{"paper_id":"362fb47b-df52-41ec-a370-08cf084eaebc","body_text":"222222\nshort communicationsКратКие  сообщения222\nis of importance in terms of theoretical rationale behind \nadministering of MT-based medications in case of hypo-\nthyroidism.\nFor explaining the mechanism of stimulating impact \nthat МТ has on the thyroid gland hormonal activity, it is \nimportant to have a look at the data related to single-time \ndetecting of blood TTH levels, which reveal lack of any \nstatistically significant change in the respective index. \nThe outcomes allow concluding that melatonin has a di-\nrect impact on the thyroid gland. The reason behind such \nactivation of the system may be found in direct stimulat-\ning effect that MT has on the thyroid parenchyma, yet \nalso involving the specific receptors [5].\nThe data obtained from the group of the animals that \nreceived MT while developing hypothyroidism, were com-\npared to the respective indices in hypothyroid rats. This \nshowed that in hypothyroid rats a course of MT brought \nup the fТ\n4  15.5 times, while the levels of Т 3 went up 1.8 \ntimes. The coefficient values went down and approached \nthe normal rate while the TTH level was 0.12±0.01 mIU/l, \nwhich was 1.4 times below that level in thyroid animals. \nThe outcomes suggest that MT may act through the pitu-\nitary-hypothalamic axis as well.\nConclusions. Given the data above, we can say that \nMT has a stimulating effect when administered against \nreduced thyroid activity. This makes it possible to suggest \nthat under natural conditions the pineal gland acts as a \nmodulator for the pituitary-thyroid functioning. This role \nis due to uneven interactions with various components \nof the endocrine axis of hypothalamus – pituitary gland – \nthyroid gland [4]. In particular , it is not impossible that the \nsystem in question is inhibited through depression of its \ncentral components with MT due to disturbed thyroliberin \nproduction by neurons of hypothalamus, as well as \nthyrotropic hormone by pituitary cells through the MT-\nreceptors embedded into these structures. \nReferences\n1. Arushanyan E. B., Beyer E. V . Melatonin: biology, \npharmacology, clinic. 2015: 395 p.\n2. Claustrat B., Leston  J. Melatonin: Physiological effects \nin humans. Neurochirurgie.  2015;61(2):77-84.\n3. Esquifino A., Agrasal  C., Vel ázquez E. Effect of melatonin \non serum cholesterol and phospholipid levels, and on \nprolactin, thyroid-stimulating hormone and thyroid \nhormone levels, in hyperprolactinemic rats. Life Sci. \n1997;61(11):1051-1058.\n4. Garcia-Marin R., Fernandez-Santos J. M., Moril-lo-\nBernal J. Melatonin in the thyroid gland: regulation by \nthyroid-stimulating hormone and role in thyroglobulin \ngene expression. J. Physiol Pharmacol. 2015;66(5):643-\n652.\n5. Vriend J., Sheppard  M. S., Bala  R. M. Effects of \nmelatonin and hypothyroidism on somatomedin levels of \nfemale Syrian hamsters. J Pineal Res.  1989;7(1):85-90.\nabout\tauthors:\nElbekyan Karine, DBS, Professor, Head of Department of General and Biological Chemistry;  \ntel.: +79624007045; e-mail: karinasgma@inbox.ru\nMarkarova Evgenia, Assistant of Department of General and Biological Chemistry; tel.: +7(8652)353683; e-mail: obiochem@stgmu.ru\nKhodzhayan Anna, MD, PhD, Professor of Department of Biology; tel.: +7(8652)353442; e-mail: biology@stgma.ru\nGevandova Margarita, PhD, Associate Professor, Head of Department of Biology; tel.: +7(8652)353442; e-mail: biology@stgma.ru\n© Group of authors, 2016\nUDC 618.14:60.9/.8\nDOI – http://dx.doi.org/10.14300/mnnc.2016.11044\nISSN – 2073-8137\nThe\trole\tof\thYsTeroscopY\tin\tDiagnosis\t  \nThe\tpelVic\tpain\tsYnDrome\tcauseD\tBY\taDenomYosis\norazov\tm.\tr. 1, radzinskiy\tV.\te.1,\tnosenko\te.\tn. 2\n1\tpeople’s\tfriendship\tuniversity\tof\trussia,\tmoscow,\trussian\tfederation\n2\todessa\tnational\tmedical\tuniversity,\tukraina\nРОЛЬ\tГИСТЕРОСКОПИИ\tВ\tДИАГНОСТИКЕ\tТАзОВОй\tБОЛИ,\t  \nОБуСЛОВЛЕННОй\tАДЕНОМИОзОМ\nМ.\tР.\tОразов1,\tВ.\tЕ.\tРадзинский1,\tЕ.\tН.