TRANSFORMATION OF MYELODYSPLASTIC SYNDROME INTO ACUTE MYELOBLASTIC LEUKEMIA (CLINICAL CASE).

Despite the availability of modern methods for diagnosing and treating myelodysplastic syndrome (MDS) in the arsenal of a hematologist, even with an adequate treatment strategy, it is not always possible to predict the timing of transformation of the disease into acute myeloid leukemia. The clinical case we presented demonstrates the rapid transformation of MDS into acute myeloid leukemia in a relatively young patient whose prognosis turned out to be poorly predictable despite a change in therapy.

MYELODYSPLASTIC SYNDROME: DIAGNOSIS, TREATMENT AND PROGNOSIS (LITERATURE REVIEW).

Given the difficulties of diagnosis, the absence of a typical clinical picture of myelodysplastic syndrome accompanied by cytopenia, a high risk of transformation into acute myeloid leukemia, discussion of the formation, terminology, pathogenesis, classification, clinical course and principles of management of this group of tumor diseases is very relevant. The review article discusses the issues of terminology, pathogenesis, classification and diagnosis of myelodysplastic syndrome (MDS), as well as the principles of management of this category of patients. Due to the absence of a typical clinical picture of MDS, in order to exclude other diseases accompanied by cytopenia, not only routine hematological examination methods are necessary, but also a mandatory cytogenetic examination of the bone marrow.

CLINICAL AND FUNCTIONAL STATE OF THE THYROID GLAND IN WOMEN OF PERI- AND POSTMENOPAUSAL AGE WITH METABOLIC SYNDROME.

The article deals with the problem of the clinical and functional relationship between the state of the thyroid gland in women of menopausal age and the components of the metabolic syndrome (MS). The purpose of the study: to assess the relationship between thyroid dysfunction and various components of MS in women of peri- and postmenopausal age. 80 menopausal women (mean age 55 years) were examined, of which 40 people with MS constituted the main group, and the comparison group - a similar number of women without MS.

[CLINICAL, MORPHOLOGICAL AND MOLECULAR GENETIC FEATURES AND PROGNOSTIC FACTORS OF PRIMARY MYELOFIBROSIS. A CASE OF PRIMARY MYELOFIBROSIS TRANSFORMATION INTO ACUTE MYELOID LEUKEMIA].

Primary myelofibrosis is a common disease from the group of Ph-negative myeloproliferative diseases. The article presents modern data on the pathogenesis of Ph-negative myeloproliferative diseases, as well as diagnostic criteria, treatment tactics and prognosis factors for primary myelofibrosis. A clinical case of transformation of primary myelofibrosis into acute myeloid leukemia is described.

[ERRORS IN THE DIAGNOSTICS AND TREATMENT OF PATIENTS WITH GOUT AND THE ALGORITHM OF THERAPEUTIC TACTICS IN DIFFERENT PERIODS OF THE DISEASE (CLINICAL CASE)].

Difficulties and errors in the treatment of patients with the gout arise, mainly, during urate-lowering therapy. The article discusses possible medical errors in acute gouty arthritis and during chronic tophaceous gout in the light of the updated international recommendations of the American College of Rheumatology (ACR) and the European Antirheumatic League (EULAR 2018). As an example of inadequate treatment, the authors describe a case of a patient with chronic tophaceous gout.

[INDICATORS OF CARDIOHEMODYNAMICS OF RHYTHM DISTURBANCES IN ELDERLY PEOPLE WITH CHRONIC HEART FAILURE].

The aim of our study was to study and analyze the electrophysiological indicators of rhythm disturbances in heart failure in elderly people who participated in the elimination of the consequences of the Chernobyl accident in the distant period. In order to assess the functional features, 50 elderly patients (65-74 years old) who participated in the liquidation of the consequences of the Chernobyl accident were examined. Patients were divided into 4 groups depending on the length of stay in an environmentally disadvantaged zone: group 1 (April-June 1986) - 8 (16%) people; 2 (June-December 1986) -14 (28%); 3 (1987-1989) -17 (34%) and group 4 (1990-91gg) -11 (22%) people.

[ARTERIAL HYPERTENSION AMONG WORKERS OF A URANIUM PROCESSING ENTERPRISE OF THE REPUBLIC OF KAZAKHSTAN: PREVALENCE, RELATIVE RISKS AND PREDICTORS OF THE DEVELOPMENT].

