Медицинский факультет. Проблемы и перспективы инновационной образовательной программы

The innovative education system developed by the medical faculty of PFUR for preparation of competitive foreign and domestic doctors on the bases of new forms of continuous post gradual education is presented. The first results of realization of the Innovative educational project, problems and prospects are discussed.В статье представлена разработанная медицинским факультетом РУДН инновационная система образования для подготовки конкурентоспособных иностранных и отечественных специалистов с использованием новых форм непрерывного образования в медицине в рамках системы дополнительного последипломного образования (ДПО). Обсуждаются первые итоги реализации Инновационного образовательного проекта, проблемы и перспективы

Антенатальное выявление девятикратного обвития пуповины вокруг шеи (случай из практики)

We present a case of nine nuchal loops of umbilical cord detected antenatally and confirmed at caesarean section We believe this is the largest number of loops detected antenatally and reported in the literature.Впервые описывается случай антенатального выявления девятикратного обвития пуповины вокруг шеи с последующей постнатальной верификацией

Интранатальные причины тяжелого состояния недоношенных новорожденных

In this article we present statistic analysis of delivery tactic in premature labors. The newborns of those mothers who took the tocolitical therapy and prevention of RDS were needed in artificial pulmonary ventilation accordingly in 3,3-5,0 and twice times rarer.В работе представлены данные сравнительного анализа тактики родоразрешения пациенток с преждевременным завершением беременности. У матерей, новорожденные которых нуждались в искусственной вентиляции легких (ИВЛ), токолиз в родах проводили в 3,3-5,0 (в зависимости от срока) раза реже, профилактику респираторного дистресс-синдрома плода (РДС) - в два раза реже, чем у матерей «неаппаратных» детей, в 94,5% случаев отсутствовало обезболивание родов

Особенности послеродовых гнойно-септических заболеваний и подходы к формированию групп риска в современных условиях

In this article we present problems of purulent-septic diseases in postnatal period. We consider questions about formation of risk groups, prophylaxis and cure.В данной статье рассматриваются проблемы ГСЗ, развивающихся после родов. Затронуты вопросы по формированию групп риска, в которых прослеживаются пути возникновения данных осложнений, их профилактики и лечения

Treatment of climacteric disorders in menopause

Treatment of climacteric disorders in menopause Radzinsky V.E., Ordiyants I.M. Peoples’ Friendship University of Russia, Moscow The onset of menopause is one of the most critical periods in a woman’s life. Climacteric syndrome (CS) develops in 65-80% of women as a result of physiological deficiency of estrogens. The most frequent phenomena, associated with the age-related insufficiency of female sex hormones, include disorders from the autonomic nervous system, emotional disorders, atrophic changes in the vaginal wall, skin and mucous membranes, resulting in urogenital chronic inflammatory diseases, dermatitis. These disorders are the decisive factor in the prescription of drugs for CS treatment. The main direction of therapeutic and preventive work is a comprehensive correction of hormone-deficient conditions based on menopausal hormone therapy. However, this therapy can be contraindicative for women with various diseases, such as estrogen-dependent oncological diseases or thrombosis in the anamnesis. In this connection, the so-called «alternative» therapies (selective modulators&nbsp; of estrogen receptors, phytoestrogens, neuropeptide vasomotor blockers) are used. The use of neuropeptide vasomotor blockers showed a confirmed positive effect in the treatment of clinical manifestations of CS. Pineamin®, created by synthesis of&nbsp; a complex of epiphysis polypeptides, is one of such drugs. Pineamin® is a non – toxic drug, which quickly stops neurovegetative symptoms of CS. Key words: climacteric syndrome, menopause, estrogen deficiency, phytoestrogens, neuropeptide vasomotor blockers, Pineamin. For citation: Radzinsky V.E., Ordiyants I.M. Treatment of climacteric disorders in menopause // RMJ. 2018. № 5(I). P.37 –40.<br

