Inflammatory Diseases Of Pelvic Organs Research Articles

Clinical and immunological efficacy of immunomodulating hexapeptide associated with the restoration of CD11b<sup>+</sup>CD64<sup>-</sup>CD32<sup>+</sup>CD16<sup>+</sup> and CD11b<sup>+</sup>CD64<sup>+</sup>CD32<sup>+</sup>CD16<sup>+</sup> neutrophil granulocytes subset in women with chronic infectious and inflammatory diseases of the pelvic organs

Failure of anti-infectious immune protection is considered a reason for the prolonged course and recurrence of chronic infectious and inflammatory diseases of pelvic organs (PID). Our aim was to evaluate the effect of an original hexapeptide (HP) on negatively altered subpopulations of neutrophil granulocytes (NG) CD11b+CD64-CD32+CD16+ and CD11b+CD64+CD32+CD16+, their phenotype and associated effector functions in immunocompromised women with PID.
 35 women (20-40 years old) with PID were studied during the period of clinical exacerbation (study group 1, SG1). Study group 1a (SG1a) consisted of patients who underwent treatment including the HP injections (45 mcg/ mL, 1 ml intramuscularly once a day for 10 days). The comparison group (CG) consisted of 20 conditionally healthy women. The numbers of CD11b+CD64-CD32+CD16+NG and CD11b+CD64+CD32+CD16+NG cell subsets and the density of receptor expression, phagocytic and microbicidal function of NG were determined.
 In SG1, decreased counts of the major NG subpopulation (CD11b+CD64-CD32+CD16+NG) was revealed (p 0.05), with a trend for increase of minor subset CD11b+CD64+CD32+CD16+NG (p 0.05). In the CD11b+CD64-CD32+CD16+NG subset, we noted a decreased expression of CD16 (1.4-fold), CD11b (2-fold) (p1, 2 0.05). In the minor subset CD11b+CD64+CD32+CD16+NG, the expression densities were decreased in CD16 (1.7-fold), CD11b (2.1-fold, p1, 2 0.05). At the same time, the phagocytic and microbicidal functions of NG were found to be decreased. In the course of immunomodulatory therapy with the HP-based drug, positive changes in immunological parameters were revealed. In SG1a, an increased number of major NC subset was observed, with an increase in the expression density of CD16 by 1.2 times, CD11b by 1.7 times relative to SG1 (p1, 2 0.05). The contents of minor NG subset tended to decrease, along with CD16 expression density reaching the indices of comparison group. CD11b increased 1.3 times relative to SG1 (p 0.05). Higher ratios of actively phagocytizing NG and their killing ability have been registered. Clinically, we observed faster regression of clinical PID exacerbation symptoms and decreased frequency of relapses 6 months after treatment in 88.6% of cases. The positive immunomodulatory effects of the HP-based drug upon altered subsets of CD11b+CD64-CD32+CD16+ and CD11b+CD64+CD32+CD16+ NGs, their phenotype and associated effector functions suggest an opportunity of its usage for the correction of NG dysfunctions in immunocompromised women with PID, thus providing stable clinical and immunological remission and protective effect.

Inflammatory diseases of pelvic organs and longed use of intrauterine contraception (clinical case)

The article emphasizes the etiology, pathogenesis and complications of pelvic inflammatory diseases in the use of intrauterine contraceptives (IUD). The risk of inflammation is higher in the first weeks of the use of IUD. The urgency of the problem is shown by the example of the case from the practice of the gynecological department of Khujand regional clinical hospital (Republic of Tajikistan).

Dynamics of proinflammatory cytokine serum levels in patients with acute inflammatory diseases of pelvic organs in the early stages of conservative treatment

