The paper highlights the issue of violations and the principles of diagnosis of the sexual function of women at the perimenopausal age.The objective: analysis of the structure of sexual disorders in women during perimenopause, development of methodological approaches to early diagnosis of sexual dysfunctions.Materials and methods. The study involved 34 women with sexual disorders during the perimenopause. The age of the patients ranged from 45 to 66 years. The average age of patients was 56.3±0.3 years, with women 50-59 years old predominating " 28 (82.4%). To study the characteristics of the course of sexual dysfunctions in women of perimenopausal age, a set of clinical and laboratory and paraclinical methods of research was assigned.Results. When studying the age-related features of women of perimenopausal age and the impact on their sexual health of somatic and psychosomatic disorders, certain features of the diagnosis of this pathology were identified for the purpose of appropriate therapy.Conclusions. The main features of sexual dysfunctions in women of perimenopausal age are determined: the incidence of sexual dysfunctions is 76,5%. In the spectrum of sexual disorders, dysfunctions predominated: 85,3% – violation of lubrication, 47,1% – desire disability, 44,1% – excitation disorders, 50,0% – primary and 55,9% – secondary anorgasmia, 70,6% – discrepancy. It was found that among women with a menopause duration of more than 2 years 76,5% remained sexually active, and 85,3% of women in the perimenopause period consider sexual activity to be one of the components of quality of life factors. In addition, in women of perimenopausal age, changes in hormonal homeostasis, such as hypoestrogenia, hypoterosteronemia, have been identified, which is one of the prerequisites for the formation of a spectrum of sexual dysfunctions.
In the article the data on the genetic and molecular and epigenetic mechanisms of carcinogenesis, shows the evolution of phenotypic similarity benign hyperplastic processes of mammary glands and breast cancer (BC). With critical positions represented a modern strategy for the prevention and treatment of breast cancer, benign breast disease, conducted an analysis of a number of pharmacological efficacy of drugs for these purposes are disclosed benefits of targeted therapy with phytonutrients.From the standpoint of evidence-based discussion about onkoprotection properties mediating most of the major pathogenetic links hyperproliferation and tumor growth in mammary glands, fitocomposition Epigalin Brest, active ingredients which are natural dopamine agonist – Vitex agnus-castus extract usual and the two most famous fitoprotection targeted 3,3-Diindolymethane and epigallocatechin-3-gallate, as well as the possibility of using Epigalin Brest as multitargeted therapy benign breast disease and prevention of carcinogenesis in women at risk for breast cancer.It is concluded that Epigalin Brest is unique fitoresources as an additional component to the diet daily diet in order to maintain the normal state of function of cells and natural deterministic genetic mechanisms onkoprotection as in patients with benign breast disease, and in healthy women who want to make informed choices in relation to the safe the prevention of breast cancer, the risk of developing that over the life of each woman has.
The objective: to analyze the results of repeated laparoscopy in gynecological patients with suspected intraperitoneal postoperative complications.Materials and methods. The study involved 42 patients (mean age 46±11,3 years), in whom postoperative abdominal complications after surgical treatment of various gynecological diseases required repeated operations. Depending on the method of re-intervention, the patients were divided into 2 groups: the main group (n=20) – women who only used laparoscopy to correct postoperative complications; control (n=22) – women who were given indications for relaparotomy to correct postoperative complications during diagnostic laparoscopy. Relaparotomy was performed in 8 patients of the control group. All patients underwent a comprehensive examination using clinical, instrumental and laboratory research methods. The groups were homogeneous in terms of age and structure of operations performed on the pelvic organs, and statistically comparable.Results. During the study, the results of repeated laparoscopy of 34 gynecological patients with suspected intraperitoneal postoperative complications were analyzed. In all patients of the main group (47,6%), laparoscopy was revealed as the only and final method of treatment of postoperative complications, while in 7 women repeated relaparoscopy was used from 2 to 4 times, and in 13 women laparoscopy was performed once. In the control group (53,3%), 10 patients during diagnostic laparoscopy were exposed to indications for relaparotomy, in 4 patients the capabilities of the operating team and laparoscopic technique allowed performing some elements of the operation and completing it with a minilaparotomy approach, and 8 patients underwent relaparotomy immediately.Peritonitis and intraperitoneal bleeding prevail in the structure of early abdominal complications. The use of the video laparoscopic technique made it possible in 28,6% of patients with diffuse peritonitis to successfully eliminate the developed complication, eliminate its source and sanitize the abdominal cavity. Laparoscopic hemostasis was successfully performed in 7 patients.Compared with the standard, the use of video endoscopic technique allowed improving the indicators of diagnostic value: to increase the sensitivity level by 1,07 times, specificity by 1,39 times and diagnostic accuracy by 1,11 times.Conclusion. In general, in the early postoperative period, 47 relaparoscopies were performed for suspected complications, which is explained by programmed abdominal sanitization and the use of dynamic laparoscopy to control the course of intraperitoneal complications. Based on the analysis of the material under study, we proposed general indications and contraindications for relaparoscopy in the early postoperative period in order to diagnose and treat postoperative complications. Justifying each of the points, we were guided by the real possibilities of the method in general clinical practice, which in some cases are inferior in their effectiveness to relaparotomy.
