The present study was undertaken to examine the lipid spectrum of erythrocytic membranes and serum in children and adolescents with type 1 diabetes mellitus (DM-1) during pathogenetic therapy in relation to the duration of the disease, its severity, and the presence of vascular events. Ninety-nine patients with DM-1 and 40 healthy children of the same age were examined. The patients were on basic bolus insulin therapy. In children, DM-1 was ascertained to be accompanied by not only atherogenic serum lipid metabolic disturbances (the elevated levels of total cholesterol, triglycerides, low- and very low-density lipoprotein cholesterol), but also by the impaired lipid spectrum of erythrocytic membranes (reductions in the level of total lipids and the fraction of phosphatidylcholine (PC) with an increase in the level of fractions of tysophosphatidylcholine and phosphaUdylinositol; elevated levels of saturated fatty acids and decreased levels of unsaturated fatty acids in the fractions of PC and phosphatidylethanolamlne; the enhanced microviscosity of deep membranous layers and the modified outer membranous ones). Complex basic therapy resulted in incomplete normalization of the study parameters of the lipid spectrum of serum and erythrocytic membranes in DM complicated by microangiopathies, which requires optimization of conventional therapeutic regimens.

The fact that diabetic retinopathy (DP) exists at the preclinical stage of evolution of type 2 diabetes mellitus (DM-2) cannot be' explained in the context of the commonly accepted theory of the etiopathogenesis of diabetic microangiopathy. The purpose of the study was to explore the prevalence of DR among patients with new-onset DM-2 and to analyze the possible causes of development of this complication at an early stage of the disease. The prevalence of DR among patients with new-onset DM-2 was found to be 16.4%. In the new-onset DM-2 patients aged above 45 years, the odds ratio for DR. is 2.6 times greater than that in those aged under 45 years. Based on the results of the study, the authors suggest that there are pathogenetic mechanisms responsible for the initiation of diabetic microvascular pathology to the stabilization of hyperglycemia at the stage of decreased glucose tolerance.

The consequences of switching of patients with type 1 diabetes mellitus (DM-1) to the short-acting insulin analogue Aspart (Novorapid*) were pharmacoeconomically analyzed. The study has indicated that switching of patients with DM-1 to the short-acting insulin analogue Aspart leads in actual practice to the decreased levels of Hb A_k due to its pharmacological properties ensuring the maximum simulation of physiological pancreatic insulin secretion, which is followed by a reduction in the absolute risk of new cases and by progression of existing chronic vascular complications as compared with the use of short-acting insulin analogue Actrapid. Calculation of the cost of treatment of all prevented vascular complications due to DM has shown that the short-acting insulin analogue Novorapid is more cost-effective agent than Actrapid.

A nationwide representative study of progress in preventing iodine deficiency in the nutrition of the population of Turkmenistan through general salt iodination was made in 879 children in the all regions of the country in January-February 2004. The findings suggest that the population in the whole country is adequately provided with iodine, which has been achieved due to the fact that qualitative iodinated salt is available in 100% of the country's households. The median urinary iodine concentration (170 ng/l) for the whole population of Turkmenistan is in the range (100-300 fig/I) recommended by the WHO, UNICEF, and ICIDC; the proportion of samples with an iodine concentration of less than 100 and SO /ig/l has proved to be much less than the recommended one. According to the results of the study, in Turkmenistan was declared a country eliminating iodine deficiency in the population's nutrition.

То study the efficiency of neurosurgical treatment of the Itsenko-Cushing disease (1CD), the authors analyzed the early and late results of adenomectomy in 99 patients (90 females and 9 males) with ICD. The diagnosis of ICD was verified on the basis of hormonal studies, functional tests, and the results of topic diagnosis. All the patients had an active stage of the disease and a pituitary tumor, as evidenced by magnetic resonance Imaging (MRI). Out of the 99 patients, 75% had a microadenoma of the pituitary and 25% had its macroadenoma. No correlation was found between the sizes of a tumor, the duration of the disease, and the severity of hy-percorticism. The Indication for surgery was a well-defined localized pituitary tumor as verified by MRI. The patients tolerated a neurosurgery well and complications as incoming diabetes insipidus were observed only in 12%, which is in agreement with the data available in the literature. Algorithms were developed for postoperative management of these patients. The findings have indicated that the development of the hormonal and clinical signs of hypocorticism serves as a good predictive marker of a radically performed operation. Six months after surgery, 82% of the patients were at remission. At an average 8.6-year follow-up, remission continued to be in 69(85.2%) of 81 patients. After surgery, patients with ICD should be, however, followed up since 14% developed a recurrence in the late postoperative period.

