The Impact of type 1 diabetes mellitus (DM-1), Including its late complications, on the utilization of major metabolic substrates during aerobic exercise was studied. A bicycle ergometic slowly increasing exercise test protocol was used in 123patients with DM-1 and 36 healthy volunteers. The ratio of fat/carbohydrate intake was estimated by Indirect calorimetry. During limbering-up, DM patients showed no metabolism transformation in response to the predominant use of fats, which was observed in healthy volunteers. With the further more strenuous exercise, there was a significantly ropider rate of utilization of carbohydrate sources in the maintenance of muscle contraction In patients with DM-1 irrespective of the severity of microangiopathy. In patients with DM-1, muscle tissue had a reduced ability to utilize fats during an aerobic exercise phase, which may Induced the accelerated uptake ofmyoglycogen, thus limiting exercise tolerance in this category of patients.

By taking into account the role of lipid peroxides in the development of atherosclerosis, the authors studied the time course of changes in the content of primary oxidized low-density lipoproteins (oxy-LDL) and secondary (malonic dialdehyde (MDA)) lipid peroxidation (LPO) products in LDL and the activity of antioxidative (АО) defense enzymes in 30 patients with type 2 diabetes mellitus (DM-2) before and during achieved compensation of carbohydrate metabolism, thereafter the patients were randomized to either a group receiving the antioxidant probucol in a daily dose of 1.0 g (n = 20) or a control group taking no antioxidant therapy (n = 10). With compensated carbohydrate metabolism, plasma LDL showed 30 and 40% reductions in oxy-LDL and MDA, respectively, and 2.2 and 1.3-fold increases in the activity of АО defense enzymes (superoxide dismutase and glutathione peroxidase), respectively. In the probucol group, there were a decrease in LDL oxygen demand by 77% of the baseline value and 45 and 6S% reductions in the LDL levels of oxy-LDL and MDA, respectively; such changes were not revealed in the control group. With administration of probucol, there was a drop in the HOMA-IR and 1SI indices, which directly correlated with the lower plasma LDL levels of oxy-LDL (r = 0.454; p < 0.05) and MDA (r = 0.549; p < 0.05). With the use of probucol, there was a rise in stimulated insulin secretion, which inversely correlated with the decreases in oxy-LDL (r = -0.4S9; p < 0.01) and MDA (r = -0.44; p < 0.05). The findings suggest that inclusion of the antioxidant probucol into the complex therapy for DM-2 not only reduces the risk of progressive atherosclerosis, but also results in diminished insulin resistance and increased secretory capabilities of betta-cells, facilitating better glycemic control.

The aim of the study was to investigate the electrophysiological features of poly fascicular atrioventricular (A V) conduction in patients with metabolic syndrome (MS). Sixty-twо patients in whom an AV-curve jump was revealed and/or А О nodal reentrant tachycardia (AONRT) could be induced during a transesophageal electrophysiological study. Of them 28 patients met the NCEP ATP criteria for MS (Croup 1); 34 had no signs of MS (Group 2). Group 1 showed reductions in the effective refractory period of the betta-pathway (300.3tl4.0 msec versus 310.6±16.3 msec; p - 0.01) and in the сиrvе jump (88.9+9.1 msec versus 95.6±12.6 msec; p = 0.02); there was no curve jump in half the cases. In this group of patients, AONRT was induced in the atypical fashion, it was more sustained and frequent showed frequent relapses and transformation to atrial fibrillation. The findings are attributable to the direct influence of MS on the stale of АО conduction.

The present study was undertaken to determine the reference values of thyroid-stimulating hormone (TSU) in a representative sample of healthy adolescents and to establish the prevalence of subclinical thyroid dysfunction in a mild Iodine-deficiency area (median Ioduria 53 mg/l). An integrated study, involving thyroid ultrasonography, determination of TSH and thyroid peroxidase Ab, was conducted in 1179 children (637 girls and 542 boys) aged 13-16 years in 23 localities of the Sverdlovsk Region. By taking into account the criteria recommended for the determination of the reference ranges of thyroid hormones, the authors formed a sample of 561 adolescents (271 boys and 290 females). The upper TSH range was 5.2 and 4.7 mIU/l for boys and girls, respectively. The established reference values of TSH show it inexpedient to reduce its upper range under the existing conditions of inadequate iodine intake, the prevalence of subclinical hypothyroidism in adolescents prevails over the incidence of subclinical thyrotoxicosis.

