Effective Pharmacotherapy最新文献

{"title":"Resolution of the Expert Council «Unexplored Dyspepsia: Short-term and Long-term Patient Management Strategies»","authors":"I. Maev, L. Lazebnik, D. Bordin, N. Dekhnich, Yu.A. Kucheryavy, A. Tryakin, O. Gaus, M. Livzan","doi":"10.33978/2307-3586-2023-19-8-16-24","DOIUrl":"https://doi.org/10.33978/2307-3586-2023-19-8-16-24","url":null,"abstract":"Purpose. To present the materials of the Expert Council, which was held on April 22, 2023 in Moscow and dedicated to modern approaches to the management of patients with unexplored dyspepsia, as well as the choice of the optimal Helicobacter pylori eradication therapy scheme in the Russian Federation. The main provisions of the resolution. An initial patient with recent dyspeptic symptoms who has not taken drugs that can cause gastric damage should be considered as a patient with undiagnosed dyspepsia. The first diagnosis to be excluded in a patient with unexplored dyspepsia is H. pylori-associated chronic gastritis. In order to alleviate or eliminate the symptoms of dyspepsia in the period before testing for H. pylori, the appointment of the prokinetic itopride hydrochloride is recommended, given the lack of influence on the results of the examination, proven efficacy and high safety profile, as demonstrated in studies on the original drug. The patient's presence of objective signs of gastrointestinal bleeding, unmotivated weight loss, aggravated family history of gastric cancer, as well as age over 50 years are indications for esophagogastroduodenoscopy with biopsy. An initial positive test for H. pylori is an indication for eradication therapy, as infection is a major etiological factor in gastric adenocarcinoma, including proximal gastric cancer and cancer of the gastroesophageal junction. Quadruple therapy with clarithromycin (amoxicillin + clarithromycin + proton pump inhibitor + bismuth tripotassium dicitrate) for 14 days can be defined as first-line therapy in the Russian Federation. In order to increase the effectiveness of eradication, the use of original preparations is recommended","PeriodicalId":11400,"journal":{"name":"Effective Pharmacotherapy","volume":"68 2-3 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77936321","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Features of Food Intolerance in Patients with Irritable Bowel Syndrome","authors":"S. Dbar, S. Bykova, E. Sabelnikova, O.V. Akhmadulina, N. Belostotsky, A. Parfenov","doi":"10.33978/2307-3586-2023-19-8-42-48","DOIUrl":"https://doi.org/10.33978/2307-3586-2023-19-8-42-48","url":null,"abstract":"The aim was to evaluate the activity of intestinal carbohydrases in patients with irritable bowel syndrome (IBS) with symptoms of food intolerance. Material and methods. 126 patients with IBS (83 women and 43 men, median age – 32.0 years (Q1–Q3: 27–38 years)) were examined. The diagnosis of IBS was established on the basis of Roman Criteria IV. A questionnaire was conducted for all patients to identify food intolerances, according to the results of which the patients were divided into three groups: the first – patients with isolated intolerance to foods with a high content of FODMAP; the second – patients with isolated intolerance to milk and dairy products; the third – patients with combined intolerance. To determine the activity of intestinal carbohydrates: lactase, sucrose, maltase and glucoamylase, all patients underwent esophagogastroduodenoscopy with biopsy samples from the duodenum. The activity of carbohydrases was determined by the Dahlquist method in the modification of N.I. Belostotsky. The control group consisted of 30 conditionally healthy people (10 men and 20 women, median age – 33.9 years (Q1–Q3: 24–35)), comparable in age and gender with patients with IBS. The activity of intestinal enzymes in this group was within the reference values. Statistical data processing was carried out using the computer program Statistica 8.0. Results. According to the results of the survey, it was found that out of 126 patients with IBS, 52 (41.3%) patients believed that they had food intolerance to certain foods. Isolated intolerance to foods with a high content of FODMAP was noted by 13 (10.3%) patients, 16 (12.7%) patients believed that they had isolated intolerance to milk and dairy products, and 23 (18.3%) patients