\tНосенко2 \n1\tРоссийский\tуниверситет\tдружбы\tнародов,\tМосква,\tРоссийская\tФедерация\n2\tОдесский\tнациональный\tмедицинский\tуниверситет,\tукраина\t\nEndometriosis, including adenomyosis, remains one of the important clinical problems of modern gynecology. \nTo date, the diagnostic value of hysteroscopy in the detection of foci of adenomyosis varies widely depending on the \nshape and the extent of spreading of the pathological process. The aim of the study was to determine the diagnostic \ncapabilities of operative hysteroscopy with adenomyosis, accompanied by the pelvic pain syndrome. 120 female pa-\ntients with pelvic pain adenomyosis were included into the present study. The verification of the diagnosis of adeno-\nmyosis was made on the basis of clinical and anamnestic, objective gynecological, ultrasound, tomography data. The \n\nМЕДИЦИНСКИЙ ВЕСТНИК СЕВЕРНОГО КАВКАЗА \n2016. Т. 11. № 2\nMedical news of north caucasus\n2016. Vоl. 11. iss. 2\n223223223\nT\nhe pelvic pain in women with adenomyosis has \na serious impact on the quality of patients life \nand disruption. Central mechanisms of vital body \nregulation of the systems [1]. The clinical symptoms are \nnonspecific and include dysmenorrhea starting at an ear-\n \nly age around the time of menarche, chronic pelvic pain \nand dysfunctional uterine bleeding. The dysmenorrhea \ntends to progressively increase and is resistant to \ntherapy with analgesics or cyclic oral contraceptives. \nWhen viewed with ultrasound, the cyst increases in size \nat the time of menstruation and hormonal suppression \nwith continuous oral contraceptive pills results in a partial \nregression [3]. Diagnostic problem can be significantly \nsolved with the help of endoscopic visualization, allowing \nto carry out differential diagnosis between endometrial \nhyperplasia, adenomyosis and submucous myoma [2]. \nHysteroscopy is an operative method of visual \nexamination of the uterine cavity using an optical instrument, \ngiving the opportunity to detect a intrauterine pathology, \nto determine the localization and size of endometriotic \nlesions. Modern hysteroscopy has become more than \njust a royal study; she opened a new section of surgical \ngynecology – intrauterine surgery. It is possible to replace \nlaparotomy operations gave an invaluable contribution to \nthe development of surgical hysteroscopy [4]. To date, the \ndiagnostic value of hysteroscopy in the detection of foci of \nadenomyosis varies widely depending on the shape and \nextent of spreading of the pathological process [5]. \nThe aim of the study was to determinate of the \ndiagnostic possibilities of the operative hysteroscopy with \nadenomyosis, accompanied by the pelvic pain syndrome. \nMaterial and Methods. 120 female patients with \npelvic pain adenomyosis were included into the present \nstudy. The verification of the diagnosis of adenomyosis \nwas made on the basis of clinical and anamnestic, \nobjective gynecological, ultrasound, tomography \ndata. The endoscopic examination was performed by \nhysteroscopy in the traditional way, using the equipment \nproduced by a well-known German company *Karl Stors*, \nwith a set of surgical instruments in the first phase of the \nmenstrual cycle, under intravenous anesthesia.\nThe dominant symptom of the disease in the focus \ngroup was the pelvic pain syndrome. Depending on the \nseverity of pain (using a VAS), the patients of the main \ngroup were divided into three subgroups: \nSubgroup 1 (n=42) – with a pelvic pain of weak intensity; \nSubgroup 2 (n=40), – with a pelvic pain of moderate \nintensity; \nSubgroup 3 (n=38) – with a pelvic pain of severe \nintensity. \nResults. The results of the study demonstrated \nthe presence of nodular form of adenomyosis in 36 \n(30.1 %) patients, diffuse forms of adenomyosis – «the \nphenomenon of wave formation» was detected in 78 \n(65 %) women with a pelvic pain of moderate and mild \nintensity. The combination of diffuse-nodular form was \ndiagnosed in 6 (5.9 %) patients.