CURRENT STATE OF THE PROBLEM OF MENSTRUAL CYCLE DISORDERS IN WOMEN OF REPRODUCTIVE AGE WITH UNDIFFERENTIATED CONNECTIVE TISSUE DYSPLASIA (LITERATURE REVIEW)

that will contribute to strengthening the reproductive health of young women.

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СУЧАСНИЙ СТАН ПРОБЛЕМИ ПОРУШЕНЬ МЕНСТРУАЛЬНОГО ЦИКЛУ У ЖІНОК РЕПРОДУКТИВНОГО ВІКУ З НЕДИФЕРЕНЦІЙОВАНОЮ СПОЛУЧНОТКАНИННОЮ ДИСПЛАЗІЄЮ (ОГЛЯД ЛІТЕРАТУРИ) Ракитянський І. Ю. Резюме. На основі аналізу доступних джерел наукової літератури представлено огляд проблеми пору- шень менструального циклу у жінок репродуктивного віку та впливу на них захворювань сполучної тканини. Порушення менструального циклу вражають 75 % молодих жінок у розвинених країнах і країнах, що розви- ваються, та становлять більшість захворювань жінок дітородного віку. Патогенез цих станів можна описати як статево-гормонально-імунну асоціацію. Добре відомо, що недиференційована дисплазія сполучної тканини (НДСТ) має негативний вплив на перебіг вагітності та можливий розвиток уражень плода. Ця проблема є в центрі уваги більшості досліджень. Виявлено зв’язок між патологічним перебігом вагітності та фенотипічни - ми ознаками захворювань сполучної тканини в матерів, чиї доньки мають порушення менструальної функції. У молодих жінок із захворюваннями сполучної тканини дисменорея та аномальні маткові кровотечі є най - поширенішими порушеннями менструального циклу, які зумовлені імунною дисрегуляцією, аутоімунними процесами та запаленням. Сучасний підхід до лікування таких пацієнток полягає в розробці індивідуального плану лікування, зважаючи на супутні захворювання, поточні лабораторні показники, патологічні особливос- ті дебюту захворювання та перебігу порушень менструального циклу. Лікування складається з призначення гормональних (синтетичних і природних естрогенів, гонадотропін-рилізинг-гормонів, аналогів прогестерону та гонадотропін-рилізинг-гормону) та негормональних засобів (нестероїдних протизапальних препаратів, транексамової кислоти), а також немедикаментозного лікування (модифікація способу життя, фізична актив- ність, раціональне харчування). На сьогодні відсутня єдина термінологія та загальноприйняті критерії діагнос- тики та оцінки тяжкості НДСТ. Діагностичні методи та критерії НДСТ не стандартизовано порівняно з іншими захворюваннями сполучної тканини. Ведення пацієнтів із захворюваннями сполучної тканини та менстру- альною дисфункцією є комплексним питанням, відповідь на яке базується на оцінці гінекологічних проблем (менструація, фертильність, сексуальність) та мультидисциплінарному підході із залученням фахівців інших спеціальностей. Ключові слова: порушення менструального циклу, жінки репродуктивного віку, недиференційована дис- плазія сполучної тканини, аномальні маткові кровотечі, дисменорея. CURRENT STATE OF THE PROBLEM OF MENSTRUAL CYCLE DISORDERS IN WOMEN OF REPRODUCTIVE AGE WITH UNDIFFERENTIATED CONNECTIVE TISSUE DYSPLASIA (LITERATURE REVIEW) Rakytianskyi I. Yu. Abstract. Based on the analysis of available sources of scientific literature, an overview of the problem of menstrual cycle disorders in women of reproductive age and the impact of connective tissue diseases on them is presented. Menstrual disorders affect 75% of young women in developed and developing countries and constitute the majority of diseases in women of childbearing age. The pathogenesis of these conditions can be described as a sex-hormonal-immune association. Undifferentiated connective tissue dysplasia (UCTD) is known to exert a negative impact on the course of pregnancy and the possible development of fetal impairment. This problem is the focus of most research. The relationship between the pathological course of pregnancy and phenotypic signs of connective tissue diseases in mothers whose daughters have menstrual disorders was revealed. In young women with connective ISSN 2077-4214. Вісник проблем біології і медицини – 2024 – Вип. 1 (172) / Bulletin of problems in biology and medicine – 2024 – Issue 1 (172) 75 ОГЛЯДИ ЛІТЕРАТУРИ / LITERATURE REVIEWS tissue diseases, dysmenorrhea and abnormal uterine bleeding are the most common menstrual disorders, caused by immune dysregulation, autoimmune processes, and inflammation. The modern approach to the treatment of such patients consists in the development of an individual treatment plan, taking into account concomitant