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The problem of the development of adverse reactions as a result of the use of diagnostic and medicinal products (drugs) in medicine is becoming increasingly important. Patients more often note reactions to local anesthetics (LA) – 43.2 %, antibiotics – 18.8 %, nonsteroidal anti-inflammatory drugs – 9.7 %, other drugs – 28.4 %. LA include two chemical groups: esters of benzoic acid (Ester-type anesthetics), which are potentially allergens, and amides (Amide-type anesthetics), which have virtually no allergenic potential. Based on the history for doctor is often difficult to assess the risk of allergic reactions, so if in the past the patient had a side effect of LA, then these drugs should be skin and provocative tests, having obtained the informed consent of the subject to conduct them. Skin prick tests are used for initial diagnosis in patients with suspected LA allergy. If the results of the pre-test and intradermal test are negative, a subcutaneous challenge test with LA is performed. Skin testing for suspected hypersensitivity (НS) of the delayed type begins with application (patch) tests and only with a negative result using an intradermal test with LA. Laboratory methods for diagnosing НS to LA are used much less often than skin and provocative tests, because for many drugs the appropriate methods have not been developed, as well as because it is a time-consuming and expensive method of diagnosis. Therapeutic tactics in the event of НS to LA include providing patients with emergency care in the development of anaphylaxis and treatment of other clinical manifestations of HS reactions in accordance with existing international and domestic protocols. Epinephrine, oxygen therapy, colloid/crystalloid infusions, antihistamines, systemic and topical corticosteroids, protease inhibitors, inhaled β2-agonists, leukotriene receptor antagonists, etc. are most commonly used for this purpose.

Iron deficiency anemia (IDA) is one of the causes of chronic fatigue with a decrease in the quality of life, impaired cognitive function and poor labor productivity. Obesity as a condition of chronic low-intensity inflammation is one of the factors that increases the risk of anemia and impairs the quality of life in the general population. We drew attention to the high global prevalence of anemia among pregnant women of reproductive age in the world and the prevalence of high body mass index among women compared to men in most countries. The objective of the work was to determine the impact of obesity on clinical features and quality of life of women with ІDA. We analyzed the main markers of ІDA and hematologic indices in women with obesity (n = 30) compared with the control group (n = 10), where there were women with ІDA but without obesity. It was found that there was no statistical difference between these parameters, but nevertheless, the serum ferritin level in obese women was (4.70 ± 2.68) ng/ml compared to (3.50 ± 2.93) ng/ml and had a significant positive correlation with body mass index. The analysis of the questionnaires revealed that obesity is still a significant factor in women with ІDA and obesity, which determines the decrease in quality of life mainly in the physical aspect in the absence of significant influence on the psychosocial components of health.

The role of macrophages in chronic periodontitis (CP) is essential, but not well understood. The purpose was a thematic analysis of the literature on contribution of M1/M2 macrophage subpopulations to the pathogenesis of chronic periodontitis, and methodology for macrophages study in order to define directions and approaches for further investigations. Our own research findings as well as papers for the topic by searching the electronic databases (the Google Scholar, PMC, PubMed) were analyzed. M1 macrophages can contribute to CP exacerbation, systemic inflammation enhancement, destruction of periodontal ligament, and inhibition of osteoclastogenesis. M2 macrophages are able both to develop tolerance influenced by LPS of periodontopathogens, and to enhance proinflammatory abilities. Experimental depletion of macrophages using clodronate liposomes can prevent the bone resorption. Influences on M1/M2 in CP with the purpose of treatment are not adequately investigated. Polarization of macrophages is regulated by a wide spectrum of recognizing receptors, cytokines, specific signaling pathways and genetic programs, some of which are used as phenotype markers of certain macrophages. The unique molecules for M1/M2 are absent. Phenotypic markers of M1 and M2 show overlap, so markers combinations are used depending on a purpose and type of macrophages or profile/combination of expressed genes. The article lists markers used in various studies for M1/M2 identification. Conclusions. Most of the data on the role of M1/M2 in CP was obtained using monocyte-derived macrophages in vitro and in animal models. This paper highlights the important role of M1 and M2 subpopulations of macrophages in the pathogenesis of CP in humans. The identification of predominant macrophage phenotypes remains elusive, as well as consequences of influences on them. Immunohistochemical methods are indispensable for human studies at the present stage due to availability of biopsy. A prospect for further scientific research is to study the role of M1 and M2 macrophages in CP pathogenesis in humans.

Background. Macrophages are of great importance in the development of obesity and psoriasis. Signaling via PPAR-γ in certain macrophage populations is associated with M2-like features and anti-inflammatory profile. In this research, we evaluated the anti-inflammatory action of pioglitazone by the immunohistochemical study of M1 and M2 macrophages in psoriasis-affected skin in obese patients. Methods. We used immunohistochemistry to characterize CD68+ and CD163+ macrophages and pathomorphological description of skin biopsy, obtained from 6 obese psoriatic patients before and after treatment with 15, 30, and 45 mg pioglitazone, once a day during 6 months. Two patients with conventional therapy and without pioglitazone served as control. Results. Generally, CD163+ cell quantities in psoriasis-affected skin significantly dominated over CD68+ before and after all treatment regiments. Among patients who received pioglitazone, some of them clearly responded to treatment from lowest to highest doses by decreasing CD68+ cells. In the group with 30 mg pioglitazone regiment, we detected a significant reduction of CD68+ cells in dermal infiltrates: CI 95% (16–32) before versus CI 95% (2–7) after treatment. Pioglitazone dose escalation led to certain normalization of skin morphology. Conclusion. The immunohistochemical study allows us to show the anti-inflammatory effect of pioglitazone in psoriatic obese patients, which can be mediated by reducing the number of СD68+ macrophages, but not СD163+ macrophages, in the affected dermis.