Dynamics of serum proinflammatory cytokines such as interleukins (IL)-1, -2 and -6, tumor necrosis factor alpha (TNFα) was examined in patients of reproductive age suffering from acute inflammatory diseases of the pelvic organs. Our study was carried out with female patients at hospital admission prior to therapy applied with conventional methods of treatment and improved treatment by using vaginal low-frequency laser in a constant continuous magnetic field. The data obtained were compared with serum cytokine level from 20 healthy female volunteers of reproductive age consulted on better contraception methods. It was found that cytokine profile of in patients with acute inflammatory processes in pelvic organs was characterized by a high level of proinflammatory cytokines. It was shown that patients receiving conventional treatment contained decreased level of serum IL-1, IL-2, IL-6 and TNFα displaying slight dynamics, which did not reach it in control group. This may contribute to ongoing inflammatory process, despite the positive clinical dynamics. In turn, imbalance of immune responses leads to a persistently impaired fertility in women and need to perform subsequent comprehensive rehabilitation measures. Moreover, patients applied with intravaginal low-frequency laser radiation in a constant magnetic field were found to contain serum TNFα 100 pg/ml observed in 59.7% of cases, IL-6 level was lower than 20 pg/ml (prevalent in control group) found in 54.2% of cases. Serum IL-2 level was decreased by 3.5-fold compared to baseline, whereas for IL-1β it was higher than 100 pg/ml in as few as 23.6% patients. Such temporal pattern of inflammatory markers with rapid significant decrease of serum proinflammatory cytokines in patients with preformed pathogenic factors can reduce probability of connective tissue formation and activate their own repair as well as regenerative events. The results obtained allow to wider use combined physical interventional factors for therapy of patients with acute inflammatory diseases of the pelvic organs.

Optimization of complex therapy of inflammatory diseases of women pelvic organs

Inflammatory diseases of women pelvic organs in reproductive period reach 60% among outpatients and 30% among inpatient gynecological patients. Aim. The aim of the study was to evaluate therapy effectiveness of women pelvic organs deseases with Galavit as part of combination therapy compared to standard treatment. Materials and methods. The study included 120 patients with diagnosis of inflammatory diseases of pelvic organs, randomized to 2 equal groups (n=60). In the main group, the patient in complex therapy received Galavit, according to the scheme: for 5 days, 100 mg intramuscularly 1 time per day, then 100 mg every 72 hours (No. 20); in the control group - only standard treatment. Results. Improvement of clinical condition (reduction of severity, normalization of body temperature, reduction of pain syndrome) in patients of the main group was observed 2 times faster than in patient of control group. Quickly resolve the signs of inflammation by ultrasound in the main group. The number of leukocytes, ESR, LII in the main group normalized faster than in patient of control group. On the background of treatment complications of inflammatory diseases of women pelvic organs was observed in 6 (5%) patients of the main group and 9 (7.5%) patients of the control group; aftercare of patients of the main group with ineffectiveness of therapy was achieved without tubectomy. The duration of treatment in the study group was 8±2.6 days us 10±3.9 days in the control group. Conclusion. The inclusion of Galavit in the complex therapy of inflammatory diseases of women pelvic organs accelerates relief of inflammation symptoms and reduces frequency of complications, which allows to preserve reproductive function. Galavit can be recommended for treatment inflammatory diseases of women pelvic organs.

Inflammatory disease of the womans reproductive system: modern trends in diagnosis and therapy (literature review)

Medical, social and economic relevance of inflammatory diseases of the woman's reproductive organs requires a very careful attitude to the diagnosis and treatment of this pathology. The number of patients with genital infections and inflammatory diseases of the pelvic organs can takes the first place in structure of gynecological morbidity, and is 60.4-65.0%, and this fact is not unique to Russia, but all over the world. Incidence rate of inflammatory diseases of the pelvic organs in the first decade of the twenty-first century is increased at 1.4 times in patients who are from 18 to 24 years old and at 1.8 times in patients aged 25-29 years. At the same time, the cost of diagnosis and treatment has increased, reaching 50-60% of the total cost of providing gynecological care for population. The inflammatory diseases of pelvic organs are a collective concept. It includes of various nosological forms. There are numerous contradictions in the views on diagnostic approaches and treatment tactics, the nature of screening and control over the long-term results of treatment, the etiological and pathogenetic significance of various microorganisms found in the genital tract in patients with inflammatory diseases of the pelvic organs. Currently, there are many opinions among specialists about diagnostic approaches and treatment tactics, the type of screening and monitoring the long-term results of treatment, the etiological and pathogenetic role of various microorganisms which can be found in the genital tract in patients with inflammatory diseases. This review presents the results of a modern approach to the diagnosis, management and rehabilitation of patients with inflammatory diseases of the pelvic organs.

