Endometrioid disease today is ranking one of the leading positions in the structure of gynaecological diseases. The prevalence of this endometrioid disease reaches 10% among the female population and up to 70% among women of child-bearing age. Ambiguity in terms of the aetiology, pathogenesis, and predictors of the disease impedes the accurate and quick diagnosis and proper management of this disease. The aim of this study is to analyze and to compare symptomatic and anamnestic data presented by women who have with endometrioid disease and have no it, and to identify and analyze predictors and consequences of endometrioid disease. The study examined 80 women of reproductive age. The main group involved 50 women with endometrioid disease; the control group included 30 women without signs of endometrioid disease. All participants underwent clinical examination and were interviewed about symptoms, family history, menstrual function, past gynaecological, reproductive, infectious (infectious diseases, transferred in childhood), somatic diseases. The information about the presence of psychological and physical overstrain in women of both groups was obtained (subjectively from the words of women) and then assessed. Contributory factors or predictors in the development and progression of endometrioid disease are as follows: an increased number of occupational hazards (22.6% versus 0%, respectively, p = 0.03) among working women with endometrioid disease; regular psychological overstrain, which can result from endometrioid disease on the one hand, and, contribute to its progression, on the other (70% versus 43.3%; p = 0.03); the presence of the 0 blood type (40% versus 16.7%; p = 0.029), the presence of chronic inflammation of the uterine appendages in the past (60% versus 36.6%; p = 0.04); human papilloma virus in past or present medical history (14% versus 0%; p = 0.04). The possible consequences of endometrioid disease include somatic pathology prevailing in 1.3 times. Special attention should be paid to the average number of gastro-intestinal diseases in the women of main and control groups: 1.34 ± 1.3 versus 0.77 ± 1.1, respectively; p = 0.04. The prevalence of diseases of urinary system is as follows: 0.66 ± 0.68 versus 0.33 ± 0.54, respectively; p = 0.04. The menstruations are described as irregular, heaving bleedings often with dark brown discharge before menstruation, pain during menstruation. The study revealed a large percentage of infertility in patients with endometrioid disease (60% versus 33.3%, respectively; p = 0.02), reduced reproductive potential in general (the average number of pregnancies per woman in the control group is 1.9 times higher). It should be noted that 14 (28%) women of the main group have relapse of endometrioid disease in the form of repeated cysts after conservative and / or surgical treatment. Thus, endometrioid disease was detected for the first time in 36 (72%) women of the main group. The information obtained in the study can be helpful for medical practitioners as it deepens knowledge about possible predictor factors, premorbid background and the consequences of endometrioid disease, and, thus, will serve in customized management of such patients.
Вступ. Вищі навчальні заклади повинні створити безпечне та надійне освітнє середовище для навчання клінічних умінь. Одним із засобів досягнення цього завдання є застосування симуляційних технологій.Мета дослідження. Запровадити в навчальний процес симуляційні технології та оцінити їх ефективність у підготовці до складання об'єктивного структурованого клінічного іспиту.Матеріал і методи дослідження. На базі кафедри створено симуляційний клас, обладнаний муляжами та фантомами. Співробітниками кафедри підготовлено дві станції: «акушерську» та «гінекологічну». Розроблено 28 алгоритмів виконання практичних навичок та чек-листи для оцінювання дій здобувачів вищої освіти. Проведено анонімне опитування 112 студентів за допомогою розробленої анкети.Результати та їх обговорення. Ураховуючи набутий досвід викладацької діяльності і великий клінічний досвід колективу кафедри, об'єднаними зусиллями співробітників розроблено алгоритми виконання практичних навичок на фантомах, муляжах, що дає змогу відпрацювати виконання певних дій, дає можливість повторного проведення маніпуляцій, скорочує час, необхідний для засвоєння навички у клінічному середовищі, мінімізує завдання шкоди здоров'ю пацієнта під час утручань.Висновки. Упровадження в освітній процес сучасних навчальних технологій у вигляді класів, центрів симуляційних технологій на базі ВНЗ та клінік дає змогу досягти максимального відпрацювання практичних навиків окремих діагностичних і лікувальних маніпуляцій. що сприятиме ефективній підготовці до ОСП(К)І.Ключові слова: симуляційні технології, навчальний процес, іспит, здобувачі вищої освіти.
The aim: To assess the CSF – 1 level in peritoneal fluid and menstrual blood of women with endometrioid disease and to investigate its diagnostic and prognostic specificity. Materials and methods: The study included 80 women of child-bearing age (mean age 30.95 ± 6.49 years) with benign gynaecological pathology of the ovaries and / or fallopian tubes. The women included in the study were divided into two groups: study group (n = 50, mean age 31.04 ± 6.3 years), consisting of patients with confirmed endometrioid disease, and control group (n = 30, mean age 30.8 ± 6.8 years), involving individuals without signs of endometriosis (p> 0.05). Results: We have found significantly higher level of CSF-1 content in the peritoneal fluid in the subjects of the study group (2027.05 ± 732.64 pg / ml) compared with those in the control group (1725.62 ± 466.06 pg / ml) (p = 0.029). There is a tendency towards an increase in CSF-1 level in women with endometriosis in its more severe stages and more severe and extended adhesions. The investigation of CSF-1 content in menstrual blood has demonstrated significant increase in its values in the women of the study group (9431.6 ± 2866.22 pg / ml) compared with the values in the control group (6637.12 ± 954.05 pg / ml), (p = 0.00004). Thus, there is a tendency towards the growth in CSF-1 level in peritoneal fluid and menstrual blood in women with endometriosis and concurrent increase in severity of the disease. Conclusions: There has been found significant increase in CSF-1 content in women with endometrioid disease in both peritoneal fluid and menstrual blood (1.2 and 1.4 times, respectively). Thus, macrophage growth factor (CSF-1) can be used as a diagnostic and prognostic criterion in evaluating the progression of endomertioid disease.
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