Методы улучшения исходов лечения бесплодия, ассоциированного с эндометриоидными кистами яичников

Study Objective: to improve the treatment outcomes of infertility associated with endometriomas, by developing a diagnostic and treatment algorithm. Study Design: randomised comparative study in parallel groups. Materials and Methods. 82 women with infertility and endometriomas were evaluated. An infertility diagnostic and treatment algorithm for patients with endometriomas was developed on the basis of previous therapies and taking into account literature data; and its efficiency was tested. Patients were allocated to one of two groups: group 1 - 38 patients managed with a traditional set of diagnostic and therapeutic tools; group 2 - 44 patients managed with the help of our new algorithm. We compared the rate and characteristics of pregnancies depending on the method used to manage patients with endometriomas. Study Results. In group 1, 14 (36.8%) patients conceived, whereas in group 2, 30 (68.2%) (p = 0.005) patients were pregnant; pregnancies were spontaneous in 6 (42.9%) out of 14 patients in group 1 and in 21 (70.0%) out of 30 patients in group 2 (p = 0.002). The rate of pregnancies after surgical treatment of infertility and endometriomas was 21.4% and 20.0% in group 1 and group 2, respectively. After a repeated surgery, 5 (35.7%) out of 14 patients in group 1 and 3 (10%) patients in group 2 (p = 0.031) managed to conceive. Conclusion. The clinical efficiency of the new algorithm was demonstrated; it allows automating the selection of the management strategy for patients with endometriomas, reducing the time required for medical decisions, and forecasting infertility treatment outcomes.Цель исследования: улучшить исходы лечения бесплодия, ассоциированного с эндометриоидными кистами яичников (ЭКЯ), путем разработки алгоритма лечебно-диагностических мероприятий. Дизайн: рандомизированное сравнительное исследование в параллельных группах. Материалы и методы. Обследованы 82 женщины с бесплодием и ЭКЯ. На основании предыдущего опыта лечения пациенток и с учетом данных литературы разработан алгоритм диагностики и лечения бесплодия у женщин с ЭКЯ, проведено исследование его эффективности. Пациентки разделены на две группы: группа 1 - 38 женщин, при ведении которых был использован стандартный комплекс лечебно-диагностических мероприятий; группа 2 - 44 пациентки, при лечении которых применяли разработанный нами алгоритм. Сравнивали частоту и особенности наступления беременности в зависимости от подхода к ведению женщин с ЭКЯ. Результаты. В группе 1 беременность наступила у 14 (36,8%) пациенток, в группе 2 - у 30 (68,2%) (p = 0,005), при этом беременность была спонтанной у 6 (42,9%) из 14 пациенток группы 1 и у 21 (70,0%) из 30 участниц группы 2 (p = 0,002). Частота беременности после хирургического лечения пациенток с бесплодием и ЭКЯ - 21,4% в группе 1 и 20,0% в группе 2. После повторных операций беременность наступила у 5 (35,7%) из 14 участниц группы 1 и у 3 (10%) пациенток группы 2 (p = 0,031). Заключение. Продемонстрирована клиническая эффективность применения разработанного алгоритма, который позволяет автоматизировать выбор тактики ведения пациенток с ЭКЯ, снизить длительность принятия врачебных решений и прогнозировать исходы лечения бесплодия

