Thе aim of the investigation was to study the urinary excretion of insulin-like growth factor 1 (ICF-1) and vascular endothelial growth factor (VEGF) at different stages of nephropathy in 57 patients with type 1 diabetes, including 22 patients with normal albuminuria, 23 with microalbuminuria, and 12 with proteinuria. The excretion of IGF-1 and VEGF was increased in the microalbu-minuric and proteinuric patients as compared with the controls (1GF-1: p = 0.004 and p = 0.00005; VEGF: p = 0.06 and p = 0.02). That of growth factors inversely correlated with glomerular filtration rates and hemoglobin levels (IGF-1: r = -0.43 and r = -0.41; VEGF: r = -0.14 and r - -0.27). In the normo- and microalbuminuric patients, IGF-1 excretion was associated with the thickness of glomerular and tubular basement membranes (r = 0.59 and r = 0.53, respectively) and with the number of podocytic foot processes (r = -0.69). VEGF correlated with the volume of the mesangium (r = 0.69) and the thickness of the glomerular basement membrane (r = 0.53). IGF-1 rather than VEGF positively correlated with HbA_1c (r = 0.47 and r = 0.02). It has been concluded that in patients with type I diabetes, the increased urinary excretion of IGF-1 and VEGF is associated with the development of nephropathy and may be used for the early diagnosis of this complication.

Туре 2 diabetes (T2D) is frequently detected too late just after development of complications requiring expensive treatment. The costs of drugs used for the treatment of diabetic complications are much greater than the funds allocated for diabetes management. The purpose of the study was to assess the impact of timely diagnosis and early initiated treatment of T2D on the total costs of the treatment. Direct and indirect costs of the treatment of the disease and its complications, using the Atakarov model with 5% annual allowance, were estimated. It was determined that with well-timed diagnosis of T2D), the total costs per patient cold be reduced by 1736 Litas or about 503 Eros (1 Euro = 3.452S Litas) over 5 years and over 10 years it would be saved even 1712 Euros. Not only indirect costs would be reduced. A total of 700 Euros would be saved per patient over 5 years and 2045 Euros over years. With the improved diagnosis of T2D and the well-timed diagnosis in at least 50% of cases of diabetes mellitus could save 10.05 million Euros over 5 years and even 34.23 million Euros over 10 years. The timely diagnosis of the disease and its proper management would prolong the life of a patient with T2D by 2.67 months over 10 years. That of T2D saves the costs of its treatment and care and can prolong the patient's life.

The efficacy and safety of a combination of ultrashort acting insulin aspart (Novorapid) with determir (Levemir) and glargin (Lantus) versus the traditional NPH-insulin (Protafan) used in basal bolus therapy were evaluated in 112 children and adolescents with type 1 diabetes 12 and 24 weeks after treatment. According to the type of basal insulin, the patients were divided into 3 groups. A significant decrease in HbA_1c levels was revealed in the group of detemir-treated patients. The analogues of basal insulin significantly reduced the risk of hypoglycemias, by simultaneously improving the quality of glycemia control. Their use could cause a significant decrease in the fasting plasma level of glucose, by completely refusing 6.00 extra insulin doses. In the detemir group, the daily dose was increased, by lowering the amount of basal insulin. The dose of dietary insulin underwent changes in the glargin group. Body mass index remained unchanged in the detemir group over 24 weeks of treatment.

Thirty-eight patients with diffuse toxic goiter (Graves' disease) were treated with radioiodine. Before ¹³¹I therapy thyrotoxicosis compensation was achieved by antithyroid medication in all the patients. Antithyroid medication was discontinued 10 days before radioiodine treatment. After its withdrawal, the use of lithium carbonate successfully prevented the development of thyrotoxicosis before ¹³¹I therapy. The administration of the agent caused a reduction in the proportion of patients with thyrotoxicosis 1.5 months after ¹³¹I therapy. Lithium carbonate used 10 days before and 4 days after ¹³¹Itherapy exerted the most considerable effect, by reducing the volume of the thyroid gland. By month 3, hypothyroidism more promptly developed in lithium carbonate-untreated patients; by month 6, the rate of different treatment outcomes (hypothyroidism, euthyroidism, or thyrotoxicosis) did not virtually depend on any lithium carbonate treatment regiment.

The purpose of the study was to determine the influence of various factors on the prediction of surgical treatment for differentiated thyroid carcinoma (TC). The long-term results of surgical treatment were studied in 266 patients with differentiated forms of TC who had been operated on at the Surgical Department of the Endocrinology Research Center in 2000-2003. To solve the put problem, the authors identified the following factors that may influence the prediction of surgical treatment for differentiated TC forms, as shown by the data available in the literature; these included gender, age, the morphological characteristics and size of a tumor, the scope and procedure of surgical intervention, the presence of metastases, postoperative radioactive iodine therapy, and suppressive levolhyroxine therapy. The investigation established the most important/actors significantly influencing the prediction of surgical treatment for differentiated TC forms. It showed the high probability of metastases being in the cervical VI lymph nodes unchanged, as evidenced by preoperative ultrasound study. The optimal algorithm was developed for the treatment of patients with differentiated TC forms - thyroidectomy, by removing fat and lymph nodes of the VI-level neck in combination with radioactive iodine therapy and suppressive L-T₄ therapy

