The viral hepatitis abnormalities in the female reproductive system are due to hepatic and extrahepatic damage. On the background of HBV- and HCV-infections, menstrual disorders prevail in the structure of reproductive system pathology; disorders of reproductive function in the form of pregnancy loss and infertility are detected in each second case. Depression of T-cell immunity in the immune status is observed in the patients with intact reproductive function. When miscarriage was in past medical history then divergent changes subpopulations of lymphocytes are found. When patients have infertility, signify depression of T-cell immunity is observed with a decrease in total T-cells, T-helper cells and active lymphocytes.
Peculiar characteristics of cytotoxic endometrial cells' response depending on the clinical aspects (frequency, gestational age, form of miscarriage, hysteroscopic pattern) have been studied. Patients with pregnancy loss in their past medical history demonstrate a decreased level of CD8 þ lymphocytes, and the decrease is exacerbated as the incidence of miscarriages increases and in the presence of endometrial hypoplasia. The content of CD16 þ lymphocytes increases in comparison with the control group, however, there is a reducing trend of this phenotype of killers as the incidence of miscarriages increases and in the presence of endometrial hypoplasia. Reduction of CD56 þ lymphocytes progresses with repeated pregnancy loss and endometrial hyperplasia. ARTICLE HISTORY
Brucellosis is a common zoonosis which still remains as a major health problem in certain parts of the world. Kazakhstan remains among the most disadvantaged territories of brucellosis from Commonwealth of Independent States countries. The involvement of the musculoskeletal system is one of the most common systemic manifestations in brucellosis infection. The frequency of osteoarticular involvement of brucellosis varies between 10% and 85%. Osteoarticular involvement includes spondylitis, sacroiliitis, osteomyelitis, peripheral arthritis, bursitis, and tenosynovitis. Sacroiliitis is the most common osteoarticular finding in adults. A high degree of suspicion in the diagnosis of brucellar spondylitis is essential to reduce the delay for the treatment. Thus, it should be essentially included in the differential diagnosis of longstanding back pain particularly in regions where brucellosis is endemic. Screening serologic tests for brucella should be used more widely even in presence of low index of suspicion, especially in endemic areas. According to studies, when diagnosed with chronic brucellosis, the results of serological studies were unreliable: the result of the standard agglutination test (SAT)-Wright's reaction was negative in 32.7% of cases in patients with chronic brucellosis. Imaging studies, including radiography, computed tomography (CT), magnetic resonance (MR) imaging, and bone scintigraphy, have been used for diagnosis. Radiography is limited to evaluating the focal form of spinal brucellosis and advanced disease at the joints. For instance, MR imaging has a low specificity to predict the exact cause of an osteoarticular lesion, and in case of arthralgia or symptoms of osteomyelitis or spondylodiscitis, the index of suspicion should be high in regions where the disease is endemic.
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