indicated combined intolerance. In patients with IBS and isolated intolerance to foods high in FODMAP, the median activity of glucoamylase was 120.0 (68.5–209.2) ng/mg of glucose per 1 mg of tissue per minute (ng/mg × min), maltase – 630.5 (480.7–951.0) ng/mg × min, sucrose – 50.0 (32.8–68.8) ng/mg × min, lactase – 10.5 (5.5–40.5) ng/mg × min. Comparing the activity of carbohydrases with the control group revealed the statistically significant difference (p < 0.05) for each enzyme studied.In the group of patients with IBS and isolated intolerance to milk and dairy products, the median activity of all the intestinal enzymes studied was also lower than that in the control group: the activity of glucoamylase was 107.0 (64.0–174.0) ng/mg × min, maltase – 622.0 (481.5–887.0) ng/mg × min, sucrose – 48.0 (35.5-60.0) ng/mg × min, lactase – 8.0 (3.0–22.5) ng/mg × min. Among patients with IBS and the presence of combined intolerance to foods (with a high content of FODMAP and dairy products), the median activity of all enzymes significantly differed from the control group (p < 0.05). The activity of glucoamylase was 107.5 (57.5–194.2) ng/mg × min, maltase – 627.0 (480.7–911.7) ng/mg × min, sucrose - 47.5(34.8–61.5) ng/mg × min, lactase - 9.0 (4","PeriodicalId":11400,"journal":{"name":"Effective Pharmacotherapy","volume":"59 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87649885","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and Safety of Vedolizumab in the Treatment of Ulcerative Colitis in Real Clinical Practice: Five Years of Observation","authors":"O. Knyazev, A. Kagramanova, I. Li, A. Lischinskaya, E. Sabelnikova, N. Fadeeva, T. Shkurko, B. Nanaeva, T. Baranova, M.Yu. Timanovskaуа, A. Parfenov","doi":"10.33978/2307-3586-2023-19-8-26-33","DOIUrl":"https://doi.org/10.33978/2307-3586-2023-19-8-26-33","url":null,"abstract":"In real clinical practice, unlike in the registered controlled trials, the analytical group includes all patients who are being treated with a drug. The aim is to evaluate the efficacy and safety of vedolizumab (VDMB) therapy in real clinical practice in patients with ulcerative colitis (UC) for five years. Material and methods. The study included 136 patients with UC (men 53.7%, women 46.3%), average age – 33.8 ± 4.4 years, duration of the disease – 3.1 ± 0.4 years (52.9% of patients with moderate severity, 72.1% with total lesion and 64.4% with chronic recurrent course, in 17.6% of cases – extra-intestinal manifestations). Results. After 12 weeks, 53 (38.9%) patients with UC achieved a clinical response, 72 (52.9%) achieved clinical remission, 13 (9.5%) did not respond or did not respond sufficiently to therapy. After 24 weeks, clinical remission reached 72.1%, clinical response – 18.4% of patients. Of 112 patients who underwent colonoscopy (CS), 68 (60.7%) had clinical and endoscopic remission at week 24. After 52 weeks of therapy, endoscopic remission persisted in 68 (60.7%) patients, endoscopic response – in 40 (36.6%), clinical remission – in 112 (82.3%) and clinical response – in 21 (15.4%). After five years of VDMB therapy, endoscopic remission persisted in 70 (51.5%) patients, endoscopic response in 36 (26.5%), clinical remission in 105 (77.2%) and clinical response in 19 (14.0%). The survival rate of VDMB therapy in patients with UC was 90.4% after 12 months and persisted for a year, 82.3% after two years, 81.6% after five years. Steroidal remission was 91.0%. The regression of extra-intestinal manifestations after 24 weeks was noted in 58.3% of patients with UC. Conclusion. Our clinical observation of 136 patients with UC demonstrated the high efficacy and safety of VDMB","PeriodicalId":11400,"journal":{"name":"Effective Pharmacotherapy","volume":"108 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87592921","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-Term Use of Non-Steroidal Anti-Inflammatory Drugs in Patients with Axial Spondyloarthritis to Suppress Acute Bone Marrow Inflammation in the Sacroiliac Joints","authors":"M. Kurbanmagomedov, A. Starkova, S. Erdes","doi":"10.33978/2307-3586-2023-19-9-12-18","DOIUrl":"https://doi.org/10.33978/2307-3586-2023-19-9-12-18","url":null,"abstract":"Long-term use of nonsteroidal anti-inflammatory drugs in daily therapeutic practice is not welcome and often causes rejection