Determination of thyroid-stimulating receptor antibodies (TSRA) a promising criterion for discontinuation of antithyroid drug therapy; however, such studies are extremely limited in childhood. The purpose of this investigation was to establish the prognostic value of TSRA on discontinuing antithyroid drug therapy in children with Craves' disease (CD). At the moment of therapy discontinuation, the level of TSRA was higher than the reference range in 15 of 31 children; there were very high values in 2 cases of hypothyroidism that preserved after discontinuation of antithyroid drug treatment. After omitting these cases while making an analysis, the authors ascertained that a relapse developed in 12 of the 13 children and following 3 months CD remission occurred in 1 case. Recurrent thyrothoxicosis occurred in 7 of the 16 patients with normal values of TSRA and 9 children were at remission. Analysis of a ROC-curve revealed that in children having a TSRA level of > 1.95 IU/l at the discontinuation of antithyroid drug therapy, the risk for recurrent thyrotoxicosis is 100% within the first year.

То study a role of hemodynamic and humoral factors in the development of arterial hypertension and myocardial hypertrophy, 20 and 21 patients with acromegalia were examined before and in the late periods after radical surgical treatment, respectively, for growth hormone-producing pituitary adenoma. The patients underwent blood pressure and central hemodynamic measurements, echocardiography, and some hormones testing at rest and after antiorthostatic tests and exercises. In patients with acromegalia, arterial hypertension occurring in the late postoperative periods was ascertained to be associated with higher vascular resistance, exhausted depressor prostaglandin system, impaired aldosterone and Cortisol reactivity, and insulin hypertension. Concentric left ventricular hypertrophy with diastolic dysfunction persisted in most patients long after surgery being maintained by hypertension and hyperin-sulinemia. Exercise tests indicated the impaired endocrine system responsiveness and diminished cardiac performance due to cardiosclerosis.

This article was prepared on the basis of the presentations of the co-authors at the plenary and breakout sessions of the V Congress of Endocrinologists in Moscow. These reports provided up-to-date information on the state of the problem of eliminating iodine deficiency diseases (IDD), and also discussed a number of controversial scientific aspects of the control and prevention of IDD.

The reproductive system implements the fundamental biological function of preserving and maintaining the process of life. Gametogenesis provides reproduction of the whole organism, and steroidogenesis, through the influence of sex hormones on the process of gene transcription, is involved in the cell reproduction of private protein substances in this organism. Reproduction is the main and most complex property of life.

The concept of physiology and pathology of the sex glands described in this work is based on a synthesis of facts and principles of fundamental biomedical sciences with the results of our own clinical studies on the etiopathogenesis of disorders of male reproductive function, on understanding the relationships between the sexual and hormon-secreting cells in gonads from the perspective of the general biological role and ontogenesis of the sexual systems, theories of functional systems. The productive subordination of sex and somatic cells (without it any life is impossible in general biological terms) can be clearly seen during ontogenesis both in physiology and in the genesis of genital gland dysfunction.

This article is a continuation of the discussion on the standards of the upper limit of the norm for the level of TSH in the blood, open on the pages of both foreign and domestic journals.

Diabetic neuropathy (DN) is one of the most common complications of diabetes mellitus (DM). Most clinical and population studies indicate that its prevailing form is distal symmetric, affecting about 30% of patients with diabetes. The main clinical manifestation of this form of DN is a decrease (up to a complete loss) of sensitivity, which is either not recognized by the patient or is perceived as numbness, loss of any sensations in the lower extremities. At the same time, in a relative minority of patients, the leading symptom in the DN clinical presentation is pain, which, in some cases, reaches high intensity, disrupts working ability, daily activity, and sleep.

Primary hyperaldosteronism (PHA) is a clinical syndrome that develops as a result of the excessive production of aldosterone by the adrenal cortex and manifests itself as low-corinine hyperaldosteronemia in combination with arterial hypertension (AH). To date, there is no single universally accepted classification of PHA. Most often they use classification according to the nosological principle.

On May 21, 2007, a meta-analysis was posted on the website of one of the most respected medical journals in the world, New England Journal of Medicine, which attracted close attention of not only healthcare professionals, but also the general public, and caused an active discussion on leading clinical journals and in the media.

The purpose of this meta-analysis, which included 42 relatively short-term (24–53 weeks) clinical trials, including 2 large ones, DREAM (A Diabetes Outcome Prevention Trial) and ADOPT (Diabetes Reduction Assessment with Ramipiril and Posiglitazone), was to assess the effect of rosiglitazone on the risk of myocardial infarction and death from cardiovascular disease. The participants in the studies were about 28 thousand patients with T2DM, of which 15,560 received treatment regimens containing rosiglitazone, and 12,283 (control group) received placebo or regimens containing other antidiabetic drugs (metformin, sulfonylurea derivatives, mainly glibenclamide, or insulin).

According to the results of meta-analysis, the use of rosiglitazone was associated with a significantly higher cardiovascular risk than the use of placebo and other hypoglycemic agents (see table). The risk of developing myocardial infarction in the rosiglitazone therapy group exceeded that in the control group by 43%, and the risk of death from cardiovascular causes by 64%.

The staff of the Endocrinology Research Center, the editorial board of the journal "Problems of Endocrinology" mourn and express deep condolences to the relatives of Tatyana A. Kravchenko, who left us.