[Migraine in women: clinical and therapeutical aspects]. / Migren' u zhenshchin: klinicheskie i terapevticheskie aspekty.

Migraine is one of the most common neurological disorders, affecting women. Physiological changes in the hormonal status can modulate the functional status of pain and analgesic systems of the brain and, by involving different pathophysiological mechanisms, change the course of migraine. In addition to an analysis of epidemiological data, the review provides current views on the clinical features of the disease in women population at different periods of life, particular attention was focused on menstrual migraine. It has certain features, such as acute and long attacks and treatment difficulties. One of main issues is the use of oral contraceptives in women with migraine according to the ratio of potential benefit to cardiovascular risk. The problems of treatment headaches in pregnant and breastfeeding women are also considered. An influence of migraine on the course and outcome of pregnancy was shown. The authors analysed the results of the studies on the course of migraine during perimenopause and postmenopause and recommendations for women with migraine attacks and climacteric syndrome. The data presented in the review are useful for clinicians, because this information represents new views on pathogenetic mechanisms, clinical features and treatment of migraine in women.

[EFFECT OF LONGIDAZE ON MICROBIAL LANDSCAPE OF CERVICAL CANAL AND UTERINE CAVITY DURING THERAPY OF WOMEN WITH CHRONIC NONSPECIFIC ENDOMETRITIS AND UTERUS MYOMA].

AIM: Evaluation of microbiological effectiveness of longidaze preparation use during therapy of active non-specific endometritis in women with uterus myoma. MATERIALS AND METHODS: 2 groups of women were formed by a method of random selection. The first was composed of patients with active chronic endometritis, that had received standard etiotropic antibacterial therapy. The second included patients, that had received longidaze in addition to the standard therapy. Therapy effectiveness evaluation was carried out based on the analysis of microbial landscape of cervical canal and uterine cavity 2 months after the therapy during phase I of the menstrual cycle. RESULTS: Non-plasma-coagulating staphylococci, enterococci and anaerobes were established to be present predominately in the examined women of both the first and the second group. CONCLUSION: The application of longidaze in combination with antibacterial therapy results in the most significant improvement of microbial landscape of cervical canal and uterine cavity.

[Estimation of central blood pressure and arterial stiffness in pregnant women with different forms of hypertension].

AIM: To estimate central (aortic) blood pressure (BP) and arterial stiffness and their prognostic value in the development of preeclampsia (PE) in pregnant women with different forms of hypertension. SUBJECTS AND METHODS: The study included 106 patients with chronic hypertension, 21 with the latter concurrent with PE, 63 with gestational hypertension, 10 with PE, and 100 without hypertension. All the women underwent 24-hour BP monitoring by an oscillometric method to estimatecentral (aortic) BP and arterial stiffness at 16-22 weeks' gestation. RESULTS: The highest average daily central systolic and diastolic BP was in the pregnant women with PE. ROC analysis showed that the average daily aortic systolic BP greater than 115 mm Hg was most significant for the prediction of PE. The highest values of arterial stiffness (augmentation index, stiffness, maximum rate of blood pressure rise) were detected in the pregnant women with PE in the presence of chronic hypertension. CONCLUSION: 24-four BP monitoring inpregnant women can provide additional characteristics that reflect the stiffness of the aorta and peripheral arteries, which may be used to predict PE.

[Clinical-anamnestic and molecular-genetic factors in different forms of hypertension and its relationship to course and pregnancy outcomes].

AIM: To assess of the relationship of clinical and molecular genetic factors in the course and outcome of pregnancy in different forms of hypertension in pregnant women. PATIENTS AND METHODS: A total of 125 pregnant women who were divided into the following groups: with chronic hypertension (n = 45), with gestational hypertension (n = 20), with pre-eclampsia (n = 10), superimposed preeclampsia upon chronic hypertension (n = 15) and 35 women without hypertension in control group. RESULTS: In pregnant women with chronic hypertension and superimposed preeclampsia upon chronic hypertension were observed higher incidence of overweight and obesity, smoking before pregnancy and family history of hypertension and thrombosis, the course and outcomes of pregnancy characterized by higher frequency of obstetric complications, higher frequency of polymorphisms of genes identified the renin-angiotensin system, folate cycle and endothelial function. CONCLUSIONS: Molecular-genetic factors, combined with the factors of cardiovascular risk may make some contribution to the phenotypic realization of pregnancy complications and adverse pregnancy outcomes in pregnant women with different forms of hypertension.

