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This article presents a clinical case of a patient with hereditary systemic hereditary transthyretin amyloidosis. Difficulties of diagnostics and differential diagnostics of this disease are shown in a patient with arterial hypertension, a clinic of angina, coronary artery disease, cardiac rhythm and conduction disturbances, cardiomegaly, heart failure and renal dysfunction. It required a comprehensive approach using the methods of routine clinical and laboratory examination, as well as nuclear cardiology, morphological studies and molecular DNA diagnostics.

The aim is to develop a method of early prediction of the severity of hemorrhagic fever with renal syndrome on the basis of clinical and laboratory data.A comprehensive clinical and laboratory examination of 144 patients with hemorrhagic fever with renal syndrome was carried out in the period of 2–5 days from the onset of the disease. Based on the discriminant analysis of the data obtained, a discriminant model for predicting the severity of hemorrhagic fever with renal syndrome was developed. The index of accuracy of prognosis of clinical forms of the disease on the basis of the developed discriminant model is 97.4%.

Aim.This study was conducted to evaluate the caries resistance of hard tooh tissues and the state of the calcium and phosphorus metabolism in children with type 1 diabetes mellitus given the mineralizing potential of saliva and antimicrobial protection of the oral cavity.Materials and methods. There was conducted a general clinical, dental, laboratory examination of 127 children with type 1 diabetes mellitus aged 7 to 12 years with the endocrinopathy experience from eight months to ten years. The obtained data were compared with the results of the examination of 37 "healthy" and "practically healthy" children of this age category. When assessing the dental status of children, were used the hygienic index (Y.A. Fedorov, V.V. Volodkina, 1970), the CFE/ cf index (WHO Expert Committee, 1962), the simplified hygienic index OHI-S (Green, Vermillion, 1964). The intensity of the enamel demineralization processes was assessed using the enamel resistance test (V.R. Okushko, L.I. Kosavera, 1984) and vital staining (L.A. Aksamit, 1978). The electrometry of hard tooth tissues was carried out by the electrodiagnostic apparatus "Dent Est" (V.K. Leontiev, G.G. Ivanova, 1985).The laboratory diagnostics of the salivary indicators included the study of calcium (total, ionized), inorganic phosphorus, alkaline phosphatase, osteocalcin, parathyroid hormone, 25-hydroxyvitamin D3, lactoferrin. The microcrystallization and mineralizing potential of saliva were determined according to Leus P.A. (1997).Results.At the early stages of type 1 diabetes mellitus development children have a compensated and subcompensated form of the carious process, the increase in the enamel permeability, a slight predominance of the demineralization processes over the remineralization processes in solid tooth tissues. It indicates that self-regulation of the mineral metabolism mechanisms takes place while maintaining the physiological remineralizing properties of saliva. At a late stage of type 1 diabetes mellitus development a high intensity and decompensated form of the carious lesions are established as well as low structural and functional enamel resistance and pronounced processes of hard tooth tissues demineralization. The emergence of this complex in children with the experience of endocrinopathy for more than five years indicates the depletion of salivary gland functionality, the disturbance of mobilization salivary systems in response to the occurrence of the cariogenic situation in the oral cavity, the change in calcium homeostasis, the decrease in enamel resistance to organic acids and the absence of saliva crystallization.Conclusion.The growing positive dynamics of index growth in children with long-term type 1 diabetes mellitus, indicating the deterioration of the dental status, requires adherence to the principles of rational nutrition, quarterly professional caries preventive measures using modern and effective oral care products, the introduction of active forms of hygienic training and education taking into account the mineralizing potential of saliva as well as careful monitoring of the acquired manual skills.

