Our expert - gynecologist Marina Vedeleeva.

Dangerous Thirty

The topic is very prosaic - sexually transmitted diseases (STDs). Almost all of us have met them personally at least once in our lives. By the way, there are more than 30 of them: from the deadly HIV infection to the commonplace chlamydia, which, by the way, cannot be called trifling either. Moreover, in terms of prevalence in Russia, it is in second place after the flu.

Of course, most STDs are curable, but not all. For example, it will never be possible to part with genital herpes - treatment only softens the course of the disease and reduces the frequency and severity of relapses. Only those under the age of 25 have a chance to get rid of (HPV) forever. Later, it will not be possible to destroy the virus, the point of treatment is to eliminate tissue changes affected by the virus. By the way, it is believed that the human papillomavirus can cause cancer of the cervix, vagina, vulva and penis. The genital herpes virus also affects sperm, and if a woman becomes infected with it during pregnancy, it can cause severe congenital diseases fetus.

Treatment will be successful only if it is started without delay and completed. How to spot the very first danger signals?

An alert has been declared!

There are seven main signs, having discovered which, you should not delay a visit to the doctor.

Itching and burning in the intimate area.

Redness in the genital area and anus, sometimes - sores, vesicles, pimples.

Discharge from the genitals, smell.

Frequent, painful urination.

Enlarged lymph nodes, especially in the groin.

In women - pain in the lower abdomen, in the vagina.

Discomfort during intercourse.

However, for example, syphilis or chlamydia can appear several weeks after infection, and sometimes STDs in general long time can proceed latently, turning into a chronic form.

Let's get to know each other better

Chlamydia

Symptoms. 1-4 weeks after infection with it, patients develop purulent discharge, painful urination, as well as pain in the lower abdomen, in the lower back, bleeding between menstruation in women, in men - pain in the scrotum, perineum.

What is dangerous? In women, it can lead to inflammation of the fallopian tubes, cervix, pathologies of pregnancy and childbirth, diseases of the liver, spleen; in men - to inflammation of the epididymis, prostate gland, Bladder, violation of potency. Newborns may develop conjunctivitis, nasopharyngeal lesions, pneumonia.

Trichomoniasis

Symptoms. They can appear on the 4-21st day after infection, sometimes later. Women have abundant foamy discharge of white or yellowish-green color with a pungent odor, causing severe itching and irritation of the genital organs, as well as pain, burning during urination, pain during intercourse. In men, there is a burning sensation during urination, mucopurulent discharge from the urethra. However, this disease is often asymptomatic.

What is dangerous? In women, the cervix and the inner layer of the uterus are affected, the fallopian tubes, ovaries, urinary tract. The infection can even cause peritonitis! Men suffer prostate, testicles and their appendages, urinary tract.

Mycoplasmosis (in men - ureaplasmosis)

Symptoms. It can detect itself 3 days after infection, or maybe a month later, manifesting itself as itching and discomfort in the genital area, scanty clear discharge, painful urination.

What is dangerous? Frequent complication trichomoniasis in women - inflammation of the genital organs, in men - a violation of spermatogenesis.

Gonorrhea

Symptoms. 3-7 days after infection, women develop a yellowish-greenish discharge from the vagina, rapid, painful, urination, pain in the lower abdomen, sometimes bloody issues. However, in most of the fairer sex, the disease goes unnoticed for a long time. Men have pain and burning sensation when urinating, yellowish-greenish purulent discharge from urethra.

What is dangerous? In women, the urethra, vagina, anus, uterus, ovaries, fallopian tubes are affected. In men - internal genital organs, chronic inflammation of the epididymis, seminal vesicles, prostate develops, which threatens impotence, infertility.