[Cytokine status of cervical mucus in women with transitory and persistent course of papillomavirus infection].

AIM: Study the levels of cytokines in cervical mucus of women with transitory and persistent course of papillomavirus infection (PVI). MATERIALS AND METHODS: Material from 122 women was studied: 32 patients in control group, 68 patients with transitory course of PVI and 52 women with persistent course of PVI. The presence or absence of high risk HPV DNA was confirmed by real time PCR. High risk HPV DNA was determined in scrapes of epithelial cells of cervical canal. Quantitative determination of cytokines (IFN-alpha, IFN-gamma, IL-1beta, receptor antagonist IL-1, IL-2, IL-4, IL-8 and IL-10, TNFalpha in cervical mucus was performed by enzyme immunoassay. RESULTS: Transitory course of PVI was characterized by an increase of IFN-alpha and IFN-gamma, persistent course of PIV--by a decrease of IFN-alpha, IL-2 level was increased in both groups of patients with PVI. CONCLUSION: The outcome of PVI is controlled by interferon component of the immunity. Because of this during observation of patients with PVI the determination of IFN-alpha, IFN-gamma content in cervical mucus is an appropriate diagnostic procedure in clinical practice for the prognosis of risk of development of high risk PIV persistency.

[Immunological indices in differential diagnosis of active and inactive chronic endocervicitis].

A total of 132 patients were examined for chronical endocervicitis by clinical, immunological and morphological methods. According to the results obtained the patients were subdivided into several groups. The first group covered 77 females with an active clinical somatic form of the disease. The second group included 55 patients with chronical inactive endocervicitis. Controls included 25 practically healthy females. No differences were found between immunological indices of peripheral blood in groups of patients with active and inactive forms of chronic endocervicitis. Immunological tests on cervical mucus in patients with chronic endocervicitis revealed differences in the total number of leukocytes, content of living cells, functional activity of neutrophils, concentration of immunoglobulins and proinflammatory cytokines. This study may contribute to the development of immunological criteria for diagnosis of inflammatory process activity as well as a diagnostic model.

[Clinical and immunological aspects of cervicitis of chlamydial etiology]. / Kliniko-immunologicheskie aspekty tservitsitov khlamidiinoi étiologii.

A total of 52 women with established presence of the causative agent of chlamydial infection in the cervical canal were examined. The chlamydial lesion of the cervix uteri was characterized by the absence of clinical manifestations in 25% of cases, faintly pronounced local inflammatory process in the lower part of the genitals in the form of chronic cervititis in 57.7% of cases and the symptoms of subacute cervicitis in 17.3% of cases. In case of a chronic course of chlamydial cervicitis a low content of cytokines IL-1alpha, IL-1beta, TNF-alpha and an elevated concentration of IL-8 were observed. In the cervical slime of patients with chlamydial cervicitis no changes in the total content of leukocytes were noted in comparison with healthy women, but the number of nitro blue tetrazoliu reducing neutrophils increased, while their functional reserve and phagocytic activity dropped. Autoneutrophilokins used for local immunocorrection in the treatment of women with chlamydial cervicitis produced a normalizing effect on the local infectious protective factors of cervical secretion, thus enhancing the effectiveness of therapy.

[Hormonal correction of the resident microflora of the vagina and uterus cervix in women with chronic cervicitis]. / Gormonal'naia korrektsiia rezidentnoi mikroflory vlagalishcha i sheiki matki u zhenshchin s khronicheskimi tservitsitami.

Clinical, microbiological and hormonal examination of women with chronic cervicitis revealed lesions in the upper section of the reproductive tract in a high proportion of those examined, hormonal disturbances being registered in 96.7% of women. Dysbiotic manifestations (suppression of lacto- and bifidoflora and the excessive growth of opportunistic microorganisms) in the uterus cervix and vagina observed in patients with chronic cervititis were not associated with the etiology of the inflammatory process. The degree of dysmicrobiocenosis in the lower section of the genital tract in women with chronic cervicitis depends on the character of hormonal disturbances. The most significant inhibition of the resident flora was observed when ovarian dysfunction occurred and less significant--in cases of hyperprolactinemia and changes in the level of hypophysial hormones. Hormonal disturbances led to contamination of vagina and cervical canal with opportunistic microorganisms that was inversely proportional to the presence of lactic acid bacteria and bifidobacteria in these organs. Complex therapy of women with chronic cervicitis with the use of preparations for the correction of hormonal disturbances made it possible to restore the normal microflora of the genital tract and to improve the results of treatment.