due to the potential for the development of a variety of adverse events. However, in axial spondyloarthritis, these drugs play the role of not only symptomatic therapy, but also modify the course of the disease. Therefore, they should be prescribed for a long period, much longer than that described in the instructions for the drug. A brief description of clinical cases of the use of various non-steroidal anti-inflammatory drugs lasting 3 or more months is presented. Against the background of good clinical efficacy, adverse events did not develop during many months of continuous use","PeriodicalId":11400,"journal":{"name":"Effective Pharmacotherapy","volume":"11 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75893231","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimal Management of Comorbid Patients with Spondyloarthritis: Focus on Cardiovascular Safety","authors":"D. Karateev, E. Luchikhina, E. Markelova","doi":"10.33978/2307-3586-2023-19-9-20-27","DOIUrl":"https://doi.org/10.33978/2307-3586-2023-19-9-20-27","url":null,"abstract":"Comorbidity and multimobidity are typical for rheumatic diseases (RD) in general. Comorbidities have a complex negative impact on the patient with RD: they are often a direct cause of the premature death of patients, they may contribute to the severe course of the inflammatory process, comorbidities reduce choice of treatment options. Spondyloarthritis, such as psoriatic arthritis (PsA) and axial spondyloarthritis (axSpA), is also characterized by the frequent presence of comorbid conditions, in particular, cardiovascular diseases. Pleiotropic effects of pro-inflammatory cytokines such as interleukin 17A (IL-17A) promote these processes. IL-17A is a versatile pro-inflammatory T cell cytokine. At the same time, there is evidence that IL-17 involved in many other pathological processes: bone tissue remodeling, the development of endothelial dysfunction, formation of the unstable atherosclerotic plaques, heart ventricle remodeling after ischemic attack, etc. Clinical data confirm the role of hyperproduction of IL-17A in the development of cardiovascular diseases. On the example of Secukinumab IL-17A inhibition in PsA and axSpA, it has been shown that this treatment is associated with a high level of cardiovascular safety, and it is likely may help reduce cardiovascular risk. Therapy with IL-17A inhibitors, in particular, Secukinumab, in combination with generally accepted methods of correction of traditional cardiovascular risk factors, may be a promising direction in the management of patients with SpA and concomitant cardiovascular diseases","PeriodicalId":11400,"journal":{"name":"Effective Pharmacotherapy","volume":"30 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74875632","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reactivation of Chronic Hepatitis B in a Patient with Rheumatoid Arthritis","authors":"G. Gridneva, B. Belov, E. Aronova","doi":"10.33978/2307-3586-2023-19-9-6-11","DOIUrl":"https://doi.org/10.33978/2307-3586-2023-19-9-6-11","url":null,"abstract":"The problem of hepatitis B reactivation in patients with rheumatology profile has been and remains relevant due to the widespread use of various immuno-suppressive drugs. As new drugs are introduced into practice, there is a need to clearly understand the likelihood of HBV reactivation and personalize the management of such patients. A case of reactivation of HBV infection in a patient treated with upadacitinib and prophylactic with entecavir is presented. This review briefly summarizes the latest data on the mechanisms of HBV reactivation and the relative frequency of HBV reactivation, associated with various antirheumatic drugs","PeriodicalId":11400,"journal":{"name":"Effective Pharmacotherapy","volume":"36 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79814099","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Possible Risk Factors for Postoperative Pelvic Organ Prolapse","authors":"O. Pauzina, I. Apolikhina, S. V. Romanov, A. R. Dudkina, A. Saidova, O.P. Abaevа, K.V. Yevdokimova","doi":"10.33978/2307-3586-2023-19-7-28-32","DOIUrl":"https://doi.org/10.33978/2307-3586-2023-19-7-28-32","url":null,"abstract":"The aim of the study was to analyze possible risk factors for the development of postoperative recurrence of pelvic organ prolapse. The