Restoration of the physiology of the vulvar epithelium in girls with dermatosis of various genesisThe article provides literature data on variants of dermatoses of the vulva skin and clinical examples of eliminating manifestations of itchy dermatosis, inflammatory and allergic reactions, as well as trophic damage to the epithelium of the external genitalia in girls and girls using a combined cosmetic for external use with sodium hyaluronate and a natural phytocomplex with antioxidant, estrogen-like, antiseptic and regenerating effects.
Features of the use of dydrogesterone for the treatment of uterine bleeding in patients under the age of 18 yearsDespite the long period of use of progestin agents to regulate the rhythm of menstruation in abnormal uterine bleeding (AMB), data on the effectiveness of such treatment vary from 21 to 97%. Such a significant difference in the frequency of achieving a regular rhythm of menstruation after treatment with gestagens is due to differences in the prescribed drugs, the route of their administration and treatment regimens. The recommended treatment regimens for the use of gestagens in AUB are contradictory and have not been verified in adolescents. In the presented work, an analysis of the effectiveness of the use of dydrogesterone to stop uterine bleeding and subsequent regulation of the rhythm of menstruation in patients under the age of 18 years was carried out. In the present work, an analysis of the effectiveness of the use of dydrogesterone to stop AUB and subsequent regulation of the rhythm of menstruation in patients under the age of 18 years was carried out. Confirmation of high efficacy and good tolerability of dydrogesterone at a daily dose of 30 mg to stop AUB and at a daily dose of 20 mg when taken on days 11-25 of the simulated cycle to regulate the rhythm of menstruation was obtained. Predictors of AUB recurrence have been identified and mathematically substantiated, taking them into account in clinical practice will help increase the effectiveness of treatment of patients with uterine bleeding.
Pathogenesis of endometriosis in adolescence: role of systemic inflammation, neoneuro-and neoangiogenesisDespite a growing number of publications, the pathogenesis of endometriosis remains unclear. Endometrioid cells can originate from cells with signs of multipotency, including from the basal layer of the endometrium, Müllerian ducts, bone marrow, and peritoneal mesothelium. The ability of endometrial stem cells to cyclic regeneration in the abdominal cavity against the background of local hyperestrogenism and hypoxia, apparently, plays a key role in the etiopathogenesis of endometriosis with a combination of both hereditary and acquired factors. The article deals with modern aspects of implantation, metaplastic, immune, dysontogenetic and hemato-/lymphogenous hypotheses of endometriosis development. Particular attention is paid to the development of an inflammatory reaction in the pathogenesis of the disease and modulation of the immune response against the background of a hyperestrogenism, as well as a decrease in the cytotoxicity of natural killers, a violation of the activity of steroidogenesis enzymes and the activation of mechanisms of tissue damage and repair. The mechanisms of estrogen effects realization are described concerning the polarization of macrophages, the activation of angiogenesis and neurogenesis in the development of the disease, and the enhancement of pain impulses.
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