No abstract

Female rats (aged three months at the start of the study) were kept for four months on drinking water (group 1) or 5% ethanol. Rats drinking ethanol were additionally divided into six groups (groups 2-7). During the next two months of the experiment, animals of group 2 continued to drink only ethanol, while rats of group 3 additionally received N-acetylcysteine, those of group 4 received ascorbic acid (vitamin C) and alpha-tocopherol (vitamin E), those of group 5 received melatonin, those of group 6 received carnosine, and those of group 7 swam in the so-called training regime for five days a week. All animals underwent bilateral ovariectomy 2.5 weeks before experiments ended, and were given daily i.m. estradiol (2 microg) during the 11 days before the last experimental day. After treatments, blood estradiol and cholesterol levels were measured, along with progesterone receptor levels, peroxidase activity, the index of proliferation, the proportions of cells in the S and G2/M phases, the thickness of the endometrium, and the extent of DNA damage (using the "comet" technique) in uterine tissue. Liver estradiol 2-hydroxylase activity was also measured. The results led to the conclusion that drinking of 5% ethanol in combination with administration of estrogens was accompanied by induction of genotoxic (G) changes in the uterus and that this was prevented by administration of N-acetylcysteine and melatonin. The combination of vitamins C and E increased some of the manifestations of the hormonal (H) effect of estrogens (uterine weight and induction of progesterone receptors), but weakened others (the index of proliferation). As a result, the combination of N-acetylcysteine and optimum doses of ascorbic acid and alpha-tocopherol can be recommended for preventing the estrogen effect-switching phenomenon (increases in the G component on the background of weakening of the H component), which is seen particularly in patients consuming excessive amounts of alcohol, increasing the risk that the genotoxic version of hormonal cancerogenesis will develop.

Обязательным условием лечения больных, в том чис-ле беременных женщин, с обструктивным пиелонефри-том и мочекаменной болезнью (МКБ) является восста-новление оттока мочи из почки [1][2][3][4][5]. Цистоскопия с ка-тетеризацией мочеточника позволяет ликвидировать об-струкцию, но после удаления мочеточникового катетера через несколько дней обструкция мочеточника может по-вториться, поэтому рассматривать катетеризацию моче-точника обычным катетером или наружным катетером-стентом в качестве самостоятельного операционного по-собия нельзя. Другим вариантом дренирования почки в этой ситуации является установка внутреннего мочеточ-никового катетера-стента (ОUble-J) [6][7][8] Внутреннее дренирование верхних мочевых путей катетером-стентом у беременных с мочекаменной болезнью при острой обструкции мочеточника является общепринятой операцией. Между тем вопросам профилактики осложнений при установке катетера-стента в практике урологов и акушеров не уделяется должного внимания, не прослеживается согласо-ванность действий между врачами смежных специальностей. Подробно представлены два клинических примера развития и лечения подобных осложнений как с урологической, так и с акушерской стороны, намечены мероприятия по совер-шенствованию мультидисциплинарного подхода в ведении таких беременных, профилактики осложнений стентирования.Авторы информируют об отсутствии конфликта интересов. External upper urinary tract drainage using a stent is a universally accepted procedure for urolithiasis in pregnant women with acute ureteral obstruction. At the same time urologists and obstetricians give no due regard to the prevention of complications in their practice when placing the stent; there is no consistency of acts between the physicians of related professions. The paper details two clinical examples of the development and treatment of these complications in both urological and obstetrical standpoints and defines measures to improve a multidisciplinary approach to managing such pregnant women, as well as the prevention of stenting complications.The authors declare no conflicts of interest.