INTRODUСTION Unfavorable ecology, demographic situation in Ukraine, somatic and oncologic diseases frequency increase, immunity and living standard decrease have predetermined the increase of number of women with endometrial hyperproliferative processes who stand for 5-20% obstetric-gynecologic profile, according to the statistical data [2, 6, 14, 16, 19]. Nowadays regardless of the scientific achievements, diagnostics, surgery and curative methods improvement, the problem of intrauterine pathology treatment still remains topical in the medical and social aspects which is determined by the high risks of neoplastic transformation and steady tendency towards the recurrence frequency increase (proportional transformation into atypia), which according to the homeland and foreign authors stands for 26 to 78% among women [1, 3, 15, 17-19, 22]. High recurrence frequency serves the ground for the repeated surgical operations [10, 12, 18, 21, 23], and sometimes they are not limited with traditional approaches possibilities, that is increases the topicality study of the main aspects of disease. Relevance of the problem is determined by the probability of the endometrial hyperplastic processes transformation into the endometrial cancer. Numerous researches prove the probability of the oncological processes development with the background of endometrial polyposis from 4% up to 67.2% of patients [13, 24, 25]. The endometrium polyposis treatment methods are standard ones and foresee the polyp's ablation followed by the hormonal therapy, nevertheless the recurrence value remains rather high standing for 25.9% to 78% [4, 5, 11]. The disease's etiopathogenesis complexity, different trends in its stages' interpretation, tactical approaches ambiguity (with and without considering the hormonal disorder individual specific features) constitute definite difficulties while choosing the pathogenetically treatment. These are the circumstances to determine the increased scientific and practical interest in the endometrial polyposis treatment and management [7, 8, 9, 22]. The topicality of our research has been determined by the controversial point of view on the uterus polyps pathogenesis, high recurrence frequency after hormonal therapy, immune system dysfunction and inflammation role in the endometrial polyposis genesis. The purpose of research: to increase the treatment effectiveness of patients with endometrium local hyperplasia (endometrium polyposis) by applying of the new endoscopic technologies and pathogenetically substantiated post-surgery therapy. MATERIALS AND METHODS 66 women aged 24-43 years participated in the research. The treatment algorithm consisted of four stages in accordance with Order of the Ministry of Health or Ukraine No. 676 dated by 31.12.2004. Stage І-hysteroscopic mutated endometrial and polyp ablation followed by the morphological research and the following determination of tactics depending on the pathology type along with the complex anti-inflammatory, anti-bacterial and anti-viral treatment. Stage II-horm...
Research aim: to evaluate the effectiveness of therapy aimed at preventing endometrial hyperplasia recurrence in premenopausal women.Materials and methods. Clinical and paraclinical examinations of 76 premenopausal women were carried out. Transvaginal ultrasound was performed, levels of estradiol, progesterone, homocysteine, folic acid, serum HOMA index evaluated, body mass index and blood pressure assessed. Women were divided into two groups after histological results obtained: the main group included 40 women who received oral progestins (dydrogesterone 10 mg) twice a day in combination with Depapilin® 395 mg twice a day; the comparison group included 36 women who received only oral progestins (dydrogesterone 10 mg) twice a day. Comparison of the therapy effectiveness was performed 6 and 9 months after the start of treatment.Results. Endometrial thickness stabilized within 9 months in women of the main group, and was within the physiological norm (before treatment – 22 ± 3.1 mm, 6 months after the start of treatment – 8,3 ± 0.46 mm, after 9 months – 9,7 ± 0.31 mm, p <0.05). The positive treatment effect consisted in a significant decrease in the frequency of endometrial hyperplasia recurrence, which was 17 (17.5%) cases in the main group and 16 (44.4%) cases in the comparison group (p <0.05). Women of the main group also showed stable normalization of the level of estrogen and progesterone, a steady decrease in the level of homocysteine and a synergistic increase in the level of folic acid, normalization of blood pressure and reduction of body mass index.Conclusions. Depapilin® inclusion in the basic therapy of endometrial hyperplasia in premenopausal aged women is pathogenetically justified due to the complex effect of the drug components on the extragonadal estrogens synthesis and the antiproliferative effect on the endometrium.
Вивчали зв'язок між показниками мозкового кровообігу і сенсомоторними показниками у людей на різних ета-пах адаптації до середньогір'я. Дослідження проводили до, під час та після тритижневого перебування в горах на висоті 2100 м, а також під час короткочасних підйомів без фізичного навантаження на висоту 3900 м. Виявлено, що в початковому періоді адаптації до гіпоксії спостерігається десинхронізація між нервовими процесами в корі головного мозку і мозковим кровообігом, спостерігається інверсія і збільшення асиметрії мозкового кровообігу в бік домінування лівої півкулі головного мозку. При стійкій адаптації до високогір'я асиметрія мозкового кровообігу зникає, знижується кровообіг в головному мозку, формується міжпівкульова симетрія і знову відновлюється син-хронізація мозкового кровообігу з нервовими процесами в корі головного мозку. Изучали связь между показателями мозгового кровотока и сенсомоторными показателями у людей на разных этапах адаптации к среднегорью. Исследования проводили до, во время и после трехнедельного пребывания в горах на высоте 2100 м, а также во время кратковременных подъемов без физической нагрузки на высоту 3900 м. Обнаружено, что в начальном периоде адаптации к гипоксии наблюдается десинхронизация между не-рвными процессами в коре головного мозга и мозговым кровотоком, наблюдается инверсия и увеличение асим-метрии мозгового кровотока в сторону доминирования левого полушария головного мозга. При устойчивой адаптации к высокогорью асимметрия мозгового кровотока исчезает, снижается кровообращение в головном мозге, формируется межполушарная симметрия и снова восстанавливается синхронизация мозгового кровотока с нервными процессами в коре головного мозга.Ключевые слова: гипоксия, адаптация, асимметрия, мозговое кровообращение, высшая нервная деятельность.
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