СКРИНИНГ ОПУХОЛЕВЫХ ЗАБОЛЕВАНИЙ ОРГАНОВ РЕПРОДУКТИВНОЙ СИСТЕМЫ: ВОЗМОЖНОСТИ И ПЕРСПЕКТИВЫ

The urgency of reproductive system tumor disease (RSTD) screening is caused by high incidence rates, a tendency to renewal of youth, and unsatisfactory therapeutic results. In Russia, indicators of RSTD active detection and diagnosis during preinvasive and early stages remain low. Thus, such diseases adversely affect the women's quality of life, life expectancy and reproductive function. The objective of the paper is to establish the reasons for the inefficiency of RSTD screening analyzing the literature available. Results. Literature analysis of modern screening principles and methods has shown that the main reasons for unsatisfactory RSTD screening and early diagnosis are low screening rates, legislative framework inconsistency, maladjustment at the beginning and the end of examination as well as in screening interval, lack of a single information base where all survey results are recorded and stored, problems in data exchange based on undertaken studies, profound diagnostic limitations in different regions, lack of an integrated approach and a single national screening program. Conclusion. One of the possible solutions to the existing problem can be a comprehensive diagnostic examination with a simultaneous assessment of all organs of the reproductive system, including mammary glands, in order to timely identify RSTD, form risk groups for tumor pathology and correct management.Актуальность проблемы скрининга опухолевых заболеваний репродуктивных органов (ОЗРО) обусловлена высокими показателями заболеваемости, тенденцией к «омоложению», неудовлетворительными результатами терапии. В России показатели активного выявления ОЗРО, диагностики в преинвазивной и ранней стадиях остаются низкими, оказывая неблагоприятное влияние на качество и продолжительность жизни пациентки и ее репродуктивную функцию. Цель исследования. На основании анализа литературных источников установить причины неэффективности скрининга опухолевых заболеваний репродуктивных органов. Результаты. Библиографический анализ современных принципов и методов скрининга показал, что основными причинами неудовлетворительных показателей скрининга и ранней диагностики ОЗРО следует считать низкие показатели скринингового охвата, противоречивость законодательной базы, несогласованность времени начала, окончания обследования и скринингового интервала, отсутствие единой информационной базы с возможностью фиксации и архивирования результатов обследования, нарушение логистики обмена данными проведенных исследований, выраженный диссонанс диагностических возможностей в различных регионах, отсутствие комплексного подхода и единой программы скрининга в масштабах страны. Выводы. Одним из возможных вариантов решения существующей проблемы может стать выполнение комплексного диагностического обследования с одновременной оценкой состояния всех органов репродуктивной системы, включая молочные железы, с целью своевременного выявлении ОЗРО с формированием групп риска опухолевой патологии и коррекцией тактики ведения

Reproductive health of adolescents in Russia: Statistics, problems and prospects of improvement

At the beginning of the 21st century we still face the problem of reproductive health of women, children and adolescents in Russia. Final overcoming of the "Russian Cross" primarily relates to preventing further decline of women in reproductive age and children aged 0-17 years.The following medico-social determinants of women's reproductive health are considered: family prosperity, somatic growth and sexual maturation, chronic extragenital diseases, sexual and reproductive behavior, environmental wellbeing of territory and gynecological care organization. Analysis of gynecological morbidity of Russian girls and adolescents at the beginning of this century spots an upward trend. The results of our anonymous questionnaire survey of socially adapted students among 3327 girls of 13-19 years testify that 59.9% of respondents in this age cohort do not practice daily genitalia toilet. According to our population-based studies, 24.0% of women have first pregnancy at the juvenile age followed by labor in 18.4% of young women, abortion in 81.6%. Menstrual disorders represent the most common symptoms and strong indications of reproductive health problems related, inter alia, to progesterone deficiency which can lead to serious consequences (infertility, miscarriage, breast disease). The choice of medication for the menstrual disorders treatment should consider instruction indications, the lack of limitations and contraindications, need for contraception, concomitant diseases and states, proved efficacy of the medication. Prospects of solving reproductive and demographic problems in the twenty-first century are largely beyond the control of clinicians being aggravated by unresolved environmental and social problems. © 2014 Informa UK Ltd

Efficacy of normalization of vaginal microbiota after antimicrobial treatment for bacterial vaginosis and bacterial vaginosis in pregnant women (results of the multicenter prospective non-interventional comparative study)