study included 245 patients (median age – 68 years) who underwent surgery for the first time during the two to three years preceding the study. The recurrence rate was 45.3%. As a result of statistical analysis, there was no statistically significant correlation between the occurrence of relapse and/or the period before its occurrence and the period from the detection of symptoms to the doctor and surgical treatment, as well as the fact of prescribing conservative therapy before surgical treatment.","PeriodicalId":11400,"journal":{"name":"Effective Pharmacotherapy","volume":"20 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87540850","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reproductive Health of Girls and Adolescents in Moscow. Development of Specialized Care","authors":"I. Karachentsova, YElyena Sibirskaya, M. Chernysheva","doi":"10.33978/2307-3586-2023-19-7-48-52","DOIUrl":"https://doi.org/10.33978/2307-3586-2023-19-7-48-52","url":null,"abstract":"Due to a steady trend towards an increase in the incidence of various gynecological diseases, one of the most significant problems of modern society is the protection of the reproductive health of girls and adolescents. Diseases that are asymptomatic or with an erased clinical presentation but have a significant impact on the reproductive potential of the young population deserve close attention. Purpose. To reveal the prevalence of gynecological diseases among the female population of the neutral, prepubertal and pubertal period in Moscow and to determinate ways to reduce incidence of preventable diseases. Material and methods. An analysis of the data on gynecological morbidity of girls and adolescents in Moscow is presented based on the data of the annual report of the chief freelance specialist gynecologist of childhood and adolescence in Moscow in 2021 (n = 925 632). According to the report, the prevalence of gynecological pathologies during examinations in 2021 is (n = 82 517): delayed puberty (n = 182), premature thelarche (n = 779), menstrual disorders (n = 11 748), other endocrine disorders (n = 15), premenstrual tension syndrome (n = 353), dysmenorrhea (n = 5265), inflammatory diseases of vulva and vagina (n = 18 796), ovarian cysts (n = 2384), labial adhesion (labia minora) (n = 6261), disorders of breast (n = 1136), anogenital warts (n = 26), congenital disorders of female genital organs (n = 71), unspecified injury of external genitals (n = 223), sexual transmitted diseases (n = 39), Turner’s syndrome (n = 21), unspecified malignant primary neoplasms (n = 5). Results. An analysis of the prevalence of gynecological diseases in girls and adolescents in Moscow in 2021 (n = 925 632) has revealed that the highest incidence among all diseases of the reproductive system (n = 82 517) is: inflammatory diseases of the external and internal genital organs – 23% (n = 18 796), as well as menstrual disorders – 14% (n = 11 748), including dysmenorrhea – 6% (n = 5265), and labial adhesions – 8% (n = 6261). Reducing the incidence of gynecological diseases among girls and adolescents in Moscow can be achieved through regular full well-child examinations and improving the quality of specialized gynecological care. Conclusion. Providing regular preventive physical examinations and educational activities among adolescents and parents is one of the ways to timely detect various diseases of the reproductive system. The incidence of gynecological diseases among this age group can also be significantly reduced by increasing the coverage of the population with medical care and improving the quality of its provision","PeriodicalId":11400,"journal":{"name":"Effective Pharmacotherapy","volume":"31 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75773930","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-Term Results of Prevention of Complications After Medical Abortion","authors":"A. E. Esedova, A.Yu. Islamova, T.S. Magomedova, F.S. Mamedov","doi":"10.33978/2307-3586-2023-19-7-24-27","DOIUrl":"https://doi.org/10.33978/2307-3586-2023-19-7-24-27","url":null,"abstract":"Relevance. The frequency of abortion complications ranges from 2.0 to 52.0%. The effectiveness of the magneto-IR light laser and ozone, which have immunomodulatory, bactericidal, analgesic effects. Purpose to increase the effectiveness of measures to reduce the number of complications after medical abortion. Material and methods. 