The aim: About 10% of socially active women of reproductive age suffer from endometriosis, is determined by the frequent occurrence of menstrual and reproductive functions disorders, and pelvic pain syndrome in patients. The difficulties of therapeutic treatment of chronic pain syndrome in external genital endometriosis (EGE) are associated with polymorphism of pain mechanisms, and delayed diagnosis and treatment. The aim of the study is to improve the effectiveness of the treatment of external genital endometriosis. Material and methods: We examined 60 female patients of reproductive age, 40 – with histologically verified diagnosis of external genital endometriosis and 20 healthy women. We used the following methods of examination: general clinical, instrumental, endoscopic, morphological, the Visual Analogue Scale (VAS) to quantify pain, the Beck Depression Scale and the SF-36 questionnaire. Results: Before the treatment of patients with EGE, VAS scale scores indicated pain in 100% of patients, the indicators of depression and level of anxiety go beyond the normative. The results of the pre-treatment questionnaire indicated lower quality of life scores on the scales of physical and mental health components. As a result of treatment there was significant decrease in the manifestations of pain, depression and anxiety, with women receiving complex therapy (hormone therapy got antidepressants and non-drug correction methods). Сonclusions: Chronic pelvic pain syndrome associated with EGE and accompanied by an unfavorable psychological state, depressive states, anxiety symptoms, and psychosomatic disorders. New approaches to the treatment of clinical manifestations of EGE are needed, taking into account patients’ psycho-emotional status and the life quality analysis. We pathogenetically justified the use of drugs that affect the psychosomatic status of patients with EGE and showed that they could significantly improve the quality of life.
The aim of the research: to optimize the treatment of patients with combined genital pathology, including internal endometriosis (adenomyosis) and inflammatory diseases. Materials and methods: prospective study has been conducted on 160 women with adenomyosis. There were 24 (15 %) patients with the I degree of adenomyosis spreading, 72 (45.0 %) women with the II degree, 33 (20.6 %) patients with the III degree, and 31 (19.4 %) woman with the IV degree of adenomyosis spreading. Microbial flora analysis included bacterioscopic, bacteriological research methods with determination of sensitivity to antibiotics, and PCR method. The concentration of cytokines in the culture medium (supernatant) was determined by the enzyme immunoassay. Results: the obtained data from the study indicate a high percentage of the combination of adenomyosis with chronic inflammatory diseases of the pelvic organs. An immuno-inflammatory reaction preceding adenomyosis is accompanied by the violation of the local cytokine balance. In turn, the increased activity of cytokines and the presence of infectious agents can participate in the relapse of endometriosis. Conclusion: considering the immuno-inflammatory reaction, accompanied by the violation of the local cytokine balance in the development of adenomyosis. The study substantiates the necessity of using antimicrobial therapy in patients with combined genital pathology, including adenomyosis and inflammatory diseases
Изучено особенности белкового обмена при беременности отягощенной внутриутробным инфицированием различной этиологии (вирусной, бактериальной и смешанной вирусно-бактериальной). Каждая из групп была дополнительно разделена на подгруппы в зависимости от реализации внутриутробного инфицирования. Установлено, что в наибольшей степени на белковый состав крови влияет вирусная инфекция, что проявилось в повышении уровня иммуноглобулинов Ключевые слова: внутриутробные инфекции, белковый обмен, протеинограмма, реализация внутриутробной инфекции, иммуноглобулины, гипопротеинемия, диспротеинемия
Objectives. To study the nature of changes in some indices of systemic immunity and cytokine profile in pregnant with recurrent form of HSV-1,2 in the 2nd and 3rd trimesters of pregnancy. Materials and methods. The study involved examination of 50 pregnant with urogenital recurrent herpes virus infection with ultrasonographic signs of intrauterine infection of the fetus at gestational term of 28-41 weeks. Group 1 included 28 pregnant with active stage of infection; Group 2 comprised 22 pregnant with latent course of the disease. Control group consisted of 50 healthy pregnant at the same gestational term without bacterial or viral infection. The study involved the assessment of population and subpopulation content of the circulating pool of lymphocytes in serum by flow cytometry, determination of systemic profile of IL-1β, IL-6, IL-10, TNF-α in serum and local level of TNF-α in vaginal secretion by ELISA. The comparison with the control group was carried out using the nonparametric Mann-Whitney test. Results. In the 2nd and 3rd trimesters of gestation the pregnant with recurrent genital herpes, regardless of its form, were found to have a deficiency of circulating pool of lymphocytes with phenotype CD4 +, CD8 +, an increase in NK cells and markers of early (CD25 +) and late (HLA-DR) activation. The study showed an increase in the level of proinflammatory cytokines IL-1β, TNF-α, IL-6 and a decrease in the anti-inflammatory mediator IL-10 at a statistically significant level compared with the indices for physiological pregnancy. The increase in the circulating pool of pro-inflammatory cytokines was accompanied by an increase in the local production of TNF-α in vaginal secretion. Conclusions. 1. In the 2nd and 3rd trimesters of gestation the patients with recurrent genital herpes, regardless of the stage of the infection, secondary to a decrease in the circulating pool of CD3+, CD4+, CD8+ lymphocytes, were shown to have an increase in the killer activity of lymphoid cells with a simultaneous increase in the number of lymphocytes bearing markers of cellular cytotoxicity activation (CD25+, HLA-DR), which indicated a priority in the expression of cytotoxic reactions. 2. Recurrence of genital herpes virus infection in the 2nd and 3rd trimesters of gestation was associated with a shift in Th-1/Th-2 ratio towards Th-1predominance, which was expressed by an increase in the systemic level of IL-1β, TNF-α with a decrease in IL-10 peripheral circulation. 3. Recurrent genital herpes in the 2nd and 3rd trimesters of gestation was accompanied by an almost 3-fold increase in the local level of TNF-α, compared with physiological pregnancy, more severe in the active form compared with the latent one.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.