编号 12 (2014)

Given the current socio-economic and demographic development, reproductive health of the population is the primary challenge for the health care system. The concept of demographic development dictates the need to preserve the reproductive potential of the population. Therefore, the most important problem of reducing unwanted pregnancies and contraception include a lack of training obstetricians and gynecologists, and lack of a unified training system. The joint work was aimed to the evaluation of the opinions of physicians, obstetrician-gynecologists on reproductive health of women in the family planning and the formation of competence on the basis of knowledge, professional experience and skills. 232 obstetrician-gynecologist from 26 regions of the Russian Federation were surveyed. Analysis of the questionnaire data showed the presence of a large amount of passive information, combined with the lack of skills of self-critical reflection of current data, adherence to prevailing views, the lack of professional communication of practitioners and lack of knowledge of the unique World medical standard for regulating the use of contraceptives (WHO, 2009). It was concluded that formation of competence in the medical practice requires a modular approach.

The article presents the results of the study involving 360 Moscow women aged 19-49 years, seeking medical care to obstetrician-gynecologist. Aim of this study was to investigate the frequency and structure of gynecological morbidity, the degree of realization of reproductive function, and methods for the regulation of fertility. According to the results of study, menstrual disorders (31 %), pelvic inflammatory disease (27 %), and hormone-dependent diseases (16 %) are predominant disorders in the structure of morbidity among Moscow women of childbearing age. Unmet demand for contraception is 37 %, while the maximum - 63 % - is in the older age group of 40-49 years. Modern contraceptive methods are used mainly by middle-aged women (combined oral contraceptives - 28 %, intrauterine device - 14 %). The most popular method of birth control for all age groups is a condom (average 68 %). Among women with gynecological diseases, increase of adherence to contraception can be achieved by high-quality consulting taking into account the existing disease, the needs and expectations of the patient and using innovative drugs with prolonged action.

The article presents the results of a prospective cohort study involving 85 healthy women of different social groups aged 18-36 years; the study was aimed to the comparative evaluation of adherence to the prolonged contraception with medroxyprogesterone and frequency of side effects. Side effects associated with prolonged contraception with medroxyprogesterone occurred 1.8 times less, and adherence to treatment was up to 36 higher in women of low-income social group than among women of middle-income social class, that perhaps influenced by the lifestyle and standard of living, nutrition and physical activity of women.

The article discusses the modern concept of the complex pathogenesis of premenstrual syndrome (PMS) and approaches to its treatment. The diversity of clinical manifestations of PMS that causes a variety of therapeutic agents used is emphasized. Numerous studies suggests the great importance of magnesium deficiency as a factor of the development of PMS. This indicates the necessity of magnesium preparations (in particular, magnesium orotate) for all types of treatment of PMS.

Article provides an overview of recent data on the effect of combined oral contraceptives on the key risk factors for cardiovascular disease (dyslipidemia, hypertension, smoking, obesity, diabetes, blood clotting). The recommendations for the use of hormonal contraception in patients with increased risk of cardiovascular events and cardiovascular disease based on WHO and the European professional societies documents are presented.

A prospective cohort study(method of research - questionnaires) was performed. The study was aimed to the assessment of practicability and effectiveness of educational programs, including education for healthy lifestyle among female students suffering from premenstrual syndrome (PMS). According to the survey of 201 female students from the Kursk city, PMS was diagnosed in 112 (55.7 %) girls. They were divided into 2 groups. For Group I of students, training seminar on a specially designed program was held, and recommendations on diet, physical exercises, etc. were given. Adherence to the recommendations led to reduction of the PMS severity in 60.4 % of the respondents. For Group II of students, training seminar was held after repeated questionnaires. The study showed the practicability of the introduction and spread of educational programs and seminars for female students suffering from PMS.

The use of standardized treatment regimens and drugs led to increasing resistance to known antibiotics. Leading European and American societies changed the conceptual approach to the treatment with antibacterial drugs that led to revision of established views on seemingly known and understandable problems. The article considers the potentials for the use of drug roxithromycin in the treatment of nongonococcal urethritis in men. Foreign and domestic clinical studies have confirmed the efficacy and safety of roxithromycin (Esparoxy).