\nMorphologically, the endometrium corresponded to the \nphase of proliferation in 48 (40 %) patients, the morphological \ncharacteristics of a simple hyperplasia without atypia were \ndiagnosed in 46 (38.3 %) patients, and 26 (21.7 %) of women \nshowed signs of the glandular-fibrous polyp. \nThe informative value of hysteroscopy in case of disputes \nregarding the identification of traits differed significantly \nwhen performing studies as planned on the last day of her \nmenstrual period or for 3 days after surgical curettage of \nthe uterus. Under these conditions the method was most \nsensitive in identifying the focal forms of the disease. \nAdenomyosis, the heterotopic presence of endometrial \nglands and stroma within the myometrium, has traditionally \nbeen diagnosed by the pathologist in hysterectomy \nspecimens. Hysteroscopy offers the advantage of direct \nvisualization of the uterine cavity, and since nowadays it \nis performed in the office, it can be offered as a first-line \ndiagnostic tool for evaluation of uterine abnormalities in \npatients with abnormal uterine bleeding and/or infertility. \nAlthough diagnostic hysteroscopy does not provide \npathognomonic signs for adenomyosis, some evidence \nsuggests that irregular endometrium with endometrial \ndefects, altered vascularization, and cystic haemorrhagic \nlesion are possibly associated with the entity. In addition \nto the direct visualization of the uterine cavity, the \nhysteroscopic approach offers the possibility of obtaining \nendometrial/myometrial biopsies under visual control. \nConclusions. Our study indicate its high diagnostic \nvalue for the detection of adenomyosis, and for differential \ndiagnosis of proliferative diseases of the uterus and \nthe endometrium. In patients with pelvic pain of severe \nintensity significantly more nodular form of adenomyosis \n(p<0.05) were detected.\nresults of the study demonstrated the presence of nodular form of adenomyosis in 36 (30.1 %) patients, diffuse forms \nof adenomyosis – «the phenomenon of wave formation» was detected in 78 (65 %) women with a pelvic pain of mod-\nerate and weak intensity. The combination of diffuse-nodular was diagnosed in 6 (5.9 %) patients. The results of the \nresearch testify to high diagnostic value for the detection of adenomyosis, and for differential diagnosis of proliferative \ndiseases of the uterus and endometrium. Significantly more nodular form of adenomyosis (p<0.05) were detected in \npatients with pelvic pain of severe intensity.\nKey words: adenomyosis, pelvic pain, hysteroscopy\nЭндометриоз, в частности аденомиоз, остается одной из важных проблем современной клинической гине-\nкологии. На сегодняшний день диагностическая ценность гистероскопии в выявлении очагов аденомиоза ва-\nрьирует в широких пределах в зависимости от формы и степени распространения патологического процесса. \nЦелью исследования явилось определение диагностических возможностей оперативной гистероскопии при \nаденомиозе, сопровождающемся синдромом тазовой боли. В настоящее исследование были включены 120 \nпациенток с тазовым болевым синдромом аденомиоза. Верификация диагноза аденомиоза производилась \nна основании клинико-анамнестических, обьективных гинекологических, эхографических, томографических \nданных. Результаты исследования продемонстрировали наличие узловой формы аденомиоза у 36 (30,1 %) в \nгруппе пациенток с тазовыми болями выраженной интенсивности, диффузной формы аденомиоза – «феномен \nволнообразования» – у 78 (65 %) женщин с тазовыми болями умеренной и слабой интенсивности. Сочетание \nдиффузно-узловой формы диагностировано у 6 (5,9 %) пациенток. Результаты исследования свидельствуют о \nвысокой диагностической ценности как для выявления аденомиоза, так и для дифференциальной диагности-\nки пролиферативных заболеваний матки и эндометрия. У пациенток с тазовыми болями выраженной интен-\nсивности достоверно больше выявлялась узловая форма аденомиоза (p<0,05).\nКлючевые слова: аденомиоз, тазовая боль, гистероскопия\n\n224224\nshort communicationsКратКие  сообщения224\nreferences\n1. Adamjan L. V . Jendometrioz: diagnostika, lechenie i \nreabilitacija: Federal’nye klinicheskie rekomendacii po \nvedeniju bol’nyh. Federal guidelines for the management \nof patients 2013;58.\n2. Ishhenko A. I. Jendometrioz: diagnostika i lechenie – \nEndometriosis: Diagnosis and Treatment. 