124 patients after abortion were examined and divided into 3 groups. In the main group I 52 (42.0%) women who were treated with antibiotics with magneto-IR light laser and ozone. In the main group II, 24 (19.3%) patients were treated with magneto-IR light-laser and ozone therapy, without antibiotics. The control subgroup consisted of 48 (38.7%) patients without prophylaxis. Results. The patients were examined 3, 6 and 12 months after the abortion. In the main group I, menstrual function was restored after 3 months in 36 (69.2%) patients, in the main group II 16 (66.7%) and control 26 (54.1%), more than 8 days continued in 16 (30.8%), 8 (33.7%) and 22 (45.9%) accordingly. After 6 months and a year, menstruation remained impaired in 2 (3.9%) patients of the main group I, in 1 (4.1%) of the main group II and in 6 (12.5%) of the control group. In the main group I, 27 (52.0%) women planned pregnancy. Pregnancy occurred in 10 (19.2%) patients: 7 (13.4%) ended in childbirth, 2 (3.9%) miscarriage, 1 abortion. In the main group II, 12 (50.0%) women planned pregnancy. Pregnancy occurred in 5 (20.9%): 4 (16.7%) they ended in childbirth and 1 (4.1%) miscarriage. In the control group, 25 (52.0%) patients planned pregnancy. It occurred in 7 (14.5%) patients: 3 (6.2%) ended in childbirth and 4 (8.3%) miscarriage. Conclusions. Magneto-IR light-laser and ozone therapy is an effective way of prevention, promotes faster recovery of menstrual and reproductive function","PeriodicalId":11400,"journal":{"name":"Effective Pharmacotherapy","volume":"83 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84027614","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Analytical Review of the Status of Reproductive Health of Girls and Young Women in Moscow Region. Analysis of Work","authors":"YElyena Sibirskaya, S. Torubarov, Ye.D. Burkhanskaya, G.N. Abbasova, L.G. Papyan","doi":"10.33978/2307-3586-2023-19-7-40-47","DOIUrl":"https://doi.org/10.33978/2307-3586-2023-19-7-40-47","url":null,"abstract":"Introduction. The protection of the reproductive health of the younger generation is one of the most significant problems due to the steady growth of various gynecological diseases, including those that are asymptomatic, which has a significant impact on the reproductive potential of the young population. Purpose to reveal the prevalence of gynecological pathologies among girls in the Moscow region. Material and methods. We have analyzed the main gynecologic diseases among patients aged 0–17 years according to the results of preventive examinations and data of visits to the pediatric gynecologist in the outpatient clinic for the year 2021. Results. Recent analytical data on the prevalence of gynecological morbidity of girls and young women in Moscow region showed that in children aged 0–4 years and 5–9 years, inflammatory diseases of the vulva and vagina (vulvitis) and labia minora adhesions predominate. In patients aged 10–14 years gynecological pathology is represented by various menstrual cycle disorders, dysmenorrhea, inflammatory diseases of the vulva and vagina (vulvitis), non-inflammatory ovarian diseases (follicular cysts and cysts of the yellow body of the ovary) and also mammary gland diseases. The predominant gynecological pathology in girls aged 15–17 is inflammatory diseases of the vulva and vagina, menstrual disorders, non-inflammatory ovarian diseases (follicular cysts, cysts of the corpus luteum), fallopian tubes and the vagina, breast diseases, and sexually transmitted infections are also frequent. Conclusion. We can talk about the general trends in the prevalence of gynecological morbidity among girls and young women in Moscow region and in the whole territory of the Russian Federation. Following the order of the Russian Ministry of Health of 20.10.2020 № 1130n «On approval of the Order of medical care in the profile „obstetrics and gynecology“», we can achieve a reduction in gynecological morbidity among girls and young girls in the Moscow region by improving specialized gynecological care","PeriodicalId":11400,"journal":{"name":"Effective Pharmacotherapy","volume":"14 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84283942","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}