Experienced multivalent surgeons are well aware that any operation has its own Achilles heel. In surgery for cholelithiasis, this is a risk of damage to the bile duct, in surgery for varicose veins - the femoral vein, in surgery for the colon and rectum - the ureter, in cardiac surgery - the ascending aorta, and in surgery for the thyroid gland - the recurrent laryngeal nerve.

This review analyzed information on the effect of manifest and subclinical thyrotoxicosis on the bone system of adults.

The causes and characteristics of the pathogenesis of various background, precancerous processes and cervical cancer have not been fully studied, and research in this area is currently ongoing. Nevertheless, the role of certain factors of the external and internal environment that have a direct impact on the development of cervical pathology is firmly defined.

The development of modern pharmacology cannot be imagined without the use of genetic engineering methods (recombinant DNA technology). The success of medicine is increasingly based on the active use of protein preparations obtained using the technology of transferring hereditary information (genes) from one organism to another.

The emergence of the ability to express foreign genes in the cells of various organisms (both eukaryotes and prokaryotes) has become one of the revolutionary events in the science of the last two decades of the 20th century and laid the foundations of modern biotechnology.

Over the past 10 years, the results of epidemiological studies in different countries indicate an increase in the incidence of type 1 diabetes mellitus (DM) among children. According to IDF, currently 430,000 children with diabetes are registered in the world. Annual growth is 3%. In 2003, 65,000 new cases of diabetes were reported. In the Russian Federation, epidemiological studies have begun relatively recently. In 1996, the State Register of SD (GDSD) was created. Monitoring of the main epidemiological indicators of type 1 diabetes in the children's population of the Russian Federation is an integral part of the organization of medical and preventive care for children. GDSD allows you to objectively assess the epidemic situation in Russia, individual federal districts and regions located in different geographical areas, to assess the quality of the provision of medical and preventive care to children, to predict the incidence rate and to plan measures aimed at improving the effectiveness of the children's diabetes service. Since 2001, the Institute of Pediatric Endocrinology of the State Research Center of the Russian Academy of Medical Sciences has been analyzing the incidence and prevalence of type 1 diabetes in children in the Russian Federation using specially designed questionnaires.

Diabetic nephropathy has long been attributed to non-immune and non-inflammatory lesions of the kidneys, considering metabolic and hemodynamic factors to be the main reason for its development. However, in recent years, the effect of inflammation on the development of diabetic nephrosclerosis has been established. This served as the basis for the further development of the concept of the pathogenesis of diabetic nephropathy, the development of methods for its diagnosis and treatment.

Today we know a lot about violations of the hypothalamic-pituitary-adrenal system in diabetes mellitus. The purpose of the review is an attempt to present the results of some studies and summarize many years of research experience in this direction.

The new requirements for the design of manuscripts is due to the desire to follow global trends in the development of evidence-based medicine. The requirements, which may be updated in the future, have been developed taking into account the “Uniform requirements for manuscripts submitted to biomedical journals” compiled by the International Committee of Medical Journal Editors.

The effectiveness and safety of the new Russian drug Rastan^® (recombinant human growth hormone) were evaluated in children with growth hormone deficiency (GHD) and Turner's syndrome (TS). An open-labeled clinical study of the drug was performed in 35 children with GHD or TS. The main efficacy criteria were growth changes and yearly calculated height velocity; the secondary criteria were changes in height SDS and IGF-1 and IGFBP-3 levels. Rastan^® was subcutaneously injected daily for 6 months; the dose of the drug being 0.033 mg/kg in GHD and 0.05 mg/day in TS. All enrolled 35 patients completed the study. During the study, the patients' growth significantly increased in all the patients (P < 0 0001), in those with GHD (P < 0.0001) and TS (P < 0.0001). Height SDS statistically significantly increased in all the patients (P < 0.0001) and in the GHD (P < 0.0001) and TS (P < 0.0001) groups. Over 6 months of therapy, the average estimated height velocity was 12.4±3.76 cm/year. There were 2-3-fold increases in lower baseline IGF-1 and IGFBR levels. The advene reactions were mild and required no drug discontinuation. Rastan^® was effective and well tolerated in patients with GHD or TS.

Forty-eight patients with diffuse toxic goiter (Graves's disease) were treated with radioactive iodine in a dose of 5.3-30.0 mCi. A special formula considering the volume of the thyroid and post-24-hour capture of the diagnostic activity of radioactive iodine was used to calculate the optimum therapeutic activity. As a result, specific therapeutic activity (S_TA) correlated with specific activity and with the volume of thyroid. The high rate (33.3%) of recurrent thyrotoxicosis was observed when the calculated S_TA was less than 0 3 mCi/ml and reduced to 11.1% if a greater activity was applied. The use of the standard activity of radioactive iodine (10mCi) with a thyroid volume of up to 40 ml, as compared to that calculated by the formula results in the similar rate of ineffective radioiodine therapy for thyrotoxicosis at a lower incidence of euthyrosis.

The comparative studies revealed a considerable increase in free radical oxidation (FRO) processes in patients with compensated and decompensated hypothyroidism. In patients with decompensated hypothyroidism, the rate of FRO processes was 2.26 times higher than that in those with compensated hypothyroidism (p<0 05). In the patients with compensated hypothyroidism, there was a positive correlation between the fast plasma chemiluminescence flash (FPCF) and the plasma levels of triglycerides (r = +0.82) and low-density lipoproteins (r - +0.69) whereas in the patients with decompensated hypothyroidism, there was a positive correlation between FPCF and the plasma levels of cholesterol (r = +0.41). In vitro and ex vivo studies provided evidence suggesting the antioxidative properties of lipoic acid preparations (thioctacidum) diminishing FPCF by 46-70% in both groups of patients with hypothyroidism.