harbingers" of impending serious problem. This indicates the importance of these species in etiopathogenetic structure of microbiocenoses of studied habitats, and, possibly, their impact on the course of this disease

SPERMATOGENIC TESTICULAR FUNCTION IN MEN WITH CHRONIC UROGENITAL MONOTRICHOMONIASIS AND PATHOSPERMIA

We did not observed significant differences in levels of inhibin B and follicle-stimulating hormone in serum samples of men with chronic urogenital trichomoniasis and different spermogram. It confirmed that spermatogenic testicular function in these men is preserved

Age-related determinants of the metabolic syndrome in women of reproductive age of the main ethnic groups of the Baikal Region

The aim of the study. To determine the age limit of the initial manifestations of the metabolic syndrome in women of reproductive age of the Caucasian and Asian ethnic groups. Materials and methods. The study included women of reproductive age of the Russian and Buryat ethnic groups (n = 1231). We carried out general clinical examination, studied glycemia levels and lipid metabolism indicators. The analysis of the components of the metabolic syndrome was performed taking into account age characteristics and ethnicity. Threshold values for the age of metabolic disorders manifestation were determined. Results. It was found that the main components of the metabolic syndrome in women of reproductive age of the Russian and Buryat ethnic groups were a decrease in  high-density lipoprotein (HDL), an increase in waist circumference, and an increase in blood pressure. The age-related determinants of the metabolic syndrome in the  population of women of reproductive age in the Baikal region were determined. It was shown that the age-related determinants of the metabolic syndrome in Caucasian and Asian women do not differ significantly and amount to 33.5 years (95% confidence interval (95% CI): 32.5; 38.5) and 36.5 years (95% CI: 27.5; 52.5), respectively. A universal critical age value was determined as 34.5 years (95% CI: 32.5; 38.5), which is associated with a significant increase in the prevalence of the metabolic syndrome in accordance with the ATP  III criteria. The ranking of metabolic syndrome criteria in the studied groups revealed the following order of their occurrence: the decrease in HDL index prevailed, followed by the increase in waist circumference, blood pressure, glucose and triglycerides; no dependence on the ethnicity was found. Conclusion. When assessing the age-related determinants of the metabolic syndrome in the mixed Caucasoid-Asian group, it is advisable to use universal approaches, taking into account the cut-off point of age, which is 34.5 years. The determination of age criteria for the correct classification of patients with respect to the manifestations of the metabolic syndrome is necessary to analyze the contribution of the age factor to the implementation of various metabolic syndrome predictors, to  develop prognostic models, and to  use effective age-determined markers of metabolic disorders