Розглянуто проблему найгострішого грампозитивного і грамнегативного сепсису як нозологічно самостійної інфекційної хвороби з урахуванням його імунозалежного патогенезу, симптоматики, діагностики і лікування. Описані клінічна картина та діагностика септичного інфекційно-токсичного шоку, а також невідкладні заходи при цьому стані. Наведено типовий випадок найгострішого сепсису. Діагноз встановлено передусім на підставі клінічних даних. Так, дуже характерний розвиток інфекційно-токсичного шоку в перші години недуги. Сугіляції на дистальних відділах кінцівок – характерні прояви злоякісності розвитку хвороби. Допоміжну роль мали анамнестичні, лабораторні та інструментальні методи. Попри відсутність бактеріологічного встановлення етіології сепсису, діагноз не викликає сумнівів.

Background. Human lifestyle significantly affects human health and reproductive functions. The presence of hypothyroidism negatively impacts the health, activity, and reproductive status. This study was aimed to assess hormonal status, metabolic and anthropometric parameters in men of active reproductive age with primary hypothyroidism. Materials and methods. Totally 60 males with primary hypothyroidism were included in the study. A comparative analysis of hormonal, anthropometric, and metabolic para­meters in 60 men with hypothyroidism (basic group) and 25 men wi­thout hypothyroidism and other chronic somatic diseases (control group) was performed. The mean age of the subjects was 42.4 ± 2.7 years. Results. It has been established that hypothyroidism was accompanied by an increase in serum concentrations of cholesterol and low-density lipoprotein cholesterol in comparison with control group (25 men without hypothyroidism) indicating metabolic disturbance. The data shows the significant effect of hypothyroidism on testosterone and follicle-stimulating hormone (FSH) serum concentration but not on luteinizing hormone, estradiol levels. Patients with hypothyroidism had lower circulating testosterone and higher FSH level in comparison with the controls. The reproductive hormone changes in men with hypothyroidism can result in deleterious effects on sexual functions including erectile dysfunction, reduced libido, and alteration in spermatogenesis. Conclusions. In men with hypothyroidism, changes in hormonal status have been found, which manifested in a decrease in testosterone and an increase in the blood level of follicle-stimulating hormone. The effect of hypothyroidism on the blood level of other hormones (luteini­zing, estradiol, cortisol) has not been established. Hypothyroidism in men is accompanied by changes in lipid metabolism (increased levels of total cholesterol and low-density lipoprotein cholesterol).

Background. In recent years, thyroid diseases occupy the top places in the structure of the endocrine pathology. There exists a tight functional relationship between the thyroid and reproductive systems, which leads to a high probability of the development of combined disorders in one of these links of homeostasis. The problem of reproductive health disorders is of particular concern around the world and is relevant to the study of the impact of thyroid diseases on both fertility and pregnancy, especially in conditions of comorbidity. The purpose of the study was to investigate the effect of myo-inositol on the reproductive function of women with subclinical hypothyroidism on the background of autoimmune thyroiditis and obesity. Materials and methods. The study included 98 patients aged 18–40 years with subclinical hypothyroidism, overweight, or obesity on the background of autoimmune thyroiditis. They were randomly subdivided into two groups. Patients of the first group (n = 49) before the basic treatment received myo-inositol at a dose of 2000 mg/day and cholecalciferol at a dose of 2000 IU/day. Patients of the second group (n = 49) before the basic treatment received only cholecalciferol at a dose of 2000 IU/day. Results. Vitamin D deficiency was observed in 90.81 % of women with subclinical hypothyroidism, and vitamin D insufficiency in 9.19 %. A negative correlation was found between the level of 25(OH)D and the level of TPO-Ab (r = –0.189; p < 0.05). There was a weak negative correlation between the level of 25(OH)D and the level of the HOMA-IR (r = –0.168; p < 0.05). The administration of myo-inositol together with vitamin D led to a significant increase in the content of 25(OH)D, as well as to a decrease in the titer of TPO-Ab. Conclusions. The positive effect of myo-inositol drugs together with vitamin D on the functional state of the thyroid gland, on the level of TPO-Ab and HOMA-IR in women of reproductive age with subclinical hypothyroidism and obesity has been established.