[Russian eligibility criteria prescribing menopausal hormonal hormones therapy for patients with cardiovascular and metabolic diseases. Consensus document of the Russian Cardiological Society, Russian Society of Obstetricians and Gynecologists, Russian Association of Endocrinologists, Eurasian Association of Therapists, Association of Phlebologists of Russia].

Menopausal symptoms can disrupt the life course of women at the peak of their career and family life. Currently, the most effective treatment for these manifestations is menopausal hormone therapy (MHT). The presence of cardiovascular and metabolic diseases in itself does not exclude the possibility of prescribing MHT to relieve menopausal symptoms and improve quality of life. However, often an obstacle to the use of this type of hormonal therapy is the fear of doctors who are afraid of doing more harm to patients than good. Caution is especially important when it comes to women with underlying health conditions. Moreover, it should be recognized that there is a lack of high-quality research regarding the safety of MHT for major chronic non-infectious diseases and common comorbid conditions. The presented consensus document analyzed all currently available data obtained from clinical trials of various designs and created a set of criteria for the acceptability of prescribing MHT to women with concomitant cardiovascular and metabolic diseases. Based on the presented document, doctors of various specialties who advise women in menopause will receive an accessible algorithm that will allow them to avoid potentially dangerous situations and reasonably prescribe MHT in real practice.

[Russian Eligibility Criteria for Prescribing Menopausal Hormone Therapy to Patients With Cardiovascular and Metabolic Diseases. Consensus Document of RSC, RSOG, RAE, EUAT, RAP].

Menopausal symptoms can impair the life of women at the peak of their career and family life. At the present time, the most effective treatment for these manifestations is menopausal hormone therapy (MHT). The presence of cardiovascular and metabolic diseases in itself does not exclude the possibility of prescribing MHT to relieve menopausal symptoms and improve quality of life. However, often an obstacle to the use of this type of hormone therapy is the fear of physicians to do more harm to patients than good. Caution is especially important when it comes to women with concurrent diseases. Moreover, it should be recognized that there is a shortage of high-quality research on the safety of MHT for underlying chronic non-infectious diseases and common comorbidities. The presented consensus analyzed all currently available data from clinical trials of various designs and created a set of criteria for the appropriateness of prescribing MHT to women with concomitant cardiovascular and metabolic diseases. Based on the presented document, physicians of various specialties who advise menopausal women will receive an accessible algorithm that will allow them to avoid potentially dangerous situations and reasonably prescribe MHT in real-life practice.

[Prophylaxis and treatment of severe bleeding in obstetrics (draft guidelines)].

The article represents draft guidelines on severe bleeding in obstetrics which is the major reason of maternal mortality throughout the world. Criteria of estimation the physiological, pathological and massive blood loss are given. Algorithms of conservative and surgical treatment are presented, as well as major indications for administration of anti-fibrinolythics, infusion and transfusion treatment.

[Combined application of interference therapy and "dry" carbon dioxide baths for the treatment of hemodynamic disorders in patients with implantation failure due to inflammation].

This work was designed to evaluate the influence of different physiotherapeutic modalities on the possibility of implantation, development and outcome of pregnancy in patients with chronic endometriosis and previous failures of implantation. The study confirmed initial sonographic changes and deficit of uterine blood supply as well as gradual improvement of these parameters under effect of adequate physiotherapy. Inclusion of dry carbon dioxide baths in the combined treatment of hemodynamic disorders made it possible to "prepare" endometrium for implantation and optimize blood circulation in the uterine vasculature in order to enhance the probability of implantation, development of pregnancy, and its success.

Heterogeneity of serum activities of matrix metalloproteinases in chronic endometritis.

Matrix metalloproteinases belong to the key molecules of tissue remodeling involved in physiological and pathological processes of the female reproductive system. Adequate levels of their expression in the endometrium are essential for effective implantation and uneventful pregnancy. Chronic inflammatory process in the endometrium is associated with low tissue expression of metalloproteinase-9. Histologically verified chronic endometritis is associated with low serum activities of metalloproteinases 2 and 9, which are restored after combined etiotropic therapy. We measured serum levels of metalloproteinases in patients with chronic endometritis concomitant with sterility and its changes during the first days after magnetotherapy.

[Chronic salpingo-oophoritis: clinical and physiological rationale for therapeutic application of impulse low-frequency electrostatic field].

