This review presents current laboratory and instrumental methods for cardiovascular toxicity diagnosing in patients with multiple myeloma undergoing autologous hematopoietic stem cell transplantation. In the absence of national guidelines on the timing and frequency of monitoring, it is particularly important to have a set of techniques to detect preclinical stages of myocardial dysfunction. The most useful methods include transthoracic echocardiography, with assessment of global longitudinal strain using speckle tracking, and measurement of cardiac biomarkers such as troponin T and I, and natriuretic peptides. Using this combination of methods allows for early detection of cardiotoxicity, which is essential for timely intervention and treatment.

Nowadays, the problem of antimicrobial resistance of some representatives of Gram-positive bacteria is one of the global threats to public health. More than 30 % of the population is asymptomatic carriage of S. aureus on the surface of the epithelium and mucous membranes, in 60 % of cases, its transient carriage is determined. The problem lies not only in the ubiquity and high frequency of isolation of Staphylococcus aureus, but also in the increasing level of drug resistance of this species. The aim of this scientific article is to conduct a comprehensive analysis of the mechanisms of Staphylococcus aureus resistance to modern antibacterial drugs, taking into account the wide spread of resistant forms of this pathogen. The materials and methods of the study were literature reviews of recent advances in the study of the molecular basis of resistance and interaction of Staphylococcus aureus with different classes of antibiotics, such as β-lactams, glycopeptides, fluoroquinolones, as well as new approaches to the creation of effective therapeutic strategies. Results. The main results of the review indicate the diversity of mechanisms utilized by S. aureus to resist antibiotics. Among them, the ability to produce β-lactamases, degradation of peptidoglycan structure and adaptation of cellular metabolism to minimize the impact of antibacterial agents are highlighted. The article highlights the importance of combining antibiotics from different groups, such as β-lactams and glycopeptides, to minimize the risk of resistance development. Conclusion. The conclusion emphasizes the need to further explore cell division pathways, nucleic acid synthesis and peptidoglycan synthesis as possible application points for future antibacterial drugs. Special attention is given to new directions such as the study of inhibitors of fatty acid biosynthesis and the FtsZ protein, which plays a key role in cell division. Thus, this work offers a deep understanding of the molecular processes underlying S. aureus resistance and forms the basis for further development of innovative approaches to the therapy of staphylococcal infections.

Recently, there has been an increase in the number of hospitalizations of patients with chronic renal insufficiency, along with a steady general increase in the number of patients undergoing programmed hemodialysis. In addition, acute pancreatitis often remains the leading diagnosis during hospitalization, but there is no consensus on diagnostic and therapeutic measures for this group of patients. The data on adverse outcomes and complications from surgical interventions in patients undergoing hemodialysis are also disappointing. A comprehensive diagnostic approach, taking into account medical history, clinical and laboratory data, and instrumental studies, makes it possible to differentiate the form of acute pancreatitis and choose a rational treatment strategy. At the same time, the lack of uniform diagnostic criteria leads clinicians to search for optimal clinical and laboratory data in the stratification of forms of acute pancreatitis in patients undergoing programmed hemodialysis. A comprehensive assessment of the severity of acute pancreatitis against the background of comorbid renal pathology provides reliable diagnostic data.

Chronic lymphocytic leukemia, being the most common type of leukemia in adults, is common in the elderly, which increases the likelihood of comorbid conditions that can significantly affect the tolerability of therapy, the quality of life of patients and survival. Objective. A review of the current literature on the impact of comorbid pathology on treatment outcomes in patients with chronic lymphocytic leukemia, as well as an assessment of the interaction between these conditions. Materials and methods. The analysis was conducted based on existing studies in the PubMed database. The following English language search terms were used: “chronic lymphocytic leukemia” in titles, abstracts and keywords in combination with the following search queries: “comorbid conditions”, “survival”, “clinical outcomes”, “quality of life”, “elderly patients”. The search and selection of literature sources was performed from September to December 2024. Various comorbid diseases and their impact on prognosis, survival, overall health status, and quality of life in patients with chronic lymphocytic leukemia. Results. The literature review emphasizes the critical importance of considering comorbidities in the diagnostic and therapeutic process. Chronic lymphocytic leukemia, being the most common type of leukemia in adults, frequently occurs in older individuals, increasing the likelihood of comorbid conditions that can significantly influence survival, treatment tolerability, and patients' quality of life. Numerous studies confirm that the presence of comorbidities such as cardiovascular diseases and diabetes adversely affects clinical outcomes. This underscores the necessity of a multidisciplinary approach to managing this category of patients, involving not only hematologists but also cardiologists and endocrinologists. Modern therapeutic methods, including targeted and immunotherapeutic approaches, demonstrate promising results; however, their application requires careful assessment of the patient's functional status and potential comorbidities. The emergence of new drugs also provides patients with the option to choose more comfortable and less toxic treatment alternatives, which can potentially enhance their quality of life. Conclusion. Further research is needed to deepen the understanding of the interactions between chronic lymphocytic leukemia and comorbid conditions and to develop more precise management recommendations tailored to individual patient characteristics. Successful treatment should not be limited to clinical outcomes but also encompass aspects of quality of life, which is an essential priority in contemporary oncology.

The gene system of enzymes of xenobiotic metabolism plays an important role in the metabolism of many substances entering the human body. According to the available scientific research, a certain amount of information has accumulated on the study of polymorphic variants of genes for xenobiotic biotransformation enzymes in bronchopulmonary pathology, in particular pulmonary tuberculosis. The aim of the study was to identify the relationship between the genotype of the xenobiotic biotransformation enzyme (GSTM1) in patients with pulmonary tuberculosis and the effectiveness of the intensive phase of chemotherapy. Material and methods. The research includes an analysis of modern literature, the development and formulation of goals and objectives of the work, the design of the scientific work carried out, the collection, processing and analysis of the results, the formulation of conclusions and practical recommendations. To solve these tasks, we analyzed the clinical, laboratory and instrumental data of 335 patients with pulmonary tuberculosis aged 18 to 65 years receiving intensive chemotherapy, including 212 patients with newly diagnosed and 123 people with chronic pulmonary tuberculosis. Associations of alleles and genotypes with predisposition to pulmonary tuberculosis were assessed using the odds ratio. Results of the study. The study revealed that in patients with newly diagnosed pulmonary tuberculosis, scarring of the decay cavities is 2,9 times more often associated with the genotype of its GSTM1 gene, while in patients with chronic pulmonary tuberculosis it is 2,4 times more often compared with the DD genotype of the GSTM1 gene (p < 0.001). A decrease in lung tissue infiltration is 5,3 times more often associated with the genotype of its GSTM1 gene in patients with newly diagnosed pulmonary tuberculosis, while in patients with chronic pulmonary tuberculosis it is 1,7 times more often compared with the DD genotype of the GSTM1 gene (p < 0,001). Conclusion. The genotype of GSTM1 gene is an independent predictor of the most favorable course of tuberculosis infection, while the DD genotype of the GSTM1 gene is associated with the most unfavorable course of this infection.