Аналіз показників імунітету у жінок репродуктивного віку із гострим неускладненим пієлонефритом у поєднанні із запальними захворюваннями органів малого таза залежно від періоду менструального циклу

Аналіз показників імунітету у жінок репродуктивного віку із гострим неускладненим пієлонефритом у поєднанні із запальними захворюваннями органів малого таза залежно від періоду менструального циклу

МЕДИКО-СОЦИАЛЬНЫЙ ПОРТРЕТ ПАЦИЕНТОК С ЭНДОМЕТРИОЗОМ

Aim. To study the medical-social profile of patients with endometriosis. Materials and Methods. Life-history based study included 97 women who had undergone laparoscopic surgery and had histologically confirmed endometriosis for the period from May 2015 till March 2016. Among them 21.5% had small endometriosis lesions, 54.5% – cystic ovarian endometriosis, 8.5% – retrocervical endometriosis, and 15.5% – adenomyosis. Results. Mean age of the investigated group was 32 ± 6.7. Minimum and maximum values were 18 and 45, respectively. According to occupational history, 74.5% of patients were engaged in the intellectual work, 6% – in physical work, 16.5% were unemployed, and 3% were students. The majority of patients were city-dwellers. Somatic pathology assessment revealed that 40.2% of women had chronic gastrointestinal diseases (gastritis, colitis, cholecystitis). 9.3% of patients suffered from chronic pyelonephritis or chronic cystitis. ENT diseases (chronic tonsillitis, chronic maxillary sinusitis) were observed in 8.9%. The cardiovascular pathology was observed in 6.2% (hypertensive disease). The respiratory disorders were reported by 4.1% of patients (chronic bronchitis, asthma). The analysis of genital system pathology showed that 56.7% of patients had inflammatory diseases of pelvic organs. 64% of women from the investigated group were subjected to STD testing. One in five patients had chlamydiae, ureaplasma, or HPV. Cervical pathology was observed in 37.1% of patients (cervical ectopy, cervicitis). Hyperplastic processes occurred in 17.5% (13.4% – endometrial polyp, 5.2% - cervical canal polyp, 5.2% - endometrial glandular hyperplasia). Uterine myoma was observed in 20.6%. Ovarian tumors were observed in 12.4%. Polycystic ovarian syndrome was observed in 5.2% of women. Conclusion. Study of the medical-social profile of patients with endometriosis has revealed that this disease is most frequently observed in women of childbearing age. External genital endometriosis is likely to prevail in early childbearing age (19–35), meanwhile adenomyosis is more often observed in late childbearing age (36–45). This disease is typical of city-dwelling women engaged in intellectual work. The main symptoms are reproductive disorders (infertility) and pain syndrome affecting the quality of life. Endometriosis is seldom detected by non-invasive diagnostic methods, which means that it is necessary to develop new informative methods in order to confirm the disease.

Serum micro- and macroelements levels in women with polycystic ovary syndrome associated with pelvic inflammatory disease

Polycystic ovary syndrome (PCOS) is the most common endocrinopathies in women of reproductive age. The aim of the study was to determine the concentrations of some essential macro- and microelements in the body of women with PCOS. Taking into account the frequent combination of PCOS with inflammatory processes of genitals, it was decided to examine trace elements concentration in this category of women. Study includes 3 groups of women: 30 women with PCOS against the background of inflammatory diseases of pelvic organs (I group), 22 patients with PCOS without inflammatory processes of pelvic organs (II group) and 25 healthy women (III group). In all groups it was studies macro- and microelements concentration in blood: magnesium (Mg), copper (Cu), manganese (Mn), nickel (Ni), zinc (Zn), chromium (Cr), selenium (Se), vanadium (V). The study revealed increase zinc and nickel level, decrease manganese level in women with PCOS, that give grounds suppose their participation in the infringement of folliculogenesis and ovulation due to their properties to intensification of the lipids peroxide oxidation and reduction activity of antioxidant system, injuries cell membranes and mitochondria, gap DNA molecules and to disturb transcription processes. More high zinc and nickel concentrations in patients with PCOS in the background of inflammatory process indicates on possible inflammation role in disorders development, because proinflammatory cytokines (IL-1, IL-6, IL-18, TNF-α) leads to the zinc accumulation and elevated nickel concentrations can induce inflammation and inhibit the functional activity of macrophages and natural killer cells, setting the conditions for chronic inflammation. Level study of trace elements (zinc, nickel and manganese) may be recommended for women with PCOS and with inflammatory diseases of pelvic organs and control their administration in complex multivitamin preparations.