V.E. Radzinskiy1, I.B. Manukhin2, I.M. Ordiyants1, V.E. Balan3, E.V. Tikhomirova3, I.V. Sakhautdinova4, E.M. Zulkarneeva4 1Russian University of Peoples’ Friendship, Moscow, Russian Federation 2A.I. Yevdokimov Moscow State University of Medicine and Dentistry, Moscow, &nbsp;Russian Federation 3Moscow Regional Research Institute of Obstetrics &amp; Gynecology, Moscow, &nbsp;Russian Federation 4Bashkir State Medical University, Ufa, Russian Federation Aim: to assess the efficacy and safety of Lactogynal® to normalize vaginal microflora after antimicrobial treatment for bacterial vaginosis (BV) and to prevent recurrences of vulvovaginal candidiasis (VVC) during pregnancy. Patients and Methods: this multicenter prospective non-interventional comparative study included 100 women in the 3rd trimester of pregnancy diagnosed with acute BV (n=50) or acute VVC (n=50). 25 women of each group received standard antimicrobial treatment only. 25 women of each group received Lactogynal® as the second step of antimicrobial treatment. Women were followed up until delivery and discharge. The rate of BV and VVC recurrences before delivery was considered the key indicator of treatment efficacy. In addition, obstetrical and perinatal outcomes, compliance, the type and duration of antimicrobial treatment for BV and VVC were evaluated. Results: in women with BV and VVC who received Lactogynal®, no recurrences during the follow-up were reported (p&lt;0.05). In women who received standard antimicrobial treatment only, the rate of recurrences of BV and VVC was 40% and 28%, respectively. As to the complications of pregnancy, delivery, and the postpartum period, women with BV who received probiotic therapy were less often diagnosed with anemia (p&lt;0.05) while women with VVC who received probiotic therapy were less often diagnosed with the premature rupture of membranes (p&lt;0.05). Conclusions: Lactogynal® is an effective and safe tool to normalize vaginal microflora after antimicrobial treatment for BV and to prevent VVC recurrences during the 3rd trimester of pregnancy. This drug (as a part of complex treatment for BV and VVC) reduces the risk of recurrences and promotes a more favorable pregnancy course until delivery. Keywords: lactobacilli, bacterial vaginosis, vulvovaginal candidiasis, pregnancy, vaginal microflora. For citation: Radzinskiy V.E., Manukhin I.B., Ordiyants I.M. et al. Efficacy of normalization of vaginal microbiota after antimicrobial treatment for bacterial vaginosis and bacterial vaginosis in pregnant women (results of the multicenter prospective non-interventional comparative study). Russian Journal of Woman and Child Health. 2021;4(3):192–200 (in Russ.). DOI: 10.32364/2618-8430-2021-4-3-192-200. <br

Reproductive health of adolescents in Russia: Statistics, problems and prospects of improvement

At the beginning of the 21st century we still face the problem of reproductive health of women, children and adolescents in Russia. Final overcoming of the "Russian Cross" primarily relates to preventing further decline of women in reproductive age and children aged 0-17 years.The following medico-social determinants of women's reproductive health are considered: family prosperity, somatic growth and sexual maturation, chronic extragenital diseases, sexual and reproductive behavior, environmental wellbeing of territory and gynecological care organization. Analysis of gynecological morbidity of Russian girls and adolescents at the beginning of this century spots an upward trend. The results of our anonymous questionnaire survey of socially adapted students among 3327 girls of 13-19 years testify that 59.9% of respondents in this age cohort do not practice daily genitalia toilet. According to our population-based studies, 24.0% of women have first pregnancy at the juvenile age followed by labor in 18.4% of young women, abortion in 81.6%. Menstrual disorders represent the most common symptoms and strong indications of reproductive health problems related, inter alia, to progesterone deficiency which can lead to serious consequences (infertility, miscarriage, breast disease). The choice of medication for the menstrual disorders treatment should consider instruction indications, the lack of limitations and contraindications, need for contraception, concomitant diseases and states, proved efficacy of the medication. Prospects of solving reproductive and demographic problems in the twenty-first century are largely beyond the control of clinicians being aggravated by unresolved environmental and social problems. © 2014 Informa UK Ltd