Vol 6, No 1 (2019)

The review reflects the current understanding of the etiology, pathogenesis, and treatment of chlamydia. The advantages of new methods for the diagnosis of chlamydial infection using methods such as real-time polymerase chain reaction (PCR-RV) and real-time NASBA transcription amplification (NASBA-Real-Time) are described. Comparison with older methods, such as bacteriological, immunomorphological and immunological, has been made; diagnostic and treatment algorithms for chlamydial infection in pregnant women have been compiled.

Introduction. Epstein-Barr virus (EBV) causes recurrent infectious mononucleosis-like symptoms. Today poisons of insects and animals were shown to be rich sources of antimicrobial substances (peptides) and contain a wide range of active biological compounds. Antimicrobial peptides play an important role in the immune response of the host’s innate immunity to pathogenic microorganisms. Based on antimicrobial peptides in Russia, an antiviral drug allokin-alpha has been developed. The active ingredient of the drug is cytokine-like peptide alloferon. The purpose of the study is to evaluate the effect of allokin-alpha therapy on the amount of EBV DNA in saliva samples and clinical complaints in patients with chronic Epstein-Barr viral infection (EBI). Material and methods. 59 chronic EBI patients (45 women and 14 men; mean age 32.52 ± 1.75 years) were examined. Patients were subjected to quantitative determination of Epstein-Barr virus DNA in saliva samples by the method of polymerase chain reaction (PCR) with real-time hybridization-fluorescence detection. The analytical sensitivity of the test system is 400 copies/ml. The patients were divided into two groups: 26 patients who received allokin-alpha therapy (9 injections subcutaneously with 1.0 mg every other day) were included in the 1st group; the 2nd group included 33 patients who received Valtrex (500 mg 2 times/day, orally) for 2 months. Results. After treatment with allocin-alpha, negative results of PCR were obtained in 59.67% of patients. After two months of Valtrex therapy, negative PCR results were obtained in only 27.27% of patients. The correlation analysis revealed a significant effect of the initial number of copies of EBV DNA on the severity of clinical complaints in the general group of EBV patients. Discussion. Allokin-alpha improves the recognition of virus-infected cells and helps to suppress viral replication. Conclusion. Allokin-alpha therapy can be recommended for the treatment of chronic EBV infection in a dose of 1 mg subcutaneously every other day with a course dose of at least 9 injections.

Material and methods. The study included 200 women of reproductive age, of whom the 1st group included 100 PCOS female patients and the 2nd group included 100 healthy women examined using clinical, instrumental, laboratory, and statistical methods. Results. Metabolic syndrome was diagnosed in 38 (38.0%) PCOS women of early reproductive age, while in healthy women only in 25 (25.0%) (p = 0.102). The serum leptin content in PCOS women amounted of 13.85 ng/ml (4.15-17.6), which was not significantly different from that of healthy women - of 8.9 ng/ml (5.5-18.4) (p = 0.732). However, in women with manifestations of metabolic syndrome (overweight and obesity), the level of leptin was higher than in women without metabolic syndrome - 16.7 ng/ml (15.6-18.8) and 19.3 ng/ml (17.4-22.8) in PCOS women - 31.7 ng/ml (21.6-38.6) and 27.3 ng/ml (20.1-32.1) in healthy women (p = 0.045 and 0.604, respectively). An increase in its level correlated with an increase in BMI (p = 0.001). We found that an increase in leptin levels in PCOS women of reproductive age correlated with its main manifestations: menstrual disorders, infertility and ultrasound parameters of the ovaries, with an increase in BMI, the relationship was stronger. Conclusion. Thus, in PCOS women of reproductive age, metabolic syndrome is more often diagnosed than in healthy women. Overweight and obesity are of major importance in the formation of metabolic disorders. Increased leptin levels exacerbate metabolic manifestations, leading to impaired ovulation and fertility. The results show the need to determine the level of leptin as an additional diagnostic criterion for metabolic syndrome in PCOS cases.

The purpose of this study is to evaluate the effectiveness of focused ultrasound (FUS) ablation as monotherapy for uterine fibroids in women planning a pregnancy. Of the 195 patients included in the study, long-term pregnancy occurred in 38. At the same time, immediately after FUS ablation, without prescribing additional methods of treatment, 7 patients became pregnant. Given the high frequency of additional surgical treatment methods (conservative myomectomy, hysteroresectoscopy), as well as additional procedures for FUS ablation, this method, despite its high efficacy in treating symptomatic myomas, cannot be recommended by us as the only treatment for uterine fibroids in women planning a pregnancy.

There are presented own data on the prevalence of uterine fibroids in women in different age groups, as well as with infertility, miscarriage and other diseases of the internal genital organs. An unusual case of a combination of the uterine form of pregnancy associated with a large submucous myoma node is considered. The use of new original technologies was shown to contributes to the reduction of blood loss during simultaneously performing surgical delivery and myomectomy.