Національна медична академія післядипломної освіти імені П.Л. Шупика, м. Київ Мета дослідження: зниження частоти порушень репродуктивної функції, акушерських та перинатальних ускладнень жінок-лікарів різних спеціальностей на підставі вивчення клінічних, функціональних, психологічних, ендокринологічних, імунологічних і мікробіологічних особливостей, а також розроблення і впровадження алгоритму діагностичних та лікувально-профілактичних заходів. Матеріали та методи. Дослідження проведено у два етапи. На першому етапі було обстежено 150 жінок-лікарів різних спеціальностей віком від 26 до 35 років зі стажем роботи від одного до 10 років. На другому етапі дослідження було обстежено 150 вагітних жінок-лікарів, яких розподілили на три групи порівняння. У комплекс проведених досліджень були включені клінічні, ехографічні, психологічні, лабораторні, допплерометричні, кардіотокографічні та статистичні методи. Результати. Результати проведених досліджень свідчать, що жінки-лікарі різних спеціальностей входять до групи високого ризику щодо розвитку різних ускладнень вагітності і пологів, а також перинатальної патології. використання медико-психологічної підготовки, починаючи з прегравідарного періоду у поєднанні з родинно-орієнтованими технологіями, дозволяє нормалізувати психологічний статус, виробити позитивну домінанту на сприятливий результат вагітності і пологів, нормалізувати функціональний стан фетоплацентарного комплексу, що сприяє зниженню частоти акушерської і перинатальної патології при розродженні, а також дозволяє зберегти репродуктивне здоров'я жінок-лікарів різних спеціальностей. Заключення. Отримані результати дозволяють рекомендувати удосконалений алгоритм діагностичних та лікувально-профілактичних заходів для застосування у практичній охороні здоров'я. Ключові слова: жінки-лікарі, репродуктивне здоров'я, діагностика, профілактика.
Íà â³äì³íó â³ä òðàäèö³éíî¿ ïåäàãîã³êè, îñíîâíå ïîëîaeåííÿ àíäðàãîã³êè ïîëÿãຠâ òîìó, ùî ïðîâ³äíó ðîëü ó ïðîöåñ³ íàâ÷àííÿ, îñîáëèâî íà ñòàðøèõ êóðñàõ, â³ä³ãðຠíå ïåäàãîã, à ñòóäåíò. Ôóíêö³ºþ âèêëàäà÷à º íàäàííÿ äîïîìîãè ñòóäåíòó äëÿ âèÿâëåííÿ, ñèñòåìàòèçàö³¿, ôîðìàë³çàö³¿, êîðèãóâàííÿ òà ïîïîâíåííÿ çíàíü. Ó öüîìó âèïàäêó â³äáóâàºòüñÿ çì³íà ïð³îðèòåòíîñò³ ìåòîä³â íàâ÷àííÿ. Íà ïåðøå ì³ñöå âèõîäÿòü ïðàêòè÷í³ çàíÿòòÿ ³ äèñöèïë³íè, ùî ì³ñòÿòü ³íòåãðîâàíèé ìàòåð³àë (ì³aeäèñöèïë³íàðí³ äèñöèïë³íè).Unlike traditional pedagogy andragogy guideline the leading role in the learning process especially at the undergraduate plays teacher and student. Function of the teacher is to help the student to identify, organize, formalization, corrections and updating of knowledge. In this case there is a change of priority training methods. Come first practical training and discipline, containing an integrated material (interdisciplinary discipline).Ó Ë. Â. Ñîêîëîâà, Þ. Ï. Âäîâè÷åíêî, Ð. Ñ. Êîðèòíþê òà ³í.Âñòóï. Àíäðàãîã³÷íèé ïîòåíö³àë ïðîôåñ³éíî¿ îñâ³-òè íåîáõ³äíî ðåàë³çîâóâàòè â ïåð³îä áàçîâîãî ïðîôå-ñ³éíîãî íàâ÷àííÿ ïðè ïåðåõîä³ â³ä äèòÿ÷î¿ ïåäàãî-ã³÷íî¿ ìîäåë³ íàâ÷àííÿ äî àíäðàãîã³÷íî¿, ÿêà äîñë³aeóº çàêîíîì³ðíîñò³ òà îñíîâí³ òåîðåòè÷í³ ï³äõîäè äî îðãàí³çàö³¿ íàâ÷àííÿ äîðîñëèõ, à òàêîae îñíîâí³ àíäðà-ãîã³÷í³ ïðèíöèïè äëÿ ðåàë³çàö³¿ ï³äõîä³â â îñâ³ò³ äî-ðîñëèõ [13].Ìåòà ðîáîòè âèâ÷åííÿ äàíèõ ñïåö³àë³çîâàíî¿ ë³òå-ðàòóðè ïðî àíäðàãîã³÷íèé ïîòåíö³àë ïðîôåñ³éíî¿ îñâ³òè.Ìåòîäè: á³áë³îñåìàíòè÷íèé äëÿ âèâ÷åííÿ äàíèõ íàóêîâèõ ë³òåðàòóðíèõ äaeåðåë.Îñíîâíà ÷àñòèíà. Áóäü-ÿêà ïðîôåñ³éíà îñâ³òà ìîaeå áóòè ðîçãëÿíóòà ñòîñîâíî îñîáèñòîñò³ â ð³çíèõ àñïåêòàõ:ÿê ï³äãîòîâêà ôàõ³âöÿ, ùî â³äïîâ³äຠñòàíäàðòó (ìîäåë³, ïðîôåñ³¿); ÿê ïðîöåñ çáàãà÷åííÿ ä³ÿëüí³ñíèõ çä³áíîñòåé îñî-áèñòîñò³; ÿê ïðîöåñ ïîñòàíîâêè, ðîçãîðòàííÿ, àäàïòàö³¿ òà ³ìïëàíòàö³¿ ïðîôåñ³éíîãî êîíòåêñòó â ñóáºêòèâíó ðåàëüí³ñòü ç íàñòóïíèì çàïóñêîì éîãî ñàìîñò³éíîãî âäîñêîíàëåííÿ òà ðîçâèòêó.  îñòàííüîìó âèïàäêó ïðîôåñ³ÿ ñòຠäëÿ ëþäèíè ñïîñîáîì áóòòÿ, à íå ïðî-ñòîãî ôóíêö³îíóâàííÿ. Çàëåaeíî â³ä âèõ³äíî¿ óñòàíîâ-êè ïðîôåñ³éíå íàâ÷àííÿ íà ïðàêòèö³ çä³éñíþºòüñÿ íà ð³çíèõ ð³âíÿõ ïðîíèêíåííÿ â ãëèáèíè îñâîºííÿ ò³º¿ ÷è ³íøî¿ ñïåö³àëüíîñò³.Öå ìîaeå áóòè: ïðèäáàííÿ êîíêðåòíèõ óì³íü ³ íàâè÷îê, ùî äîçâî-ëÿþòü âèêîíóâàòè ëîêàëüí³ îïåðàö³¿ ³ 䳿, âèð³øóþ÷è òèì ñàìèì îêðåì³ ïðàêòè÷í³ çàâäàííÿ; îñâîºííÿ ìåòîäèê îðãàí³çàö³¿ ä³ÿëüíîñò³, òåõíî-ëîã³é çä³éñíåííÿ òèõ ÷è ³íøèõ ïðîöåñ³â; íàêîïè÷åííÿ (îíîâëåííÿ) òåîðåòè÷íèõ â³äîìîñ-òåé, çä³éñíþâàíå ôðàãìåíòàðíî àáî ñèñòåìíî; ôîðìóâàííÿ ïðîôåñ³éíî-îñîáèñòèõ óñòàíîâîê, ñèñòåìè ö³ííîñòåé, ïîâÿçàíèõ ç ïåðåáóâàííÿì ó ïðî-ôåñ³¿, çíàõîäaeåííÿ ñìèñë³â ïðîôåñ³éíî¿ ä³ÿëüíîñò³, òîáòî ôîðìóâàííÿ âëàñíî¿ ô³ëîñîô³¿ ïðîôåñ³¿.
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