2002;104.\n3. Orazov M. R., Sulayeva O. N., Nosenko E. N. Some \npathological changes in the myometrium of women \nwith adenomyosis, accompanied by chronic pelvic pain \nsyndrome. Moskovskij Hirurgicheskij Zhurnal. – Moscow \nSurgery Magazine. 2015;3(43):20-23.\n4. Dakhly D. M., Abdel Moety G. A., Saber W., Gad Allah \nS. H., Hashem A. T ., Abdel Salam L. O. Accuracy of \nHysteroscopic Endomyometrial Biopsy in Diagnosis \nof Adenomyosis. J. Minim. Invasive Gynecol.  \n2015;23(3):364-371. doi: 10.1016/j.jmig.2015.11.004 \n5. Brosens I., Gordts S., Habiba M., Benagiano G. Uterine \ncystic adenomyosis: a disease of younger women. J. \nPediatr. Adolesc. Gynecol. 2015;28(6):420-426.\nabout\tauthors:\nOrazov Mekan, MD, PhD, associate Professor of Department of obstetrics and gynecology with a course of Perinatology;  \ntel.: +79152375292; e-mail: omekan@mail.ru\nRadzinskiy Victor, MD, PhD, Professor, an honored scientist of Russia, Head of Department of obstetrics and  \ngynecology with a course of Perinatology; tel.: +79037232212\nNosenko Elena Nikolaievna, MD, PhD, Professor, Department of obstetrics and gynecology; \n \ntel.: +380506383828; e-mail: nosenko.olena@gmail.com\n© Group of authors, 2016\nUDC 616.12-008.313.2\nDOI – http://dx.doi.org/10.14300/mnnc.2016.11045\nISSN – 2073-8137\ncorrelaTion\tBeTWeen\tfiBrinogen\tBeTa-chain\tgene\t\npolYmorphism,\tplasma\tfiBrinogen\tanD\tThromBoemBolic\t\ncomplicaTions\tin\tpaTienTs\tWiTh\taTrial\tfiBrillaTion\nBulgakova\tn.\te. 1,\tBaikulova\tm.\tKh. 2,\tscheglova\te.\tV. 1,\tKolesnikov\tV.\tn. 2,  \nYagoda A. V.1,\tBoeva\to.\ti.  1\n1\tstavropol\tstate\tmedical\tuniversity,\trussian\tfederation\n2\tstavropol\tregional\tclinical\tcardiology\tcentre,\trussian\tfederation\nВзАИМОcВЯзЬ\tПОЛИМОРФИзМА\tГЕНА\tБЕТА-ЦЕПИ\tФИБРИНОГЕНА\t  \nИ\tуРОВНЯ\tФИБРИНОГЕНА\tПЛАзМЫ\tС\tРАзВИТИЕМ\tТРОМБОЭМБОЛИчЕСКИХ  \nОСЛОЖНЕНИй\tу\tБОЛЬНЫХ\tС\tФИБРИЛЛЯЦИЕй\tПРЕДСЕРДИй\nН.\tЕ.\tБулгакова1,\tМ.\tХ.\tБайкулова2,\tЕ.\tВ.\tЩеглова1,\tВ.\tН.\tКолесников2,  \nА.\tВ.\tЯгода1,\tО.\tИ.\tБоева1\n1 Ставропольский\tгосударственный\tмедицинский\tуниверситет,\tРоссийская\tФедерация\n2\tСтавропольский\tкраевой\tклинический\tкардиологический\tцентр,\t \n   Российская\tФедерация\nIn a prospective cohort study the effect of the fibrinogen β-chain gene polymorphism -455G-A and fibrinogen \nplasma levels on the risk of stroke and systemic thromboembolism in 102 patients (83.3 % men, mean age 52.9±8.4 \nyrs) with non-valvular atrial fibrillation. Identification of fibrinogen B gene 455G-A polymorphism can be useful to \ncustomize the anticoagulation strategy in patients with atrial fibrillation.\nKey words: atrial fibrillation, fibrinogen, thromboembolic complications, genetic polymorphism, fibrinogen β-chain gene\nВ проспективном когортном исследовании изучено влияние полиморфизма -455G-А гена фибриногена B и \nуровня фибриногена плазмы крови на риск развития инсульта и системных тромбоэмболий у 102 пациентов с \nнеклапанной формой ФП (83,3 % мужчин, средний возраст 52,9±8,4 года) в течение 24 месяцев. Определение \nполиморфизма -455G-A гена фибриногена В может быть рекомендовано с целью индивидуализации тактики \nантикоагулянтной терапии у больных с фибрилляцией предсердий.\nКлючевые слова: фибрилляция предсердий, тромбоэмболические осложнения, генетический полимор-\nфизм, ген β -цепи фибриногена\nT\nhe key focus in treating patients with atrial \nfibrillation (AF) is prevention of thromboembolic \ncomplications (TEC) [5]. Currently, assessment \nof TEC risk in patients with AF is done employing \nthe CHA\n2 DS 2 -VASc clinical scale, which leaves the \ndoctor with no precise recommendation regarding \ntactics for antithrombotic therapy in case the number \nof points scored on the scale belongs to the 0-to-1 \nrange [2]. The issue of identifying certain additional \nTEC risk factors in this group of patients yet remains \nunresolved. Gene polymorphism of coagulation \nfactors has a significant impact on the hemostatic \nsystem. Proper attention paid to the genetic \nparameters may facilitate developing individual","source_license":"CC0","license_restricted":false}