Syphilis

Symptoms. Incubation period disease from 3 to 6 weeks. The first sign is a rounded sore (hard chancre). In women, it lives on the labia or vaginal mucosa (sometimes in the anus, in the mouth, on the lips), in men, on the penis or scrotum. By itself, it is painless, but after a week or two after its appearance, the nearest The lymph nodes. This is the time to start treatment! This is the first stage of the disease, when it is still reversible. 2–4 months after infection, the second stage develops - a rash “spreads” all over the body, heat, headache almost all lymph nodes are enlarged. In some patients, hair falls out on the head, wide condylomas grow on the genitals and in the anus.

What is dangerous? This disease is called slow death: if not fully cured in time, there are serious problems with the musculoskeletal system, irreversible changes occur in the internal organs, nervous system- the third stage of the disease begins, in which about a quarter of patients die.

Forget about the Internet!

Did you notice that something is wrong? It is better to play it safe and hurry to the doctor, rather than looking on the Internet for symptoms and treatments.

How is an STD diagnosed? First - an examination by a doctor, then - tests and studies. Most modern method DNA diagnostics: PCR (polymerase chain reaction). For research, scrapings are taken from the urethra, vagina and cervix.

Doctors also use the ELISA method (blood is taken from a vein or a scraping is done and the presence of antibodies to STDs is determined), bacterioscopy (most often it detects gonococci and Trichomonas) and many other diagnostic methods.

STDs are treated with antibacterial drugs, as well as local procedures (washing the urethra in men, sanitation of the vagina in women and other procedures). At the end of the course of treatment, it is imperative to undergo a control examination - to pass several tests to make sure that there is no infection in the body.

How to protect yourself?

The classic self-defense against STDs is the condom. Good quality and true to size.

used and emergency drug prophylaxis– single dose or injection antibacterial drugs which can only be prescribed by a dermatovenereologist. The procedure helps to prevent gonorrhea, chlamydia, ureaplasmosis, mycoplasmosis, syphilis and trichomoniasis. But this method should not be used frequently.

But as for douching after intercourse with special gels or chlorine-containing antiseptics, most experts believe that this does not reduce the risk of infection.

Some diseases can sneak up on you without a single sign or symptom. Or the symptom will be so specific that it will baffle the doctor. No wonder sometimes you need to spend a lot of time to put correct diagnosis. Insofar as early detection disease leads to more effective treatment, illnesses that do not fall into your (or doctor's) field of vision can be especially dangerous. Therefore, it is very important to find time for medical examination, and become familiar with some silent diseases.

What diseases are asymptomatic?

1.Deep vein thrombosis (DVT). It starts with a blood clot that clogs a vein, most often in the legs. The clot can then move up and block blood flow to the lungs, causing a condition known as thromboembolism. pulmonary artery which can cause serious damage internal organs and even death. Sometimes pain and swelling in the leg can indicate DVT, but often this disease does not have any warning signs.

2.Pancreas cancer. Symptoms such as jaundice, abdominal pain, and weight loss only appear when pancreatic cancer is advanced. This disease is considered one of the worst forms of cancer. Smokers, as well as people with obesity or a family history of pancreatic cancer, are at the greatest risk of suffering from this disease.

3.Silent myocardial infarction. MI occurs when the blood supply to a part of the heart is interrupted. Symptoms include chest pain, shortness of breath, nausea, vomiting, restlessness, pallor, and dizziness. Frighteningly, about 25% of all cases of MI are asymptomatic. Such heart attacks are most common among the elderly and diabetics.

4.Diabetes. This is serious illness may remain undiagnosed long time because symptoms such as excessive thirst, frequent urination, and irritability don't look like signs of illness, especially if you lead a hectic lifestyle. Almost a third of patients do not even suspect that they have diabetes. Often, if left undiagnosed, this disease can lead to hypertension and damage to blood vessels.

5.HIV. The virus that causes acquired immunodeficiency syndrome (AIDS) does not initially manifest itself, although some of those infected may have flu-like symptoms during the first two to four weeks after infection. However, once a person becomes infected with HIV, they can immediately pass it on to someone else, especially through unprotected sex or exchanging hypodermic needles. So the best way protect yourself and the people around you will be tested for HIV infection.