Diabetes mellitus (DM), due to its high incidence and prevalence, presents an urgent problem for the scientific community, which requires new ways of treating and preventing complications. Existing hypoglycemic treatment approaches do not always contribute to the achievement of glycaemic targets.Objective. Study of Subetta-based therapy for patients with DM 1 and DM 2 in real-life clinical practice.Materials and methods. The program involved 71 patients with DM 1 and 289 patients with DM 2, HbA1c ≥ 7.0%, who took Subetta in combination therapy of diabetes. The duration of the program was 12 weeks. The laboratory examination included the determination of the level of HbA1c, fasting plasma glucose.Results. The administration of Subetta in complex therapy of DM 1 and DM 2 led to a significant reduction in HbA1c from 9.2 ± 1.85 to 8.13 ± 1.29 mmol/L and from 8.62 ± 1.54 to 7.49 ± 1.1 mmol/L, respectively (pConclusion. In real-life clinical practice, use of new locally developed antidiabetic drug Subetta demonstrated a significant decrease of HbA1c and fasting blood glucose, with no episodes of hypoglycemia in patients with DM 1 and DM 2.

The article describes a rare case of a manifest late neurosyphilis with a fatal outcome. Literature data on the features of the clinical course of neurosyphilis and its pathomorphological pattern are given. The results of a laboratory examination, including a histological examination, confirming the syphilitic lesion of the nervous system in this clinical observation are presented.

Impairments in haemostatic system function may result in the clinical manifestations in the form of haemorrhagic and/or thrombotic episodes and their combinations. Such cases are widespread in clinical practice, and a physician across specialties may face them. The creation of a laboratory examination program at the initial stage and in the follow-up of a patient depends on the clinical situation and working hypothesis, on the involvement of various mechanisms of the haemostasis system. Screening tests are the basis of the initial examination algorithms for the patient. Additional tests are added based on the initial examination results, clinical picture and medical history data. It is necessary to understand the essence of the performed examinations, their characteristics and the areas of responsibility of each in order to effectively use modern laboratory diagnostic capabilities. The most important clinical decisions can be made on the basis of the lab examination results — from establishing diagnosis to identifying the risks of recurrent thrombotic or haemorrhagic events and creating an appropriate secondary prevention program and choice of therapies, lifestyle changes, pregnancy planning and contraceptive methods.

The results of complex clinical and laboratory examination of 146 children aged 2—3 years attending kindergarten were presented. The leading predictors of frequent respiratory disease: disturbance of microbiocenosis oropharyngeal mucosa, immunoglobulins decrease, respiratory allergic pathology were established and scientifically substantiated. The results obtained prove the main directions of therapeutic and preventive measures.

Objective: evaluation of the hemostatic system in patients with endometrioid ovarian cysts before and after treatment of various types of surgical exposures.Materials and methods. 90 patients with with endometrioid ovarian cysts were operated, depending on the method of surgical treatment and therefore divided into two groups. The study was prospective in nature. The patients then underwent a complete clinical and laboratory examination, genotyping of the most significant thrombophilic polymorphisms.Conclusions. The analysis showed a reduction in performance of hemostasiogram compensatory mechanisms even in the absence of pronounced changes of hemostasis. In such a situation it is very important to choose the least traumatic method of surgical treatment, which allows not only to preserve ovarian reserve, but also reduce the level of response to the hemostatic system of interventions.

Objective: to evaluate the efficiency of the elaborated intensive therapy policy for acute acetic acid poisoning complicated by exotoxic shock. Subjects and methods. The results of treatment were analyzed in 72 patients admitted in 2008—2012 with severe acute acetic acid poisoning complicated by exotoxic shock. The patients were divided into 2 groups: 1) combination therapy added by an improved intensive therapy complex; 2) conventional therapy. All the patients underwent comprehensive clinical and laboratory examination. Results and discussion. Group 1 versus the study group showed 1.7-, 2.0-, and 2.4- fold increases in the reduction of free hemoglobin levels 12, 24, and 48 hours after applying the improved complex of intensive therapy, respectively. In Group 1, hemodynamic and acidbase balance parameters recovered much faster and the incidence of acute renal failure and mortality rates were 2.1 and 2.0 times lower than those in the comparison group. Conclusion. Incorporation of the agents that correct volemic disorders and improve microcirculation into intensive therapy for acute acetic acid poisoning can considerably reduce the time of shock emergence, prevent acute renal failure, and decrease mortality rates.

