The results of epidemiological studies of risk factors for the development of dystrophic diseases of the vulva (DDV) in women of reproductive and perimenopausal age are presented. Authors executed the testing of DDV patients according to specially developed questions of the questionnaire, aimed at the obtaining of the most complete information about the lifestyle of patients, social and medical factors, possibly contributing to the occurrence and formation of DDV. Also, the authors performed an examination of patients for the most common sexually transmitted infections (STIs), and urogenital infections in order to clarify the infectious factor in the genesis of dystrophy of the vulva. Direct and indirect factors that contribute to the formation of dystrophic diseases of the vulva in women are established to be as follows: perimenopausal age; endocrine diseases; emotional stress of a social character; more than 3 pregnancies in anamnesis; presence of STIs (herpes simplex virus, cytomegalovirus) and inflammatory diseases of the pelvic organs; presence of Candida fungi, Ureaplasma urealyticum bacteria, human papillomavirus - HPV 16/18, HPV 31/33 and some other infections on the background of DDV; lack of information about the disease; discharge from the genital tract; lack of treatment-effect; inappropriate treatment. The identified factors should be taken into account in the development of therapeutic and preventive measures in relation to DDV in women.
BACKGROUND: Reactive oxygen species play important and ambiguous role in carcinogenesis, and local oxidative metabolism may differ significantly from systemic metabolism and determine the processes occurring in tumor tissues. AIM: This study aimed to examine the expressions of key oxidative metabolism genes, particularly CYB5R, POR, NOX4, SOD1, NF-B, and NRF2, in ovarian neoplasm tissues, and determine cytochrome b5 reductase and cytochrome P450 reductase activity, blood neutrophil activity, and antioxidant indices in the blood plasma and peritoneal fluid. MATERIALS AND METHODS: The study included two groups of patients: a study group (n = 10) with ovarian adenocarcinoma and a comparison group (n = 6) with benign ovarian neoplasms. The expressions of CYB5R1, CYB5R2/R4, CYB5R3, POR, BIRC3, NOX4, NRF2, NF-B, SOD1, HMOX1, and BCL2 genes, cytochrome b5 reductase, and cytochrome P450 reductase activity, oxidative activity of blood neutrophils, and antioxidant potential of plasma and peritoneal fluid were evaluated in these two groups of women. RESULTS: The expression levels of CYB5R3 and BCL2 were significantly lower in adenocarcinoma tissues. The activities of cytochrome b5 reductase and cytochrome P450 reductase increased in the group with adenocarcinoma. On average, the activity of blood neutrophils corresponded to the reference values. For blood plasma, the antioxidant capacity were not different, whereas the antioxidant capacity in the peritoneal fluid increased approximately twofold in ovarian cancer. CONCLUSIONS: Significantly increased cytochrome b5 reductase activity in adenocarcinoma tissues may be a response to intracellular oxidative stress, whereas CYB5R3 gene expression may be reduced by a negative feedback mechanism. The activities of cytochrome P450 reductase and its gene change to a lesser extent in the presence of ovarian adenocarcinoma. The oxidative balance in the blood and peritoneal fluid correlated with the tissue expressions of NF-B and NRF2.
The habitual miscarriage of the pregnancy is one of the most urgent problems in obstetrics and gynecology. There was performed a study of the antioxidant activity of blood plasma by kinetic chemiluminescence, the determination of tryptophan fluorescence was used to evaluate the oxidative modification of albumin. The study included 28 pregnant women with the threat of abortion (TA), 19 of them had a diagnosis of habitual miscarriage, and 9 women - an undeveloped pregnancy. The control group 1 included 61 women with normal pregnancy, the control group 2 - 22 non-pregnant women, control group 3 - 5 women after spontaneous miscarriage (up to 22 weeks).The results showed spontaneous abortion to be followed by the decline in the antioxidant capacity of the plasma, which indicates to the development of oxidative stress; on the contrary, in women with an undeveloped pregnancy, the antioxidant capacity was higher. In the determination of the proportion of oxidized albumin in all patients, but nonpregnant women, there were noted negative values indicating to the presence of specific antibodies or, possibly, cytokines possessing tryptophan fluorescence.
Metabolic syndrome characterized by tissue insulin resistance, hyperinsulinemia, impaired glucose tolerance, essential hypertension, dyslipidemia, and abdominal obesity and hyperuricemia in the same patient, not accidentally is causing the great interest of researchers. In clinical lecture there are presented data concerning both different variants of the metabolic syndrome (MS) and its prevalence rate in the population. There are given as well diagnostic criteria for MS as algorithm of examination ofpatients. There is considered the concept of the treatment of metabolic syndrome.
The purpose of this study is to evaluate the effectiveness of focused ultrasound (FUS) ablation as monotherapy for uterine fibroids in women planning a pregnancy. Of the 195 patients included in the study, long-term pregnancy occurred in 38. At the same time, immediately after FUS ablation, without prescribing additional methods of treatment, 7 patients became pregnant. Given the high frequency of additional surgical treatment methods (conservative myomectomy, hysteroresectoscopy), as well as additional procedures for FUS ablation, this method, despite its high efficacy in treating symptomatic myomas, cannot be recommended by us as the only treatment for uterine fibroids in women planning a pregnancy.
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