Rheumatology and Nephrology Interview with an expert

Alexey Denisov: “Many kidney diseases are asymptomatic”

2014-03-13

Every year on the second Thursday of March, World Kidney Day is celebrated. Today, more than 500 million people on the planet - about one in ten adults - have one or another pathology of the kidneys. About 15 million Russians suffer from various kidney disease. People with chronic diseases kidneys are at risk for hypertension, diabetes and cardiovascular disease.

World Kidney Day is celebrated at the initiative of the International Society of Nephrology and the International Society of Nephrological Federations with the aim of increasing the knowledge of the general population about the functions of the kidneys, diseases associated with disorders in their work, as well as the prevention and treatment of these diseases. MED-info talked with the head of the hemodialysis department of the Federal State Institution Central Clinical Hospital of the Presidential Administration of the Russian Federation, candidate of medical sciences Alexey Yurievich Denisov .

- To begin with, let's remind our readers about what functions the kidneys perform in human body.
— Critical Role kidneys - maintaining a stable disequilibriuminternal environment organism. I didn't make a reservation. That disequilibrium, which is life. After all, the constancy of our internal environment comes only after death, and even then not immediately. And the kidneys provide such regulation of the parameters of the internal environment, which allows you to constantly fluctuate key indicators adapting to constantly changing living conditions. Strictly speaking, there is no such side of the metabolism in the human body that would not be somehow connected with the kidneys.

The kidneys excrete the end products of metabolism, that is, those that the body can no longer use. They purify the blood by filtering out toxic substances from it. All blood in the human body passes through the kidneys in five minutes. In addition, they allow you to remove excess salts and water from the body or, on the contrary, to retain them if necessary. Managing acid-base balance is also one of the functions of the kidneys.

The kidneys produce some hormones that regulate blood pressure, such as renin, and are also involved in the activation of a hormone that controls the exchange of phosphorus and calcium in the body. In addition, normally functioning kidneys provide the state of the body environment in which the most important hormones human body can work successfully.

An extremely important function of the kidneys is the production of erythropoietin, a factor that stimulates the production of new red blood cells, blood cells, as they used to say, "red blood cells." There is also a hypothesis that the kidneys are involved in the thermoregulation of the body.

“The most important role of the kidneys is to maintain a stable imbalance in the internal environment of the body. I didn't make a reservation. It is precisely this disequilibrium that is life.”

Is this an irreversible condition? Can CKD be cured?
- Chronic kidney disease is irreversible in the sense that with it it is no longer possible to return everything to its original state. healthy state or significantly improve kidney function. But on early stages CKD in some cases can successfully slow down the extinction renal function. On the late stage x lost function, as I said, can be replaced by starting dialysis or performing a kidney transplant, but there are some nuances here. The most important thing is the timely start of replacement therapy.

Is there a relationship between CKD and cardiovascular disease? It seems that there is even such a thing as "renal pressure"?
— Oh yes, there is a close relationship. After all arterial hypertension and atherosclerosis can lead to the development of both heart and kidney failure. There is practically no patient with heart failure who does not have a slight kidney failure. Besides, chronic illness kidneys is recognized as an independent factor provoking the development cardiovascular diseases. As for "kidney pressure" - I don't really know what that is. So they say, but this is only a fiction, meaning nothing in reality.

"Practically there is no patient with heart failure who does not have a slight kidney failure"

Can kidney failure cause a heart attack or stroke?
- Maybe. But the opposite is also true - a heart attack or stroke can be complicated by the development of kidney failure. Reduced kidney function leads to an increased risk of myocardial infarction and stroke by 6-8 times. Moreover, with the progression of the disease, this figure increases by tens and hundreds of times.

- How can such patients deal with increased blood pressure?
- Firstly, the drugs prescribed by the doctor should be taken carefully and regularly. Secondly, salt restrictions prescribed by a doctor should be considered mandatory. Well, and thirdly, dietary advice in our patients may include restriction of protein intake and foods high in potassium and phosphate. It seems to me that the very regularity of monitoring a patient with CKD should be stricter than with many other diseases.