Significant alterations in arterial and venous circulation, primarily in the vascular bed of the small pelvis, were detected in 63 patients with chronic salpingo-oophoritis. All the women received intensive therapy with impulse low-frequency electrostatic field (ILFEF). In 52 women the exposure was abdominovaginal, in 11 women the exposure was preceded by placebo procedures. ILFEF produced marked and long-term positive effects (up to 18 months): pain relief, reduction of vegetative anxiety, increased uterine motility, softening and better elasticity of the commissures in the regions of the uterine appendages, normalization of the circulation in the vascular bed of the small pelvis. This therapy is pathogenetically sound as it rests on changes in activity of central regulation resultant from trigger stimulation and normalization of hemodynamics in the vascular bed of the small pelvis (in 76.6%) especially in the veins in response to stimulation of the sympathetic nerves in the inflammation focus.

Effects of a phasic oral contraceptive containing desogestrel on facial seborrhea and acne.

BACKGROUND: The combined oral contraceptive containing ethinylestradiol and the selective progestogen, desogestrel, in a phasic regimen (DSG-OC, Tri-merci) has been shown to reduce facial oiliness. OBJECTIVE: This study was designed to evaluate further the effects of this OC on the skin of women with facial seborrhea and mild or moderate acne. DESIGN AND METHODS: This was an open, noncomparative, bicenter study in 60 healthy Russian women, aged 18-30 years, with facial seborrhea and mild or moderate facial acne, who wished to use oral contraception. All women received the OC containing desogestrel (50/100/150 microg) and ethinylestradiol (35/30/30 microg) for three phases of 7 days followed by a 7-day pill-free interval, for six cycles. Seborrhea was assessed using the Sebutape technique, in which strips of adhesive microporous polymeric film pressed onto facial sites are used to assess sebaceous activity. Acne was assessed by counting facial lesions. Subjective evaluations of skin and hair condition, patients' feelings to them and satisfaction with the OC were made using a visual analogue scale (VAS). Assessments were made at baseline, and after one, three and six treatment cycles. RESULTS: Sebutape assessments of seborrhea were significantly improved, on the right and left cheeks, after one treatment cycle, and on the forehead after three treatment cycles. These improvements increased steadily and were much larger at the end of Cycle 6. Acne grades were significantly improved after three and six treatment cycles. VAS scores in response to questions dealing with self-esteem and self-confidence were significantly improved after three cycles and in some cases after just one cycle. The women's views of their skin and hair (greasiness) were correspondingly significantly improved. Subjective assessments indicated that after one, three and six cycles, 69%, 93% and 98%, respectively, of women were satisfied or very satisfied with the DSG-OC. CONCLUSION: In women with facial seborrhea and mild or moderate acne, the use of DSG-OC appears to improve seborrhea after just one cycle and acne grades after three cycles. These improvements are accompanied by increases in self-esteem and confidence.

NetWork: an interactive interface to the tools for analysis of genetic network structure and dynamics.

We designed a Java applet called NetWork which enables a user to interactively construct and visualize a genetic network of interest, and to and to evaluate and explore its dynamics in the framework of a Boolean network model. NetWork displays the mechanism of gene interactions at the level of gene expression and enables the visualization of large genetic networks. NetWork can serve as an interactive interface to tools for the analysis of genetic network structure and behavior.

Graphical interface to the genetic network database GeNet.

UNLABELLED: We designed a Java applet which enables the visualization of genetic networks and can be used as a Web publishing tool by molecular biologists studying the mechanisms of gene interactions. AVAILABILITY: http://www. csa.ru/Inst/gorb_dep/inbios/ genet/Graph/Genes_Graph.html CONTACT: samson@fn.csa.ru

[Endotoxin and antiendotoxin immunity in pelvioperitonitis]. / Endotoksin i antiéndotoksinovyi immunitet pri pel'vioperitonitakh.

The levels of bacterial blood endotoxin, antiendotoxin antibodies and the overall immunity were studied in 48 females with inflammatory genital diseases complicated by pelvioperitonitis. The severest pelvioperitonitis-complicated abnormality was shown to characterized by high concentrations of endotoxin and low levels of antibodies. Endotoxinemia was found to be of diagnostic and prognostic value.

[Hyperplastic ovarian processes from the clinico-morphological aspect]. / Giperplasticheskie protsessy iaichnikov v kliniko-morfologicheskom aspekte.

Clinico-morphologic analysis was carried out in 93 patients with hyperplastic changes in the ovaries (stromal hyperplasia, thecomatosis, interstitial gland, etc.) and endometrial hyperplasia (glandular, atypical, etc.). A relationship was revealed between endometrial hyperplasia and ovarian hormone-producing structures, but the intensity of proliferation and structural rearrangement of glandular epithelium did not correlate with the activity of gonadal hormone-producing structures determined by morphofunctional studies, nor did it correlate with blood plasma estradiol level. Ineffective hormonal therapy of patients with hyperplasia of the endometrium may be caused by hyperplastic processes in the ovaries.

