The aim: To perform a retrospective analysis of leptospirosis morbidity in Ivano-Frankivsk region, to give the etiological characteristics of leptospirosis according to clinicallaboratory parameters, to determine the peculiarities of the course, prognostic features. Materials and methods: Data of the State Enterprise “Ivano-Frankivsk Regional Laboratory Center of the Ministry of Health of Ukraine”, reports and abstracts of medical records of the Regional Clinical Infectious Diseases Hospital for 2009-2018 were used. Clinical observation of patients, analysis of general-clinical, biochemical, and serological indices were carried out. Results: The leptospirosis morbidity in Ivano-Frankivsk region during 2009-2018 was higher than in general in Ukraine. Activation of foci of leptospirosis L. pomona and grippotyphosa in 2009-2013, decrease of L. grippotyphosa and increase of L. pomona foci and “new” L. autumnalis, australis, bataviae, cynopteri in 2014-2018 were noted. The emergence of leptospirosis L. autumnalis, which had a high virulence and caused a severe course, was noted. Conclusions: The leptospirosis morbidity in the Ivano-Frankivsk region over the past 10 years has exceeded the incidence in Ukraine and varied within 0.62-2.2 per 100,000. During the last 5 years, the serological structure has changed: L. pomona (27.7%) prevailed, L. grippotyphosa decreased (2.1%), L. bataviae and cynopteri, autumnalis increased (by 8.5%). Seasonality is shifted in the autumn-winter period (November-February) (L. grippotyphosa, australis, pomona, canicola). According to forecasts, leptospirosis induced by L. autumnalis was most adverse. Leptospiroses of serogroups L. australis, bataviae, cynopteri had a mild course, there were fewer complications.

The aim: To determine changes of FSG of neutrophilic granulocytes of peripheral blood (NGPB) of patients with CHC with concomitant DM-2. Materials and methods: We’ve examined 180 patients with CHC: 160 with concomitant diabetes mellitus and 20 ones without it. The NGPB genome was studied using cytogenetic method. There were analyzed 100 interphase NGPB nuclei in the preparation, structural characteristics were evaluated according to indices: chromatization (IC), nucleolar (IN), pathologically altered nuclei (PAN), micronuclei (MNI). Results: Violations of FSG OF NGPBwere found according to all indices in patients with CHC, they were more pronounced in patients with concomitant DM-2. Conclusions: FSG NGPB is more disordered in CHC with concomitant DM-2. The reduction of IC in CHC with concomitant DM-2 is more pronounced in men. Reduction of IN in patients with CHC with and without DM-2 is a marker of violations of the second stage of realization of hereditary information. The tendency to change the components of the cytogenetic status of all examined patients due to the frequency of MNI was determined.

The aim: To study the clinical and epidemiological peculiarities of measles in adults according to the data of the Regional Clinical Infectious Disease Hospital in Ivano-Frankivsk, Ukraine. Materials and methods: The article analyzes the epidemiological and clinical features of 113 cases of measles among adults who undergone inpatient treatment in 2017-2018. The diagnosis was confirmed by the detection of antiviral Ig M antibodies. Determination of the genotype of the virus was performed in Regional WHO Reference Laboratory in Luxembourg. Results: The genotype of the measles virus was MVs/Cambridge GBR/5.16 D8 is circulating through the region territory. In 98.3% of adult patients a typical clinical picture of moderate severity was observed. Measles was accompanied by complications such as acute bronchitis (23.9%), reactive hepatitis (13.3%), reactive pancreatitis (10.6%) and pneumonia (7.1%). Сonclusions: The following epidemiological peculiarities in adult patients with measles: young people are mostly ill, urban residents are not vaccinated, partly vaccinated or with an unknown vaccine status. There was a change in the genotype of the virus of measles circulating in the Ivano-Frankivsk region: in 2012 genotype MVs/ManchesterGBR/10.09D4 was confirmed, now the genotype of the measles virus is MVS/ CambridgeGBR/5.16D8. In 98 (86.73%) patients was a typical clinical picture of the disease, of moderate severity. Among the complications of the disease were diagnosed: bronchitis and pneumonia (23.9% and 7.1% respectively), reactive hepatitis and reactive pancreatitis (13.3% and 10.6%).

Vaccine-controlled viral diseases require a deeper study of the pathogenesis and immunological component. When performing this work, we've set the following goals: to study and distinguish the clinical and laboratory peculiarities of the measles course in adults, to describe the method of forecasting severe and complicated forms of the disease, as well as the possibility of using the ribonucleic acid medicine in the comprehensive treatment of the studied patients. During the performance of the work, there were analyzed 32 cases of measles in people of working age. Among the patients there were 6 (18.75%) people who confirmed the presence of two doses of the MMR vaccine. At the phase of the admission to the hospital, patients were divided into two groups, and they were compared according to the severity of the disease. The group I of patients received basic therapy; group II, in addition to basic therapy, received a ribonucleic acid medicine as an etiotropic agent. Evaluation of the clinical picture, hematological data, calculation of endogenous intoxication indices was performed at the phase of admission to the hospital, as well as during the third and fifth days of treatment. In the course of the study, the average severity of the disease was determined in most patients-27 (84.4%), and 5 (15.6%) patients-had severe disease. In all patients with measles, at the early stage of the disease, there was a significant increase in the integrative indices of endogenous intoxication: LII, ILS, RINM, NI, II, and IK. This was accompanied by a violation of immunological reactivity (increased ILS and decreased ILG) and an active adaptive response of the body (decrease in RIEL). When evaluating clinical data during the third and fifth days of the disease, it was noted that the main clinical manifestations of the disease subsided relatively faster in patients of the group II in contrast to the patients of the group I. A severe course of the disease was registered in 4 (25%) cases in patients of the group I, in 1 (6.25%) case in patients of the group II (р<0.05). The average length of hospital stay in patients of the group II was 7.8 ± 0.8 days against 9.2 ± 0.7 days of the patients of the group I (p<0.05). Integrative indices of endogenous intoxication against the background of the use of the ribonucleic acid medicine during the 3 rd and 5 th day of the disease had significant differences in the compared groups of patients, indicated the fading of the inflammatory reaction, activation of factors of a specific immunological response, and reduction of the extent of the endogenous intoxication syndrome. The application used by us for calculating indices of endogenous intoxication is a convenient and accessible method of visualization of pathogenetic and immunological processes of a viral disease, it makes it possible to influence these processes with medications and adjust therapy in a timely manner, and it is also a way of predicting possible complications.