Вплив гіпертрофії лівого шлуночка (ГЛШ) і підвищення швидкості поширення пульсової хвилі в аорті (ШППХ) на ризик розвитку кардіоваскулярних ускладнень доведено в різних груп пацієнтів. З метою вивчення особливостей структурно-функціонального стану міокарда та пружно-еластичних властивостей артеріальної стінки, а також їх взаємозв’язку, обстежили 53 чоловіки у віці 30–67 років, які страждають на гіпертонічну хворобу (ГХ) І–ІІ стадій. Структурно-функціональний стан серця вивчали за даними ехокардіографії у В і М-режимах, пружно-еластичні властивості – за результатами супрасистолічної артеріографії за допомогою приладу Arteriograph TensioМed (TensioClinic, Угорщина). Встановили, що у чоловіків, які страждають на ГХ, на етапі формування ГЛШ підвищення ШППХ асоційоване зі збільшенням маси міокарда ЛШ (ММЛШ), індексу ММЛШ (ІММЛШ), ІММЛШ/р1,7 і ІММЛШ/р2,7 унаслідок збільшення товщини міжшлуночкової перегородки. У хворих ГХ з уже сформованою ГЛШ на процес ремоделювання серця значно впливає підвищення центрального систолічного та центрального пульсового артеріального тиску (ЦПАТ). У хворих на ГХ і ГЛШ підвищення ЦПАТ сприяє збільшенню розміру лівого передсердя і зниженню систолічної функції ЛШ., Impact of the left ventricular hypertrophy (LVH) and increasing of the pulse wave velocity in aorta (PWV) at cardiovascular risk proved in various groups of patients.Aim. The aim of the study was to investigate the features of the myocardial structural and functional conditions and the arterial wall stiffness, as well as their relationship to male patients with essential hypertension (EH) I-II stage.Materials and methods. 53 male patients with essential hypertension stage I and II, aged 30–67 years were surveyed. All patients underwent clinical and laboratory examination in accordance with Ukrainian National Guidelines and ESH/ESC Guidelines for the management of arterial hypertension (2013). Echocardiography was performed in B- and M-modes. Elastic properties of the arterial wall were investigated with Arteriograph TensioMed (TensioClinic, Hungary).Conclusions. At the male patients with essential hypertension PWV was associated with increasing of LVM, LVMI, LVMI/h1,7 and LVMI/h2,7 by increased SWTat stage of the left ventricular hypertrophy formation. cSBP and cPP increase makes a significant contribution to the process of the heart remodeling in hypertensive patients with LVH. cPP increase contribute to LA size enlargement and LV systolic function reduce in patients with EH and LVH., Влияние гипертрофии левого желудочка (ГЛЖ) и повышения скорости распространения пульсовой волны в аорте (СРПВ) на риск развития кардиоваскулярных осложнений доказано у различных групп пациентов. С целью изучения особенностей структурно-функционального состояния миокарда и упруго-эластических свойств артериальной стенки, а также их взаимосвязи, обследовано 53 мужчины в возрасте 30–67 лет, страдающих гипертонической болезнью (ГБ) І–ІІ стадий. Структурно-функциональное состояние сердца изучили по данным эхокардиографии в В и М-режимах, упруго-эластические свойства – по результатам супрасистолической артериографии с помощью прибора ArteriographTensioМed (TensioClinic, Венгрия). Установлено, что у мужчин, страдающих ГБ, на этапе формирования ГЛЖ повышение СРПВ ассоциировано с увеличением массы миокарда ЛЖ (ММЛЖ), индекса ММЛЖ (ИММЛЖ), ИММЛЖ/р1,7 и ИММЛЖ/р2,7 за счёт увеличения толщины межжелудочковой перегородки. У больных ГБ с уже сформированной ГЛЖ на процесс ремоделирования сердца существенно влияет повышение центрального систолического и центрального пульсового артериального давления (ЦПАД). У больных с ГБ и ГЛЖ повышение ЦПАД способствует увеличению размера левого предсердия и снижению систолической функции ЛЖ.