Роль коморбідної патології у пацієнток з «проліферативними» захворюваннями геніталій та синдромом хронічного тазового болю
Bibliographic record
Abstract
У статті було визначено клінічні прояви коморбідної патології та її вплив на перебіг синдрому хронічного тазового болю (СХТБ) у 120 пацієнток з генітальним ендометріозом у поєднанні з доброякісними захворюваннями геніталій. Хворі були розподілені на 3 клінічні групи, в залежності від наявності та інтенсивності тазового болю. Наявність коморбідного «вісцелярного синдрому» ми спостерігали у 32% випадків жінок 1-а підгрупи, у 45% жінок 1-б підгрупи, тобто у «больових» групах і в 5% випадків в підгрупі 2-а і 20% жінок підгрупи 2-б. Визначено вплив вісцелярних проявів на перебіг СХТБ, що корелюють з захворюваннями шлунково-кишкового тракту (ρ=0,33; р<0,001), сечостатевої системи (ρ=0,26; р=0,004), залізодефіцитними станами (ρ=0,29; р=0,001). Спостерігається середньої сили прямий кореляційний зв’язок з тривалістю СХТБ (ρ=0,35; р<0,001), силою болю за ВАШ (ρ=0,63; р<0,001), а також з підвищеним рівнем тривожності (ρ=0,50; р<0,001) і депресії (ρ=0,52; р<0,001) у пацієнток з коморбідною патологією. Патологічна больова аферентація призводить до дизрегуляції ноцицептивної системи і сприяє хронізації тазового болю, що підтверджується статистично значимими асоціативними зв’язками. The comorbid diseases represent a practically important and not enough studied problem in patients with CPP with a genital endometriosis in a combination with benign hormonal pathology of the genitals. Interaction of gynecological diseases of the reproductive system and somatic diseases with CPP, changes the clinical picture of the main nosology, the nature and severity of complications, restricts diagnosis and treatment, negatively afects the quality of life of a woman. The aim of our study to determine an influence of the clinic comorbid extra genital pathology to the course of chronic pelvic pain syndrome in patients with genital endometriosis in a combination with benign hormonal pathology of the genitals.Object and methods. We examined 120 patients with a genital endometriosis in a combination with benign hormonal pathology of the genitals. There were 120 women in research were divided into several groups, depending on visual analogue scale (VAS) and durations of disease: of 1 group (n=44) VAS are 7-10 points; 2 group (n=41) VAS 4-6 point; 3 group (n=35) VAS 0-3 points. The Teilor’s Manifest Anxiety Scale determination of level of personality anxiety. The level of depression was determined by Hamilton Rating Scale for Depression (HDRS). McGill Pain Questionnaire, (MPQ) measured sensory, emotional and quantitative description of pain. The result of the study with the determination of cytokine levels of pro- inflammatory (IL-6, TNF-α) and anti-inflammatory cytokines ( IL-10) by immunoassay method (ELISA) using the sets of CJSC Vector-Best. The statistical processing was carried out using STATISTICA 6.1 software (StatSoftInc., Serial No. AGAR909E415822FA) and the MedCalc Statistical Software trial version 17.4 software package. (MedCalc Software bvba, Ostend, Belgium; https://www.medcalc.org; 2017).Study results and their discussion. The frequency of extra genital pathology, was statistically meaningful (р<0,05) for the patients of a 1 group by comparison to the patients of 3 group. A disease of gastrointestinal tract is in 1-б groups (75 % (95 % ДІ 53,13 – 88,81) comparatively with 37,14 % (95 % ДІ 23,17 – 53,66)); with 2 groups. Chronic gastritis met for 50% women 1th groups and in 60% womens of 1-б group, chronic cholecystitis in 35,7% and accordingly in 46,6%. Irritable bowel syndrome, constipation, diarrhea in 14,2% and accordingly in 26,7%. The disease of the urogenital system, dysuria, was observed accordingly in «pain groups» 1th – 37,7% and 1-б – 35,0%. During the progress of СРР, the level of cytokines ІL-10 was low, and increased of ІL-6, TNF -α comparaЦvely with 3th a group (р<0,05). The level of cytokines of ІL-6, TNF-α correlated with the higher points of intensity of pain syndrome in a 1-th group, with pain anamnesis duration, and enhance able level of anxiety and depression. Сomorbid pathology in research marked as a “visceral syndrome”(VS). A VS correlates with the diseases of gastrointestinal tract (ρ=0,33; р<0,001), urogenital system (ρ=0,26; р=0,004), iron-deficient states (ρ=0,29; р=0,001). Marked middle force direct cross-correlation. Copulas connection of VS with duration of CPP (ρ=0,35; р<0,001) and force of pain for VAS (ρ=0,63; р<0,001), and also related to the enhance able level of anxiety(ρ=0,50; р<0,001) and depression(ρ=0,52; р<0,001). Conclusion. Influence of extra genital comorbid pathology, genesis of that has multifactorial reasons, chronic inflammation, pathological pain sensitiveness results in violation of the nociceptive system and assists progress of СРР, that is confirmed statistically by meaningful associative connections.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.008 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.003 | 0.003 |
| Science and technology studies | 0.003 | 0.003 |
| Scholarly communication | 0.009 | 0.006 |
| Open science | 0.001 | 0.003 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.045 | 0.018 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".