- Tell me about modern approaches for the diagnosis and treatment of CKD. Is it different Russian practice in this regard from foreign?
— Russian nephrologists are well acquainted with all modern trends, methods of diagnosis and treatment, they know how to apply the most advanced of them. The main problem is the acute shortage of nephrologists and insufficient funding for this branch of medicine. Nephrological care in Russia is poorer than in the developed countries of Europe or America, but richer than in some African countries. Practical nephrology in Russia occupies a position somewhere between Pakistan and Bangladesh, if we compare the number of dialysis performed, for example.

What are the advantages and disadvantages of hemodialysis? Can replacement therapy compensate function healthy kidneys?
- The main advantage of dialysis, both hemodialysis and peritoneal dialysis, is that it saves lives, makes it possible to lead a decent life for patients with extremely reduced or absent kidney function. Of course, kidney function replacement therapy does not fully compensate for the lost function (only 15%), some manifestations of kidney failure have to be dealt with. medical methods. So, for example, it is now possible, by introducing erythropoietins and iron preparations, to successfully compensate for anemia, which is experienced by almost 80% of dialysis patients. It is possible, using new medicines, to regulate the phosphorus-calcium balance and treat severe complication CKD is hyperparathyroidism, which develops in about half of patients and threatens with profound disability against the background of bone tissue destruction.

“Nephrological care in Russia is poorer than in the developed countries of Europe or America, but richer than in some African countries”

— Are there any possibilities drug treatment CKD or the only salvation for such patients is dialysis?
—In the early stages of CKD, some drug regimens may be used to reduce the rate of decline. glomerular filtration. It is the task of a nephrologist working with such patients to develop a strategy for nephroprotection, to protect the fading kidney function. In the late stages of CPB, replacement therapy and drug correction of concomitant pathologies are needed.

Do these patients need a special diet? What is it?
Yes, such a diet is necessary. Since this topic is huge, it is best to get acquainted with it on my website “Life in spite of CRF”. In short, we can advise patients on dialysis to consume at least 1.2 g of protein per 1 kg of body weight per day, warn them against abundant intake of fluids, salt, foods containing a lot of potassium and phosphorus.

- How do such patients live? Can I lead an active life on dialysis?
“Effective dialysis allows most of our patients to lead active lives—to study, work, start families, raise children, exercise, even travel. Dialysis does not block this kind of activity, it creates necessary condition- a life. True, it takes some time and makes the lifestyle quite unusual.

How can you protect yourself from CKD?
— Lead healthy lifestyle life: smoking and alcohol are among the most terrible enemies kidneys. Do not abuse painkillers! At least once a year, check the condition of the kidneys, consult a doctor. Avoid charlatans.

— What should be the national CKD strategy?
- I am a doctor, not a statesman or deputy, so it is quite difficult to answer this question ( Thinking.) But it is clear even to me that it is necessary to teach nephrologists, create a federal renal registry, and introduce the principles of nephroprotection into practical healthcare. It is necessary to allocate significant budgetary funds, stimulate the opening of nephrology centers, increase the number of dialysis places and the number of transplants, and educate people about ways to combat kidney disease and its consequences. Build trusting doctor-patient relationships and raise the prestige of the medical profession.

Photo from the personal archive of A. Denisov

Author:

Unfortunately, not all diseases in our time can be identified and identified by certain symptoms. After all, we are used to the fact that if the stomach hurts, feels sick and vomits, then you need to go for a consultation with a gastroenterologist, if a woman has white curdled discharge, then in this case the gynecologist will help, if the heart hurts, then we go to the cardiologist. Below we will look at the most common asymptomatic diseases that everyone needs to know about, or at least have some idea.

ovarian cancer

This is a serious disease that can indeed be fatal if left untreated. Ovarian cancer occurs without any symptoms that bother a woman. Only if the tumor has reached a very large size, the patient may complain of bloating. But, even at this stage, women do not always go to the doctor, but believe that their digestion is temporarily disturbed.