The aim of this study was to establish the prevalence, relative risks, and predictive factors of the development of arterial hypertension (AH) in workers of a uranium processing enterprise (UPE). An open cross-sectional comparative study of 809 UPE workers was conducted. The compared them to the 696 workers of the bearing plant, located at a distance of 10 km from UPE.

[Ways of optimization in teaching of internal diseases in a medical institute].

A method of practical clinical games (PCG) performing is represented. For the PCG themes the extreme and urgent situations requiring the doctors of various specialities (especially on the cardiology and hematology cycles) are selected. A model of specific clinical situation, where students play roles, corresponding to the duties of speciality under conditions, maximally approximating to reality, is reproduced.

[Clinicofunctional characteristics of primary mitral prolapse in adolescents].

To investigate clinicofunctional features of primary mitral prolapse (PMP) in adolescents, 60 patients were examined (42 adolescent girls and 18 adolescent boys aged 14 to 20 years). Control group consisted of 15 healthy adolescents of the same age. PMP in adolescents was characterized by marked manifestations of connective tissue dysplasia (CTD) and vegetative dysfunction (VD).

[Morphometric parameters of malignant cells in non-leukemic hemoblastosis with primary lymph node involvement].

Morphometric studies were conducted to distinguish reactive and malignant lymphoid processes and to obtain a more objective and reproducible grading system for non-Hodgkin's lymphomas (NHL). Twenty-three untreated patients (3 with reactive lymphadenitis, 2 with diffuse lymphomas, 18 with lymphosarcomas) were studied. The sections of lymph nodes were stained with 50% aqueous silver nitrate solution and then counter-stained with methylene blue.

[The characteristics of the clinical course of lymphosarcomas when using combined therapy including splenectomy].

The authors relate the results of a clinico-morpho-instrumental analysis of the clinical course of lymphosarcomas in 38 patients with different morphological patterns of the disease with primary injury to the spleen. The patients received multimodality therapy including splenectomy. It has been established that later the short-term effect of splenectomy permits the implementation of different polychemotherapy programs, favouring a better lymphosarcoma prediction.

[Lymphoid cell glycosidases in various forms of lymphoproliferative disorders].

Activity of 8 glycosidases (6 acid lysosomal and 2 neutral cytosolic enzymes) was estimated in lymphoid cells of 28 patients with different forms of lymphoproliferative disorders: B- and T-chronic lymphocytic leukemia (CLL), non-Hodgkins lymphoma (NHL), Sezary syndrome, hairy cell leukemia (HCL) and B- and T-acute lymphoblastic leukemia (ALL). Activity of these glycosidases was also studied in mononuclear cells and granulocytes of healthy volunteers and in immature myeloid cells of 16 patients with chronic myeloid leukemia (CML). In lymphoid cells of all the patients studied (except of ALL) the glycosidases activity was decreased as compared with that of normal mononuclear cells and immature myeloid cells.

[The characteristics of the clinical course of lymphosarcomas in conformity with the morphological variants of the WHO and Working Formulation classifications].

Histological and cytological preparations of the lymph nodes, spleen, bone marrow and other tumors from 140 patients with different variants of lymphosarcomas were subjected to a comparative clinicomorphological analysis. The data obtained were correlated to the WHO classification and the working formulation of non-Hodgkin's lymphomas intended for clinical use. It has been found desirable that the working formulation may be used for predicting the disease course and elaboration of the programs of lymphosarcoma treatment.

[The parameters of tumor cell proliferation as a prognostic factor in lymphosarcomas].

Cytophotometry of DNA was used to measure cell fractions in the S + G2 phases of the mitotic cycle in imprints of the involved lymph nodes and/or smears of the cells isolated from archival paraffin blocks of 60 patients with lymphosarcoma. Parallel studies have shown that both cell sources permit obtaining similar results (r = 0.98, p less than 0.

[Hematological masks of malignant neoplasms of the internal organs].

Hematological "masks" of malignant tumors of the internal organs are not infrequent in clinical practice. A total of 45 patients with malignant tumors of the internal organs (stomach-12, colon-9, liver-3, lungs-9, kidneys-6, pancreas-2, thyroid-2, bladder-1, prostate-1) were under observation. Hematological signs of bone marrow metastatic involvement were as follows: anemia (mainly hypochromic), leukemoid neutrophilic reaction, leukemoid reaction of myeloid type, erythrocytosis, thrombocytosis, plasmocyte bone marrow reaction.