The most important problem of modern clinical diabetology is the prevention and treatment of late complications of diabetes.

Until recently, it was believed that the prevention and treatment of diabetic microvascular lesions was mainly a problem for endocrinologists. However, to date it has been reliably established that diabetic complications not only develop more often in patients with insulin-dependent diabetes mellitus (IDDM) in childhood, but are also widespread among children and especially adolescents [1, 2].

Besides detection and treatment of congenital hypothyrosis, neonatal screening for hypothyrosis can be used for analysis of iodine deficiencies at the population level and for evaluating the severity of iodine deficiency.

We evaluated the significance of iodine deficiency diseases in various regions of the Tyva Republic by the results of screening for congenital hypothyrosis. Use of criteria for diagnosis of iodine deficiency (neonatal TTH) required no extra expenses, because the congenital hypothyrosis screening program has been functioning in the Republic since 1995. TTH was measured in whole neonatal blood by the dry spot method using Delphia immunodiagnostic system at Department of Biomedical Problems, Ministry of Health of Republic of Tyva, in the town of Kyzyl. We analyzed TTH in 8427 newborns born from June 1, 1995 to September 1, 1998.

Analysis of the incidence of neonatal TTH demonstrated the severity of iodine deficiencies in various regions of the Republic and the areas of severe iodine deficiency at the West. For the entire Tyva, blood TTH levels under 5 microunits/liter was 43.2%, which corresponds to severe iodine deficiency. The incidence of transitory hypothyrosis (TTH 25 microunits/liter and higher) in the Republic is 5.36%, which is 30 times higher than in Europe. Therefore, urgent measures are to be taken to liquidate severe iodine deficiency in Tyva.

Approaches to diagnosis and treatment of endocrinoophthalmopathy practiced by the leading endocrinologists in Russia are analyzed. The interviews were carried out using questionnaire suggested by Research Group of European Thyroidology Association for a similar study in Europe in 1998. The data of the European and Russian studies are compared.

A hundred of perimenopausal women were examined. The pituitary-thyroid and pituitary-ovarian status of women with different thyroid status and different course of the perimenopausal period was evaluated.

Case histories were analyzed using a universal information file. Serum Tj, T₄, TTH, FSH, and LH were radioimmunoassayed.

The results indicate that functional deficiency of the thyroid augments during the perimenopausal period particularly so during the climacteric syndrome, the hypothalamo-pituitary structures are discoordinated in patients with the climacteric syndrome in the presence of hypothyrosis, which favors the development of severe forms of the syndrome.

Cardiotropic activity of estrogens after a single administration and during 12-week substitute hormone therapy was studied during echocardiography and Doppler echocardiography in estrogen deficient women with natural or surgical postmenopause with negative cardiovascular (vasomotor) symptoms with hyperkinetic central hemodynamics, high arterial pressure, and disordered diastolic function of the left ventricle. The results confirm the cardioprotective and positive hemodynamic activity of substitute estrogens. Estrogens improved the initially disturbed diastolic and systolic function of the left ventricle, moderately decreased heart rate and systolic and diastolic arterial pressure. Time course of cardioprotective and hemodynamic effects of substitute monoestrogen therapy and estrogen/gestagen hormone therapy was virtually the same.

Although the efficacy of substitute hormone therapy (SHT) is proven, the list of contraindications to it is short, and new drugs and dosage forms have been created, the number of periand postmenopausal women administered SHT is scanty. Among the factors responsible for it is insufficient information and the level of education of women. Our research was aimed at improving the quality of life and prevention of complications in periand postmenopausal women by developing programs for treating and training women of periand postmenopausal age. The program was tried in 106 women aged 39 to 62 years (51.83±0.68), 24 of whom were offered a course of group psychotherapy. Control group consisted of 48 women matched for their social status and age who were not trained.

The training decreased the anxiety caused by somatic state, the women became more open and spontaneous, their mood improved, and anxiety decreased due to explanations offered by the doctor. Special psychotherapeutic training added to preparatory measures improved the psychological state of women still more.

The knowledge of women after a course of training essentially improved in comparison with the control: 3.64±0.02 (p<0.00001) and 2.68+0.03 points (p<0.00001). Ninety-three (87.7%) women decided to resort to SHT after training and so did 31 (64.6%) women who were not trained. About half of untrained women discontinued SHT or had an insufficient course for this or that reason, while in the trained group only about 17% women did so.

Pituitary tumors are a fairly common and often very severe form of neuroendocrine pathology. They make up about 10% of all intracranial tumors detected in clinical practice. They are found at autopsy in 10-20% of cases. Therefore, elucidation of the fundamental mechanisms of the pathogenesis of various types of pituitary tumors, the characteristics of their cellular biology and the development on this basis of effective approaches to their diagnosis, monitoring and treatment are one of the priorities in endocrinology.

The effect of maternal stress or so-called prenatal stress (PS) on the neuroendocrine regulation of reproduction and stress reactivity of the progeny was studied. Prenatal stress prevented the formation of sex dimorphism of catecholamine content and aromatase and androgen 5a-reductase activities in the preoptic region of the brain and mediobasal hypothalamus of 10-day-old rats. Leveling of sex-specific differences in the size of the neurocyte nuclei in the suprachiasmatic nucleus was the morphological equivalent of functional disorders induced by PS. Stress and adrenergic reactivity of the hypothalamo-pituitary-adrenal system was changed in prenatally stressed males and females. Remote effects of PS are regarded as a manifestation of disorders in the hormone neurotransmitter imprinting of the neuroendocrine system.

The quantitative parameters of triiodothyronine (Ту) metabolism at a tissue level have been determined in animal experiments. The method for evaluating Ту metabolism is based on a mathematical model reflecting the current notions on the biological cycle of this hormone.

Congenital hypothyroidism (HB) is detected in 1 out of 4,000 newborns [1, 2]. G is one of the most common diseases in pediatric endocrinology [3 |, as well as one of the most common cases of reversible brain damage and mental retardation in industrial countries. The delay in mental development in hepatitis A is associated with the fact that thyroid hormones take an active part in the development of the brain | 4], the formation of which occurs in utero and in the early postnatal period until the 2nd or 3rd year of life [5].

December 15, 1999 marks the 100th anniversary of the birth of one of the most prominent pathophysiologists-endocrinologists and metabologists of our country, Honored Scientist, Doctor of Medical Sciences, Professor Samuel Moiseevich Leites.