No 3 (2017)

In pregnant women, the presence of arterial hypertension is associated with such serious complications of pregnancy as preeclampsia, eclampsia, preterm delivery, placental abruption, antenatal fetal death, cerebrovascular disease and stroke in the mother. The review presents the modern classification of arterial hypertension in pregnant women (chronic hypertension, gestational hypertension, «de novo» pre-eclampsia or pre-eclampsia on the background of chronic hypertension; «white coat» hypertension); principles of diagnosis of various hypertensive disorders and their pathogenesis during pregnancy are discussed. International and national recommendations on the tactics of management of pre-eclampsia and its prevention and treatment (antihypertensive therapy, aspirin, calcium supplements, vitamin D) are presented. It is emphasized that the results of treatment of hypertensive disorders in pregnant women are not always successful. Therefore, special attention should be paid to the prevention of their development at the stage of preparation and planning of pregnancy.

The purpose of the study was to assess the quality of health care for women regarding the choice of planned method of contraception due to unwanted pregnancy and abortion in the early stages in outpatient settings and identify ways to optimize the organizational measures and methodological approaches to its improvement. Outcomes of 760 cases of termination of pregnancy for up to 6 weeks of gestation performed in single outpatient clinic in Kurgan city in 2015 in women aged 20 to 45 years, and the choice of method of contraception for them were evaluated. The group of vacuum aspiration group consisted of 186 women; medication-induced abortion group included 574 women. Hormonal contraception, which was started immediately after vacuum aspiration and medication-induced abortion, was selected as a planned contraceptive method in 80.1% (149/186) and 79.9% (459/574) of cases in the respective groups. lUDs have been used only in 1.1% (2/186) and 1.2% (7/574) of the cases in the respective groups during the next menstrual period. Thus, the use of combined oral contraceptives was preferential (80%) planned method of contraception, but the choice was made doctor’s orders, not on the basis of the preferences and expectations of women, which increases the risk of refusal over time. The frequency of use of lUDs after an abortion seems unreasonably low - only 1%, and their deployment is performed in delayed terms after abortion, which increases the risk of unwanted pregnancy in «unprotected» period.

To date, the frequency of the use of menopausal hormone therapy (MHT) for the correction of climacteric syndrome and metabolic disorders is still low due to possible complications of such therapy. Not only the low dose of estrogen, but characteristics of progestogen in the composition of combined mode of MHT have a great significance. The results of evaluation of changes in abdominal obesity (AO), and carbohydrate metabolism disorders in women in early postmenopause against the background of long-term combined MHT with 1 mg E2/2 mg drospirenone (DRSP) are presented. This study demonstrates the possibility of use of combination of 1 mg E2/2 mg DRSP for long-term MHT in women in early postmenopause with metabolic disorders.

The article presents the results of the evaluation of efficacy of laboratory diagnostics of nosocomial infections (NCI) in the obstetric hospital, epidemiological surveillance system for NCI, and sanitary and anti-epidemic (preventive) measures. The objectives of the study included the early detection of postpartum purulent-septic infections (PSI) in women and newborns, prevention of their contamination and prevention of their manifestation in the infection process, including by optimizing the microbiological monitoring using active search for nosocomial strains and improving laboratory methods for diagnosis of PSI cases.

The examination and treatment of 100 patients (72 men and 28 women) aged 38 to 90 years (mean age 65±10 years) admitted to the Department of Urology CCH №68 and Department of Urology KROD with diagnosed bladder cancer (BC), in most cases in an urgent order due to gross hematuria, were performed. Additionally, blood test for immunoglobulins (Ig) IgG, IgM to herpes (HSV - herpes simplex virus) types 1 and 2, cytomegalovirus (CMV), Epstein-Barr virus (EBV), urine polymerase chain reaction (PCR) to the aforementioned viruses, urethral scraping to detect high-risk oncogenic human papilloma virus (HPV) were performed. Tumor tissue and urine samples of patients were obtained for PCR diagnostics for HSV types 1 and 2, oncogenic HPV, CMV, and EBV. A statistically significant increase in the level of viral antibodies in patients with recurrent, locally advanced bladder cancer with high malignant potential was revealed. Statistically significant correlations between the presence of viral CMV and EBV DNAs in the tumor, the level of their antibodies, the process stage and recurrent nature of the tumor were detected. The morphological features of the BC against the background of persistent CMV herpes viral infection were described. Potentiation of action of viruses to each other was proved. Further evaluation of the significance of lymphoid infiltration and vascular component in this category of patients is required.

Erectile dysfunction (ED) is one of the most common problems in urology. Despite the fact that ED is not life-threatening condition, the appearance of sexual disorders leads to rapid personal and social maladjustment of the patient. Currently, European Association of Urology and American Urological Association recommend phosphodiesterase type 5 (PDE-5) inhibitors as first line therapy for patients with ED. Given the safety profile and the lack of convincing evidence of drug dependence, as well as the self-confidence of man against the backgeound of use of sildenafil (Dynamico), the drug can be considered as one of the leading drug in the treatment of ED. Chronic use of Dynamico by certain group of patients can be considered a way of maintaining a adequate quality of life.