[Reserves in decreasing maternal mortality due to obstetrical hemorrhages]. / Rezervy snizheniia materinskoi smertnosti ot akusherskikh krovotechenii.

Analysis of 542 lethal cases at pregnancy terms 28 weeks and more, of parturients and puerperae in Russia over 1987-1991 has shown that obstetrical bleedings were responsible for 42.2% of deaths, being the most frequent causes of lethal outcomes. Analysis of records documenting 283 lethal cases has shown a high incidence of somatic (90.9%) and obstetrical diseases (95.5%). Assessment of medica care quality has shown inadequate care of pregnant women and parturients and inadequate emergency care. Prevention of massive blood loss should involve hemostasis studies in pregnant women and parturients and its correction; if a bleeding occurs, comprehensive intensive care and surgical interventions are indicated.

[Congenital cytomegalic inclusion disease--clinico-anatomical characteristics]. / Vrozhdennaia tsitomegaliia--kliniko-anatomicheskaia kharakteristika.

Analysis of labor histories, case histories, and autopsy records over a decade, 1980-1990, has revealed 32 cases of cytomegalic inclusion disease in children. Eleven placentas of seropositive mothers were histologically examined. The findings evidence that cytomegaloviral infection was mostly combined with other bacterial and viral diseases. The central nervous system, kidneys, and lungs were the most sensitive to the virus effects. The DIC syndrome was present in all the cases.

[Effects of prenatal factors on the colloid-osmotic status of the newborn]. / Vliianie prenatal'nykh faktorov na kolloidno-osmoticheskoe sostoianie novorozhdennykh.

Studies of prenatal factor effects on the newborns' colloid-osmotic status, a pressing problem in present-day obstetrics, were carried out in 2 groups of women: Group 1 consisted of 50 women with spontaneous delivery and Group 2, also consisting of 50 women, who delivered via cesarean section, 25 of them because of a cicatrix on the uterus and the rest because of severe gestoses characterized by nephropathy and Stage III pre-eclampsia. Blood samples were collected directly after delivery from the mother's vein and from the newborn's umbilical vein, and the colloid-osmotic status of the plasma was analyzed. The results permitted singling out a number of prenatal factors influencing the newborns' colloid-osmotic status. These factors are as follows: obstetrical abnormalities, gestosis among other things; intensive care of the mother during delivery or after surgery, administration of diuretics, delivery mode, etc. These results have brought the authors to a conclusion that standardized infusion therapy without due consideration for the colloid-osmotic status is inadmissible, for it may result in iatrogenic complications in the newborns.

[Informative value of various biochemical parameters of homeostasis in the formation of endometrial cancer risk groups]. / Informativnost' nekotorykh pokazatelei gomeostaza v formirovanii grupp riska po razvitiiu raka éndometriia.

A total of 97 patients suffering from endometrial polyposis, hyperplasia, adenomatous hyperplasia, and carcinoma were examined. The levels of malonic dialdehyde as an index of lipid peroxidation, average-mass molecules, C peptide, humoral immunity parameters were studied. The content of circulating immune complexes were also determined. Specific changes which might be an auxiliary factor in predicting the therapy and forming cancer risk groups were identified.

[Characteristics of infusion therapy in parturients with gestosis after cesarean section]. / Osobennosti infuzionnoi terapii u rodil'nits s gestozom posle operatsii kesareva secheniia.

The paper addresses fluid therapy after cesarean section in toxemic parturients. A comparative study involved 130 parturients and 540 women with a history of toxemia of pregnancy of variable severity. It was demonstrated that the routine fluid therapy employed in women with mild toxemia was not suitable for parturients with Grade III pregnancy-associated renal disease and preeclampsia. This is explainable by 3 types of abnormality in the colloid oncotic pressure (hyper-, hypo- and normo-osmolar++ dysosmia); most of the patients presented with hypo-osmolar and hypo-oncotic++ plasma states coexisting with impairment of renal excretory and concentrating function.

[Clinico-morphological characteristics of fetuses and newborn infants of mothers with hemorrhagic shock]. / Kliniko-morfologicheskie osobennosti ploda i novorozhdennogo pri gemorragicheskom shoke u materi.

A clinical and morphological analysis has been done using 24 obstetric histories of mothers with hemorrhagic shock (HS) and autopsy protocols of fetuses and newborns who died ante-, intra- or postpartum. Maternal HS was related to placenta previa and presented as a poor general status and microcirculatory disorders, respiratory and adrenal insufficiency. Histologic and electron microscopic studies showed fetal and neonatal lesions in organs and tissues which might be interpreted as irreversible shock. Reduction of neonatal mortality dictates further efforts in the prevention of hemorrhagic complications in parturients.