diseases, current laboratory findings, pathological features of the onset of the disease and the course of menstrual cycle disorders. Treatment consists of prescribing hormonal (synthetic and natural estrogens, gonadotropin-releasing hormones, progesterone and gonadotropin-releasing hormone analogues) and non-hormonal agents (nonsteroidal anti-inflammatory drugs, tranexamic acid), as well as non-drug treatment (lifestyle modification, physical activity, rational nutrition). To date, there is no unified terminology and generally accepted criteria for diagnosing and assessing the severity of UCTD. Diagnostic methods and criteria for UCTD are not standardized compared to other connective tissue diseases. Management of patients with connective tissue diseases and menstrual dysfunction is a complex issue, the answer to which is based on the assessment of gynecological problems (menstruation, fertility, sexuality) and a multidisciplinary approach involving specialists from other branches. Key words: menstrual cycle irregularities, women of reproductive age, undifferentiated connective tissue dysplasia, abnormal uterine bleeding, dysmenorrhea. ORCID and contributionship: Rakytianskyi I. Yu.: https://orcid.org/0009-0009-5986-6988 ABCDEF ________________________________________________________________ Corresponding author Rakytianskyi Igor Yuriyovych Kharkiv National Medical University Ukraine, 61000, Kharkiv, 4 Nauky Avenue Tel.: +380678033564 E-mail: [email protected] ________________________________________________________________ A – Work concept and design, B – Data collection and analysis, C – Responsibility for statistical analysis, D – Writing the article, E – Critical review, F – Final approval of the article. Received 02.09.2023 Accepted 14.02.2024 DOI 10.29254/2077-4214-2024-1-172-75-81 UDC 616.61:591.3:546.48:612.6 Shatorna V. F. INFLUENCE OF HEAVY METALS ON MORPHO-FUNCTIONAL STATE OF BONE TISSUE Dnipro State Medical University (Dnipro, Ukraine) [email protected] Connection of the publication with planned re- search works. The work was carried out in accordance with the sci- entific theme of DSMU “Morphological and functional features of organs and tissues under the influence of external and internal factors”, state registration number 0120U105219. Introduction. Increasing rates of environmental pollution in indus- trialised countries require studying the impact of envi- ronmental factors on human health. One of the most widespread and dangerous environmental pollutants is heavy metals, which, when ingested by the human body, lead to acute and delayed complications, change the balance of trace element systems, cause diseases or The article presents an analysis of scientific literature on the impact of heavy metal compounds on bone and cartilage tissue. The most common environmental toxicants in the group of heavy metals are mercury, cadmium and lead salts, which, when ingested, accumulate in the body, provoke a hypoxic state and compete with biogenic metals for binding to the active site of many proteins and enzymes, causing a violation of their functions. Modern scientific research has shown that chronic cadmium intoxication creates an imbalance in the process of bone remodelling, in- ducing the development of osteopenia and osteoporosis. The ability of the toxicant to accumulate in the extracellular bone matrix has been experimentally determined, leading to its bioaccumulation and an increase in the half-life of the metal from the body. The accumulation of cadmium in bone tissue leads to a decrease in calcium and zinc levels, which disrupts the basic processes of ossification and negatively affects cartilage and joint tissue. Understanding the mechanisms of osteo- and chondrotoxicity of cadmium will help to find adequate therapy methods for cadmium- induced osteoporosis and prevent the negative impact of the toxicant on bone and cartilage tissue. Studies of the accumulation level of trace elements in bones and their changes under the influence of negative factors are also relevant. It is perspective not only to determine the accumulation level of heavy metal salts but also to search for possible bioantagonists of heavy metal salt accumulation. Key words: bone tissue, femur, lower jaw, microelements, dyselementoses, cartilage tissue, rats, heavy metals, cadmium, zinc, iron, influence, accumulation.