Important! With ovarian cancer, bloating is a specific reaction of the body to an increasing tumor.

How to avoid cancer?

Gynecologists emphasize that this is a reversible disease that can be prevented in advance. To do this, a woman needs to visit a gynecologist 2 times a year and without fail do pelvic ultrasound and ultrasound abdominal cavity.

If women in your family had ovarian cancer in any form, then you definitely need to donate blood for tumor markers. This analysis can be done in a private laboratory without a referral from a doctor. Why is this analysis needed? To determine your risk for ovarian cancer or other types of cancer.

So, if you want to avoid ovarian cancer then:

• 2 times a year visit a gynecologist for a preventive examination;
• Once a year, do an ultrasound of the pelvic organs and abdominal cavity;
• Take a blood test for tumor markers.

brain aneurysm

An aneurysm of a blood vessel in the brain is pathological expansion blood vessels, which begins due to weakness of the vessels. The disease proceeds without symptoms. The danger of an aneurysm lies in the fact that at any moment (which cannot be predicted in any way), it can burst abruptly. What happens in this case? A large amount of blood immediately enters the cavity of the brain. This leads to rapid cerebral edema, tissue compression, extensive edema, and this leads to complete violation functioning of all brain cells. If an aneurysm bursts in the brain, then in this case a person feels a severe headache, loses consciousness abruptly, and death occurs.

What to do with a cerebral aneurysm?

• Need to do computed tomography or magnetic resonance imaging - so the doctor can determine if you have a cerebral aneurysm;
• If an aneurysm is found small size, then the doctor will recommend regular monitoring, if large sizes and grows, then in this case, the pathology must be treated;
• If a blood vessel aneurysm is at risk of rupture, you will be advised to surgical intervention- insert a wire into the vessels, which will help strengthen the walls of the vessel and prevent it from breaking in case of exposure to negative external factors.

Pancreas cancer

It is impossible to detect pancreatic cancer at an early stage. If the disease has already reached its peak ( last stage), then its first sign is diabetes. Why? Because physiologically the pancreas is aimed at producing the digestive enzymes we need, as well as the production of insulin. When the pancreas is affected cancerous tumor, then the production of insulin stops, which means a sharp increase in blood sugar.

Self help is:

• To do an ultrasound of the abdominal cavity to determine changes in the cells of the organ for malignancy;
• It is advisable to do an ultrasound of the abdominal cavity for prevention every year;
• The prevention of pancreatic cancer is the rejection of processed foods in the form of sausages and sausages, as they are in in large numbers contain nitrite and nitrate. Upon penetration into gastrointestinal tract and then - into the bloodstream, these substances turn into carcinogenic (that is, poisonous, poisonous);
• Take a blood test for blood sugar to detect diabetes;
• Get tested for tumor markers - if they are above the norm, then in this case you are at risk of rapid degeneration of healthy cells into malignant ones.

Inflammatory processes of the genital organs

As a rule, all inflammatory processes of the genital organs occur in the body in latent form. They occur due to sexually transmitted infections. The first organs that lend themselves negative impact- ovaries, uterus For example, a symptom is heavy menstruation, but for some reason, women believe that pain during menstruation is the norm, and not a reason to consult a gynecologist.

What to do?

To avoid the occurrence inflammatory processes genital organs, it is necessary for women to undergo a consultation with a gynecologist once every six months. Most diseases in the form of ovarian cysts, benign and malignant tumors can be cured at an early stage. But, unfortunately, not all women go to the doctor at the initial stage of the disease.

Summary: we are all exposed to the adverse effects of diseases, which means that in order to save our lives and health, it is necessary not only to take vitamins and lead a healthy lifestyle, but also periodically - once a year (and, better - once every six months) undergo a preventive examination by a general practitioner, cardiologist, gastroenterologist and gynecologist (urologist for men).

