Cervical intraepithelial neoplasia associated with papillomavirus infection: Pathogenetic rationale of treating patients during the reproductive period
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01.01.2018 |
Davydov A.
Shakhlamova M.
Lebedev V.
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Voprosy Ginekologii, Akusherstva i Perinatologii |
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3 |
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© 2018 Dynasty Publishing House. All rights reserved. The lecture deals with treatment of patients with CIN associated with papillomavirus infection (HPVI). The issues of epidemiology, diagnosis and treatment of CIN are discussed. Emphasis is put on a complex approach to treating patients with HPVI-associated CIN. Special attention is paid to studying the mechanisms of dysregulation of immune response during the period of human papillomavirus virus (HPV) persistence, which promotes immune suppression and is considered to be a necessary precondition for progression of HPV-associated cancer. Based on analysis of literature sources, the authors show that high oncogenic risk E6 and E7 HPV types interact with key proteins of interferon signalling pathway, inhibiting its production. This accounts for insufficient effectiveness of preparations of pure interferons and their inductors for treatment of HPV infection. From the pathogenetic positions, the use of inosine pranobex as a medication in complex therapy would be appropriate, since it ensures complete elimination of HPV and reduces the frequency of HPV infection recurrences.
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Modern conception of treatment of patients with cervical intraepithelial neoplasia associated with papillomavirus infection
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01.01.2018 |
Belotserkovtseva L.
Davydov A.
Shakhlamova M.
Pankratov V.
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Voprosy Ginekologii, Akusherstva i Perinatologii |
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1 |
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© 2018, Dynasty Publishing House. All rights reserved. The objective. To study the effectiveness of two-step treatment of female patients with cervical intraepithelial neoplasia (CIN) associated with papillomavirus infection (PVI). Patients and methods. 126 female patients of reproductive age were examined (mean age – 31.4 ± 2.1 years), in whom CIN was associated with papillomavirus infection (PVI). In all cases, cervical pathologies – low-grade squamous intraepithelial lesions (L-SIL) have been found. In all patients treatment included a surgical step (laser and plasma energy) and medication, which was employed in 101 (80.1%) patients (treatment group). 25 (19.9%) women comprised the control group, since they did not receive post-operative pathogenetic therapy. In the treatment group, patients received an immunostimulating and antiviral drug inosine pranobex (IP) – Isoprinosine. Results. The effectiveness of treatment was assessed after 60 and 120 days from the termination of complex therapy (treatment group), or surgical intervention (control group). After a 60-day period, complete elimination of virus was noted 97 (96%) patients of the treatment group and in 18 (72%) of the control group. After 120 days, PVI relapse was recorded in 3 women of the treatment group (3%) and in 4 (22%) – of the control group among patients with complete elimination of virus. Conclusion. The use of IP as monotherapy is an optimal solution ensuring minimal risks of relapses of pathological PVI. Preparations of pure IFN and their inductors do not always promote complete elimination of PVI owing to interferon resistance of HPV-infected patients.
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A complex solution for therapy of uterine cervical pathology associated with human papillomavirus infection
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01.01.2018 |
Davydov A.
Shakhlamova M.
Ter-Ovakimyan A.
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Voprosy Ginekologii, Akusherstva i Perinatologii |
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1 |
Ссылка
© 2018 Dynasty Publishing House. All rights reserved. The objective: To optimize a tactics of examination and treatment of patients with a benign cervical pathology associated with papillomavirus infection (PVI) in female patients of reproductive age. Patients and methods: 124 patients aged 22 to 35 years underwent complex examination and treatment. Two groups were singled out: the first (main) group included 72 patients, who in the postoperative period received treatment with an antiviral immunostimulating drug isoprinosine, the second group comprised 52 patients, who did not receive the antiviral medication (control group). Inosine pranobex (isoprinosine) was administered 3 g/day (2 tablets 3 times daily) for 28 days. A carbon dioxide (CO2) laser and argon plasma were used to destroy the affected uterine cervical epithelium. Results: The Pap test found various pathological changes in 112 (90.3%) patients. ASCUS smear results had similar incidence rates in the groups 16 and 18% (p > 0.05). The incidence of LSIL in the groups was 31.9 and 32.6%, respectively (p > 0.05). In the basic group, 60 days afterwards complete elimination of virus was noted in 95.8% of cases; in the control group in 78.8%. The frequency of HPV infection recurrence among patients with complete virus elimination was 2.9% in the basic group, in the control group - 14.6%. Conclusion: The employment of the surgical stage permits to destroy pathological tissue, deactivate virus at the local level and prepare conditions for deactivation of virus in the body. Postoperative antiviral and immunostimulating therapy not only ensures practically complete elimination of virus but also reduces recurrences of PVI.
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Effects of succinate-based antioxidant on in vitro conversion of methemoglobin in oxyhemoglobin
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01.01.2018 |
Chernysh A.
Kozlova E.
Moroz V.
Sergunova V.
Gudkova O.
Manchenko E.
Kozlov A.
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Obshchaya Reanimatologiya |
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0 |
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© 2018, V.A. Negovsky Research Institute of General Reanimatology. All rights reserved. The purpose of the study - to determine the feasibility of using the succinate-based antioxidant for the in vitro reduction of excessive methemoglobin to oxyhemoglobin in blood. Materials and Methods. Blood sampling was performed in five healthy donors in microvettes containing EDTA during prophylactic examinations. NaNO2 solution was added to blood samples in vitro in order to yield methemoglobin (MetHb). The complex drug containing the following active ingredients: succinic acid, inosine, riboflavin, nicotinamide, was used as an antioxidant. The absorption spectrum of red cell suspensions with different drug content Dl(λl) exper was measured with 1 nm increments. The non-linear regression method was used to calculate concentrations of hemoglobin derivatives in suspensions. Results. In our experiments, when methemoglobin reacted with drug the optical density of peaks typical for oxyhemoglobin increased and the spectral peak of methemoglobin decreased. The greater the concentration of drug, the more was the incubation time, the more efficient was the process of reduction of MetHb to HbO2. Conclusion. We proved experimentally that while the baseline concentration of MetHb was an average of 91-93%, addition of drug decreased its concentration to 25-7%. Without drug, due to autoreduction, the concentration of MetHb decreases only to 84%. The revealed effect provide a potential for practical applications in critical illness, during the storage of donor blood, in blood transfusions, and under the action of physico-chemical factors on blood.
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