The authors examined the influence of a factor of late consequences of the Chernobyl atomic power station accident (CAPSA) and that of the age structure of a population on the increased prevalence of thyroid cancer (TC) in the regions of the Ukraine. Based on the data of 554 case histories and official statistic indicators, they calculated age-specific rates of morbidity and accumulated morbidity of TC in the Kharkov Region. There was a considerable rise in the prevalence of TC in all regions of the Ukraine over a period of I9S9 to 2004. Late CAPSA consequences have been shown not to influence the prevalence of thyroid cancer in the Ukraine's regions and the increased mean age of the population is a factor that contributes to the higher prevalence of TC in the population.

The diagnosis and treatment of oxyphillc-cell tumors (OCT) of the thyroid have been the subject of much controversy. The authors describe 11 years' experience in treating 159 patients with OCTs, of them there were 102(64%) adenomas, 15 (9%) follicular carcinomas, 38 (24%) papillary carcinomas, and 4 (2.5%) tumors of unknown malignancy potential. Among the follicular carcinomas, their miniinvasive forms were prevalent (11/15; 73%). The size of follicular carcinomas was significantly more than that of adenomas (36.5 vs 17 mm; p < 0.001) and that of widely invasive carcinomas was more than miniinvasive ones (50.5 vs 33 mm; p < 0.04). In papillary thyroid carcinoma, multiple foci were found in 3S%, extrathyroid invasion In 10%, and regional metastases in 36%. No distant metastases were detected in any of the patients with papillary or follicular carcinomas. OCT commonly developed in the presence of thyroiditis (papillary carcinoma in 74% of cases, adenoma in 40%, and follicular carcinoma in 33%). Multiple adenomas (12%) and a concomitance of adenomas and papillary carcinoma (20%) were frequently encountered. Surgical treatment was made as thyroidectomy (31%), hemithyroidectomy (64%), subtotal thyroidectomy (5%) supplemented by cervical fat excision (44%). Among 102 patients followed up for 6-126 months (median 24 months), a relapse was detected in 4 (4%) patients, including 3 patients with multifocal adenomas and associated papillary carcinoma after hemithyroidectomy (in the residual tissue (n = 3) and lymph node metastases (n = 2) and 1 patient after thyroidectomy (cervical lymph nodes). The clinical behavior of cancer arising from oxyphilic cells is similar to that of поп-oxyphilic cancer. Hemithyroidectomy suffices in solitary OCT without signs of extrathyroid invasion and regional or distant metastases. Thyroidectomy is recommended for multiple tumors because of the high relapse rate (33%) in residual tissue.

The paper reports the results of the Мoscow regional register of patients with acromegaly over 2005-2007. The register covers 70 patients (14 males and 56 females) (mean age 53.1 = 13.08 years (range 23-77 years), including 57 (81.4%) patients with an active phase of acromegaly. The interval from the onset of the first signs of acromegaly to its diagnosis was 5.85±5.79 years. Multiple complications of acromegaly were observed. The fasting level of growth hormone (GH) was normal in more than a third of the patients while the normal level of insulin-like growth factor I (ILGF-1) was obsened only in 5 (8.19%) of the patients with acromegaly, which suggests that ILGF-1 is of greater diagnostic value than fasting Gil. CH suppression in an oral glucose tolerance test enables the activity of the disease to be verified in individuals with normal fasting GH and ILGF-I levels. When entered into the register, 12.2% of the patients with active acromegaly received the present-day therapy with somatostatin analogues; 85.9% are currently taking this therapy.