Often we do not attach importance to a sudden headache, dry mouth or lingering cough. However, it is these symptoms that can become signs of diseases that live imperceptibly in the human body. What are these diseases and how to avoid them?

1. DIABETES
Contrary to known opinion, normal level blood sugar does not always mean that a person does not have diabetes. At an early stage of development, this disease has almost no obvious symptoms. Thirst, dry mouth, blurred vision, and frequent urination can be cause for concern. Unfortunately, these symptoms are almost always ignored by the person until the very last moment.

A hallmark symptom of diabetes is darkening of the skin around the neck and armpits, as a result of which the skin in these places seems very tanned.

HOW TO AVOID ILLNESS?
Diabetes most often occurs in people over 45, so check with your doctor regularly starting at this age. People with high blood pressure are also at risk, overweight and high level cholesterol in the blood.

2. POLYCYSTOSIS OVARIAN SYNDROME
About 10% of women childbearing age suffer from this disease. PCOS is a syndrome in which female body too many male hormones are produced, which disrupts the processes of the menstrual cycle and ovulation. In addition, the syndrome leads to the risk of sleep apnea, type 2 diabetes, endometrial cancer and heart problems.

HOW TO AVOID ILLNESS?
Watch for changes in your body. Due to PCOS, acne often appears, lengthens menstrual cycle(more than 35 days), the hair on the head becomes thin, and on the body, on the contrary, grows more actively. If you notice these symptoms in yourself, do not delay going to the doctor. By the way, PCOS is quite easy to control: regular physical exercise and a low-carb diet will bring your body back to normal.

3. INCREASED PRESSURE
Scientists say that almost 50% of people are not even aware of their high blood pressure. This ailment can live long and imperceptibly inside a person and slowly harm blood vessels. But one day he will definitely manifest himself with kidney disease, a heart attack or a stroke.

HOW TO AVOID ILLNESS?
Even if you feel great and think that you are absolutely healthy, be sure to measure your pressure at least once a year. This simple check does not take much time: if it is not possible to go to the doctor, then you can go to any pharmacy where the pharmacist will measure your pressure. In addition, you can buy a blood pressure monitor and check your pressure at home.

4. GLAUCOMA

Glaucoma develops very slowly, and therefore imperceptibly for a person. This disease appears due to increased eye pressure, which impedes the circulation of fluid in the eye. As a result, a person's vision is blurred, the field of view narrows, which can eventually lead to blindness.

HOW TO AVOID ILLNESS?
Most often, glaucoma develops in people older than 40 years. If you are at risk, have your vision checked by a specialist every year.

5. SLEEP APNEA (BREATHING STOP)
Many mistakenly believe that sleep apnea can only happen to an obese person. In fact, regardless of weight, up to 50% of women between 20 and 70 suffer from these dangerous attacks. Apnea is a condition in which a person suddenly stops breathing during sleep. Seizures may be caused by possible problems with heart and type 2 diabetes.

Apnea victims are almost always women. Symptoms of this disease may include mood swings, headaches in the morning and slight dizziness. Insidious symptoms are often attributed to the weather, PMS, etc.

Another an alarming symptom apnea is insomnia. Women wake up several times a night due to respiratory arrest.

HOW TO AVOID ILLNESS?
If you notice symptoms of sleep apnea, contact your doctor immediately. The specialists will necessary tests and determine if you have this disease. If it is found, then most likely the doctor will prescribe you CPAP therapy. A CPAP machine is a device that delivers a constant stream of air into Airways and creates positive pressure.

6. LUNG CANCER
Lung cancer is one of the most dangerous types of cancer for humans. In the early stages, this disease practically does not manifest itself. At risk are heavy smokers and those who have never picked up cigarettes.

HOW TO AVOID ILLNESS?
Smokers with experience should be regularly observed by a doctor. Watch out for symptoms of lung cancer: chest pain, wheezing, shortness of breath, hoarseness, and a dry cough that lasts more than 2 weeks.