The paper presents the data of examination and treatment of children with pubertas precox (PP) resulting from hypothalamic hamartoma, a rare malformation of the brain. It analyzes the results of 27 cases that is one of the largest series of cases in the world literature. Of the greatest interest are the clinical and anatomic comparisons presented by the authors, which make it possible to define the involvement of different hypothalamic structures in the development of specific endocrine disorders. When located parahy-pothalamically, hamartomas (a peduncular type) are characterized by the symptoms of PP; when located intrahypothalamically (a sessile type), in addition to PP, there are convulsive typical symptoms (compulsive laughter attacks). At the suprahypothalamtc site, there are commonly diencephalic disorders (obesity, diabetes insipidus). The paper provides the results of surgical and hormonal treatment (the use of long-acting luteinizing hormone-releasing hormone analogues), evidence for the high efficiency of medical treatment and the low efficiency attended by a high risk of complications, surgical treatment.

The purpose of the study was to evaluate the efficacy of growth hormone (GH) drug Saizen in a new formulation (lyophilizate for the preparation of solution for injections as 8-mg vials in combination with bacteriostatic solvent in cartridges) in children with GH deficiency and to determine whether a Van.Click syringe-pen was handy for injection of Saizen in the new formulation. Thirty children (7 girb and 23 boys) were treated for 6 months. Ten patients had isolated GT deficiency; 18 patients had multiple adenohypophyseal hormonal deficiency; de Morsiau's syndrome was observed in 2 patients. The dose of the test drug was 0.033 mg/kg/day. During 6-month treatment, Slzen showed a good growth-stimulating effect: the mean growth rate was 11.15±0.71 cm/year; there was a 2-3-fold increase in the baseline low levels of insulin-like growth factor (ILGF-1) and ILGF-CB-3. Over 6 months of treatment, there was a significant decrease in the sum of 4 measured fat folds, which suggests a reduction in the body's adipose tissue. Significant changes were observed in biochemical parameters during the performed therapy: the decrease in the levels of total cholesterol and low-density lipoproteins, which suggests the antiatherogenic effect of GH therapy on lipid metabolism; a significant increase in the level of calcium and phosphorus, the activity of alkaline phosphatase, which is 3.5 times greater than the normal values, which indicate the acceleration of bone metabolic processes. According to the evaluation made, there were no unfavorable phenomena or significant deviation from the normal laboratory parameters, including glucose values. By and large, Sizen tolerance may be regarded as good and its treatment is safe. The use of the autoinjector for GH administration is handy and atraumatic to patients.

The study was undertaken to evaluate the efficiency of the 2003-2004 neonatal screening for congenital adrenal hyperplasia (САН) in Tyumen and to estimate the prevalence of classical forms of 21-OH deficiency in the newborns by the results of the screening. Neonatal 17-OHP levels were determined in 20,011 neonatal infants by bilateral enzyme-linked immunosorbent assay (ELISA) at a sensitivity of 0.13 n/mol/l, by using "Delfia Neonatal 17-OHP" kits. In 124 (0.61%), the level of 17-OHP was greater than 60 nmol/l; retests identified 2 babies with salt-loosing САН. Thus, the Incidence of classical forms of САН was 1:10,005 in the Tyumen population. In low-weight premature infants, 17-OHP levels were significantly higher than those in full-term or normal-weight babies

То evaluate the effectiveness and safety of drug treatment for acromegaly, the authors conducted an open-labeled prospective study of the impact of treatment with long-acting octreotide Sandostatm LAR) on the content of growth hormone (GH) and IRF-1 and on the size of a pituitary tumor. The study covered 40 patients (28 females and 12 males) aged 21 to 65 years (median 45 years) who had active acromegaly; 4 (10%) patients were diagnosed as having pituitary microadenoma; 36 (90%) had pituitary macroadenoma. Twenty-four patients received no therapy; 16 patients had tumors after their ineffective removal. All the patients took Sandostatin LAR, 20 mg intramuscularly, once every 28 days. The mean duration of treatment was 8.25 months (range: 3 to 12 months). Clinical and hormonal parameters were estimated 3, 6, and 12 months of treatment. A treatment-induced decrease in GH and/or insulin-like growth factor 1 (ILGF-1) by at least 30% of their baseline values considered effective. The state of a tumor was evaluated by brain magnetic resonance imaging in 26 patients. Three month following Sandostatin LAR treatment, the median concentration of GH significantly decreased from 33.5 to 5.55 ng/ ml (p < 0.001) and later on it remained nearly at this level (5.1 ng/ml and 5.35 ng/ml after 6 and 12 months, respectively). The concentrations of ILGF -1 similarly changed: its median was 779 ng/ml at baseline, 390 (p < 0.001), 390, and 330 ng/ml after 3, 6, and 12 months, respectively. Following 12 months of treatment, there were reductions in GH levels in 52.2% of the patients (including a < 2.5-ng/ml reduction in 33.3% of the patients) in the concentration of ILGF-1 by more than 50% of the baseline values in 49.9% (including a complete ILGF-1 concentration normalization in 33.3%). Twelve months after treatment, there was a reduction in the size of a tumor in 38.4% of the patients (by an average of41.25±7.22% of the baseline volume) and its growth stabilization in 59.1%. The findings suggest that treatment with Sandostatin LAR in a dose of 20 mg Is an effective and safe treatment, leads to a significant reduction in the values of GH and IL GF-1 just 3 months after treatment, and controls hormonal secretion and tumor growth in most patients with acromegaly.