The present paper pools the first experience with Bivalos used in therapy for postmenopausal (PM) osteoporosis (OP) in Russia. The main objective of this investigation was to study the impact of one-year Bivalos therapy on spinal bone mineral density (BMD). As secondary end points, the authors evaluated the effects of Bivalos on BMD of the femoral neck and femur as a whole, on the level of bone metabolic markers, the quality of life in patients with OP, and the tolerability of long-term therapy. The study covered 60 females aged 55 to 15 years who had PMOP treated in 3 Moscow medical centers (Endocrinology Research Center; Institute of Rheumatology, Russian Academy of Medical Sciences; N. N. Priorov Central Institute of Traumatology and Orthopedics) with 20 patients in each center. At 1 year of Bivalos use, there were significant increases of BND in the lumbar vertebrae by 4.68±4.94%, femoral neck by 2.0±4.29% and in the overall index of BMD in the proximal femur by 3.10±3.34%. Assessing the time course of changes in bone metabolism markers revealed a statistically significant increment in bone alkaline phosphatase by 19.5% and a reduction in C-terminal telopeptide collagen type 1 by 16.57c, which supports the heterodirectionai effect of Bivalos on osteogenesis and bone tissue. Bivalos therapy improved quality of life, extended motor activity, diminished depression, increased self-assessment, decreased the number of patients with spinal pain, relieved pain, and reduced the frequency of its occurrence. Bivalos was well tolerated; the incidence of adverse reactions was not greater than 15% and the drug discontinuance was required in 5% of cases. No serious side effects were observed. Despite the fact that an open-labeled uncontrolled clinical study had been conducted, our results were consistent with those of multicenter double-blind placebo-controlled studies in larger groups.

Type 1 diabetes mellitus in children and adolescents is characterized by marked lability of the course, as well as the difficulty in achieving compensation for carbohydrate metabolism. Sudden changes in glycemia during the day lead to the development of vascular complications. Features of adolescence (unwillingness to diet and regularly administer insulin “so as not to stand out among peers”) and the presence of the “morning dawn” phenomenon in adolescents lead to decompensation of diabetes mellitus and an increased need for insulin. An increase in the dose of insulin is one of the reasons for the development of hypoglycemic conditions. Rational insulin therapy allows not only to achieve normoglycemia, but also to avoid explicit and latent hypoglycemia and thereby prevent or slow the development of micro- and macrovascular complications.

Type 2 diabetes mellitus (T2DM) is characterized by impaired insulin secretion in the 0-cells of the pancreatic islets and a decrease in tissue sensitivity to this hormone. One of the causes of 0-cell deficiency is a violation of insulinotropic stimuli from the gastrointestinal tract. In recent years, a new direction in the treatment of T2DM has been developed, based on the use of the incretin effect, the essence of which is to stimulate the secretion of insulin by gastrointestinal hormones.

The widespread introduction of non-invasive imaging diagnostic methods into practice has led to a progressive increase in the number of incidentals - randomly detected formations of various localization, without clinical signs of the disease. Incidentalomas of the adrenal gland, pituitary gland, lungs, liver and other localizations are referred to as the so-called diseases of modern technology. The choice between active and wait-and-see tactics for patients with incidentalomas becomes a general medical problem.

Endocrine diseases characterized by excessive production of adrenocorticotropic hormone (ACTH) are associated with a heterogeneous group of pathological processes: Itsenko-Cushing's disease (BIC), whose morphological substrate is corticotropinoma or corticotrophic hyperplasia, and ACTH-ectopic syndrome (ACTH-EC, present in most cases) cases of bronchopulmonary carcinoids and, less commonly, small cell lung cancer (SCLC). The clinical picture of these diseases, despite the variety of underlying pathological processes, is similar. The transnasal transsphenoid pituitary adenomectomy is the treatment choice method for patients with NIR. However, after surgical treatment in 17-20% of cases, relapse develops or tumor growth continues. For ACTH-ES, the method of treatment choice is surgical removal of the tumor. The prognosis of treatment depends on the degree of malignancy of the tumor.