Purpose of the study. To evaluate the role of chronic chlamydial infection in the genesis of proliferative processes in the female genital area.Materials and methods. The study involved 267 women aged from 27 to 43 years. Depending on the severity of the pathological process in the genital tract and the presence of the Chlamydia trachomatis infection, 6 groups were distinguished: 1st — 30 somatically healthy women without pathologies of the female reproductive system; 2nd and 3rd — those with inflammatory processes in the reproductive organs of non-chlamydial (36) and chlamydial nature (38); 4th and 5th — those with proliferative processes in the pelvic organs of non-chlamydial (50) and chlamydial nature (58); 6th — patients with cervical cancer (55). The PCR and ELISA (Chem Well, USA) methods were used to identify the presence of Chlamydia trachomatis. The concentration of estradiol (E) and progesterone (P) (ELISA) in the blood, as well as their ratio (E/P), was determined. The as-obtained data were compared with the results of cytomorphological and ultrasound studies.Results. Proliferative processes in the genital tract are accompanied by a change in the level of female sex hormones, in particular, by a sharp decrease in progesterone in the luteal phase of the cycle against the background of absolute or relative hyperestrogenism. These changes are more pronounced in women with chronic chlamydial infection. A connection between the presence of the infectious agent in question and the severity of hyperplastic processes in the female genital tract is established. A comparison of the obtained morphological data with the blood progesterone content in women without Chlamydia trachomatis showed that an increase in the severity of disorders correlates with a decrease in the level of female hormones. In women infected with Chlamydia trachomatis, the severity of hyperplastic processes shifts to the right, i. e. towards normal progesterone values. Therefore, even at maximal progesterone concentrations close to the reference values, a greater severity of pathological changes is observed.Conclusion. The obtained results demonstrate the undeniable role of chronic chlamydial infection in initiating a hormonal imbalance towards absolute or relative hyperestrogenia with a severe progesterone deficiency. A causal relationship of the Chlamydia trachomatis infectious agent with the severity of hyperplastic processes in the pelvic organs is established. It is concluded that the detection of chlamydial infection should be considered as an essential element in the screening and prevention of hyperplastic processes.

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Purpose of the study. Analysis of the possibility of using presepsin in the early diagnosis of sepsis in cancer patients after extensive surgical interventions for tumors of the thoraco-abdominal localization.Materials and methods. The study included 27 people: 10 healthy individuals (control) and 17 patients who received surgical treatment at the National Medical Research Center of Oncology for malignant neoplasms of thoraco-abdominal localization. In the blood of all patients, studies of sepsis markers were performed: presepsin (P-SEP), highly sensitive CRP (hsCRP) (PATHFAST, Japan), procalcitonin (PCT), interleukin 6 (IL6) (Cobas e 411, Germany), as well as lactate, total leukocyte count (WBC) with a leukocyte formula, a blood culture test for suspected septic complications included in a routine examination. The studies were carried out before and on the 2nd day after the operation. Data were assessed by comparing P-SEP levels with hsCRP, PCT, IL6, lactate, WBC, blood culture test results, and the clinical status of patients. Depending on the data obtained, 2 groups were distinguished: I – patients with confirmed sepsis (3 people), II – without sepsis (14 people). Statistical processing was performed using STATISTICA 13.0.Results. In the control group, the level of P-SEP was 182.7 ± 11.9 pg/ml. In patients before surgery, the marker values were 213.7 ± 47.7 pg/ml, which did not differ statistically from the control data and did not go beyond the reference values, as did the content of PCT, hsCRP, IL6. On the 2nd day after surgery, all patients showed unidirectional changes, characterized by an increase in the levels of the studied parameters, but with varying degrees of intensity. The most significant was the increase in the concentration of presepsin. At the same time, it was noted that the level of presepsin on the 2nd day after surgery in patients of group I patients with confirmed sepsis averaged 2577.5 ± 1762.5 pg/ml with a maximum level 4340.0 pg/ml, and in group II with In the absence of confirmed bacteremia, there was an increase in the level of presepsin 1205.0 pg/ml. The data obtained correlated with the dynamics of changes in the concentration of other sepsis markers – hsCRP, PCT, IL6. Thus, the study of the level of presepsin, along with widely used markers – hsCRP, PCT, IL6, allows diagnosing sepsis in the early postoperative period in cancer patients.Conclusion. In patients with malignant neoplasms of thoracoabdominal localization, changes in the levels of sepsis markers in the early postoperative period can be used as a basis for prescribing antibiotic therapy. Presepsin may be recommended for use as an early marker of sepsis in patients with oncological pathology.

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The aim of this work was to assess the significance of investigating clinical and laboratory parameters for diagnosing acute monocytic leukemia in children on the basis of a clinical case. The article demonstrates specific features of differentiating AML M5a from other forms of acute myeloid leukemia. According to the results of hematological, morphological and cytofluorimetric studies of blood and bone marrow samples, the diagnosis of acute myeloid leukemia was established. The morphological and phenotypic characteristics of blast cells hampered the diagnosis of an AML form. However, a comprehensive analysis of the expressed CD antigens allowed acute monocytic leukemia to be identified, which diagnosis was subsequently confirmed by a cytochemical study. Thus, the clinical diagnosis was established over a short period of time. This was of importance given the rising severity of the patient’s condition requiring immediate treatment, the initial hyperleukocytosis and the development of life-threatening complications associated with leukostasis in the lungs and the central nervous system. In the presented case, the clinical manifestations of the underlying disease and the results of flow cytofluorimetry were determining factors in initiating timely specific therapy.

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