[Functional activity of phagocytizing cells of the female reproductive tract in inflammation of the upper part of genitalia]. / Funktsional'naia aktivnost' fagotsitiruiushchikh kletok reproduktivnogo trakta zhenshchin pri vospalenii verkhnego otdela genitalii.

66 women of reproductive age with different course of the inflammatory process in the upper section of the reproductive tract (endometritis and salpingo-oophoritis) were examined. The cell composition, viability and functional activity of the phagocytizing cells of cervical and endometrial secretions, as well as peritoneal exudate, were studied. The study revealed that these characteristics of the phagocytizing cells of the reproductive tract in women with the inflammatory process differed from similar characteristics in healthy women. Different changes in the functional activity of neutrophils and macrophages in the biological fluids under study in different course of the inflammatory process were detected.

[Factors of the local immune defence of the reproductive tract in pregnant women with vaginosis]. / Sostoianie factorov mestnoi immunnoi zashchity reproduktivnogo trakta pri vaginoze beremennykh.

Clinico-immunological examination of 99 pregnant women with diagnosed vaginosis and 132 pregnant women without genital infection as a control group, was carried out. The immunological factors of cervical and vaginal secretions in pregnant women before and after local treatment were studied. The conclusion was made that the established changes in the cell-mediated and humoral factors of the immune resistance of the reproductive system could probably play some pathogenetic role in the development of vaginosis and its relapses in pregnant women. As found in this study, more pronounced changes in the local factors of immune protection (the signs of the functional irritation of neutrophils in combination with the prevalence of sIgA and lysozyme simultaneously with a decrease in the level of IgM and IgG in cervical slime) developed in patients with subsequent relapses of vaginosis, these changes remaining after local treatment. The defects of cell-mediated and humoral factors of cervical and humoral secretions, together with some clinical parameters, were shown to be prognostically unfavorable with respect to the relapses of vaginosis in pregnant women.

[Local anti-infective protection of the reproductive tract in women of different ages]. / Mestnaia protivoinfektsionnaia zashchita reproduktivnogo trakta zhenshchin razlichnogo vozrasta.

Healthy girls and women of the reproductive age, as well as women immediately before and after menopause, were examined. Neutrophils and immunoglobulins of cervical and vaginal secretions were studied and, as a result, age-dependent differences in the activity of the anti-infectious protection of the reproductive tract of women were found.

[The local immunity of the genital system in pregnant women with a genital infection]. / Mestnyi immunitet polovoi sistemy u beremennykh s genital'noi infektsiei.

In 101 healthy pregnant women and 132 pregnant women with genital infection (colpitis, endocervicitis, cervicitis) the characteristics of the anti-infectious protection of cervical mucus were studied. In pregnant women with inflammatory diseases of the vagina and cervix uteri disturbances in the local immunity of the sex system were detected. The study showed that in genital infections local immunodeficiency depended to a greater extent on the localization and spread of the process rather than on the etiological factor of the disease.

[The immunocorrective properties of bacterial preparations (lactobacterin, bifidumbacterin) and bemitil in pregnant women with a urogenital infection]. / Izuchenie immunokorrigiruiushchikh svoistv bakterial'nykh preparatov (laktobakterina, bifidumbakterina) i bemitila u beremennykh s urogenital'noi infektsiei.

The results of the analysis of the cell-mediated and humoral factors of the peripheral blood and cervical mucus in pregnant women with urogenital infections (pyelonephritis, colpitis, cervicitis, endocervicitis) and in healthy pregnant women are presented. These results indicate that considerable changes in the systemic immunity of the body and in the local antiinfectious protection of the reproductive tract develop in pregnant women with urogenital infections. The prescription of bifidumbacterin and lactobacterin to the patients during pregnancy (intravaginally) and bemitil after parturition (orally) completely restores the functional validity of their immune system and decreases the number of postnatal complications.