Clinical and morphological determinants of infertility associated with inflammatory diseases of the pelvic organs

There is a violation of the secretory transformation of the endometrium during the implantation window in patients with the infertility associated with inflammatory diseases of the small pelvic organs, against the background of a high incidence of chronic endometritis and salpingitis. The impact of inflammatory changes in the small pelvic organs leads to disruption of morphological and functional state of the endometrium and also to receptor imbalance.

СHANGES OF TLR GENE EXPRESSION IN CERVICAL EPITHELIUM FROM THE PATIENTS WITH UROGENITAL INFLAMMATORY DISEASES

Toll-like receptors (TLR) are involved into innate immune recognition of microorganisms, including pathogenic bacteria. The aim of this work is to assess relative levels of TLR2 and TLR9 expression in cervical epithelial cells of women with inflammatory diseases of pelvic organs. The total group of patients consisted of 47 persons, including 20 women with urogenital infections, and 27 women comprised a control group. Using real-time PCR, we identified the opportunistic pathogens and gene expression levels of TLR2, TLR9 in the cervix epithelial cells. It was shown that expression of TLR9 in the group with urogenital infections was 13.7-fold higher than in control group. We have revealed that a significant increase of TLR9 expression in the mucosal epithelium from cervical canal correlated with detection of infectious pathogens in the samples.

MULTIPOTENT MESENCHYMAL STROMAL CELLS OF BONE MARROW IN THERAPY OF CHRONIC INFLAMMATION OF THE MURINE OVARIES

Today the cause of reproductive disorders in women frequently is the inflammation of pelvic organs. Chronic inflammation of the ovaries (oophoritis) is a common disease, accompanied by various gynecological dis-orders, and occurs independently as well. According to the Ministry of Healthcare of Ukraine, the frequency of inflammatory diseases of pelvic organs in the structure of pathology in gynecological practice reaches 60–65% [1]. As a consequence, prolonged and recurrent course of the disease in 60% of cases can lead to infertility. It should be noted that oophoritis largely occurs due to the presence of primary immunodeficiency, which facilitates the transition of acute inflammatory process at a chronic stage. At the same time prolonged inflammation causes a decrease in immunological reactivity of an organism. In chronic inflammatory processes the change of cytokine profile is natural, which leads to statistically significant decline in the efficiency of infertility treatment [2].During the treatment of uterine appenda ges’ inflammation the patients receive medicines of almost all pharmacological groups, inclu-ding the reserve antibiotics and non-steroidal anti-inflammatory drugs that lead to forma-tion of antibiotic-resistant strains, activation of opportunistic flora, increased allergization, dysfunction of the immune system [1, 2]. As a rule the effectiveness of oophoritis treatment is low, and therefore the researches of alternative methods of treatment are intensively carried out, particularly the use of cell therapy. Taking into account the abovementioned it is reasonable to search for new medicines having the ability to impact on the chronic phase

Anent the treatment of acute cystitis in women with chronic inflammatory diseases of pelvic organs

The study was aimed at investigating the efficacy of Kataria drug use in combination with Polymic drug in women with chronic inflammatory diseases of pelvic organs with acute cystitis.It was proved that administration of Kataria as urine alkalizer contributes to faster and more marked dysuria regress that causes improvement of quality of life of female patients. Obtained study results show the reasonability of additional indication of Kataria drug along with antibacterial therapy (Polymic drug) at acute cystitis in women with chronic inflammatory diseases of pelvic organs.

1589 – Level of mental health in women with inflammatory gynecological diseases

Aim of research is study of the levels of mental health in women at reproductive age with acute inflammatory diseases of pelvic organs. 100 women at reproductive age (from 18 to 45 years) with acute inflammatory gynecological diseases (N70 - ICD-10) were object of research. Results of the investigation have been processed with standard kit of programs Statistica (version 8.0). Analysis of level of mental health of women with pathology of reproductive system has allowed distinguishing great percent (42%) (p Thus, high co-morbidity of mental disorders in patients of reproductive age with inflammatory gynecological diseases was revealed. This had a negative impact on course and prognosis of disease, and worsened quality of life and efficacy of therapy in gynecological patients.