The results of a screening for carbohydrate metabolic disturbances depend on used diagnostic criteria and a study method: determi-nation of fasting blood glucose levels alone or use of an oral glucose tolerance test (OGTT). The results of a population-based screening among the adult populations of two districts of the Moscow Region (n = 2638), which involved OGTT in 2508 persons, were used to analyze the sensitivity (Se) and specificity of different screening models (developed by WHO, ADA, and IDF and several hypothetic models) and to estimate the prevalence of type 2 diabetes mellitus (DM-2), glucose intolerance (GI), and impaired fasting glycemia (IFG). Eight screening models were considered. Choice of a screening model sub-stantially was shown to affect the prevalence of DM-2, GI, and IFG, which is attributable to a varying sensitivity of the models in detecting carbohydrate metabolic disturbances. Screening using the 1999 WHO recommendations shows the highest sensitivity in detecting DM-2 and GI but the screening model in which plasma glucose is measured only after 75-g glucose load has the least one (Se = 0.80) in identifying DM-2. According to the ADA and IDF consensus, screening may considerable reduce the number of OGTTs by 43.5% without substantially affecting the sensitivity (Se = 0.96) in detecting DM-2.

The purpose of the Investigation was to study the efficacy and tolerability of Bivalos in the treatment of postmenopausal osteoporosis (OP) in women with type 2 diabetes mellitus (DM-2). Twenty-nine women with OP verified by the DEXA test at the age of above 50 years who had a postmenopause and a verified diagnosis of DM-2 were examined. After examination comprising the determination of blood calcium and phosphorus, glycated hemoglobin, glycemia on an empty stomach and two hours after a meal, testing with the European quality of life questionnaire EQ-5D, evaluation of the natural history of pain syndrome by a 100-ml visual analog scale, the patients were given osteoporosis therapy with Bivalos, 2g/day, Calcium D₃ ^Nikomed, 2 tablets daily. Reexamination was made following 12 months. A significantly higher bone mineral density was revealed in both the lumbar (by 6%) and distal (by 5.6%) segments of the femur. At the same time, there was a reduction in 85.7% of the patients with pain syndrome, the quality of life improved in 51.7% of the females. Bivalos was well tolerated by patients with DM-2; adverse reactions occurred rarely, regressed sufficiently rapidly, and required no drug discontinuance. The findings have led to the conclusion that the use of Bivalos is safe and effective in patients with comorbidity (postmenopausal OP and DM-2).

The study was undertaken to assess a role of repeated fine-needle aspiration biopsy (FNAB) in the diagnosis of cystically altered thyroid nodules and to attempt to find the clinical and ultrasound indicators of their malignancy. The study covered 112 patients (94 women and 18 men; their mean age was 43±1.59 years) with cystically altered thyroid nodules whose punctures provided scanty data to establish a cytological diagnosis. After the first FNAB, the nodule was unseen at ultrasonography and did not recur. Seventy-four patients underwent repeated FNAB that was informative in 58(78.38%) of them (it yielded materials enough for cytological study; the nodule was unseen at ultrasonography). Surgery was performed in 35 patients. Histological studies revealed thyroid cancer in б (17.14%) cases. Gender, age, the size of a nodule, and the color and volume of aspirated fluid did not differ in patients with benign nodules of the thyroid and in those with its cancer. The only sign of malignancy of a cystically altered thyroid nodule was its high fluid accumulation rate. Rapid fluid accumulation was detected in (83.33%) of the 6 patients with thyroid cancer and only in 5(29.41%) of the 17 patients with benign cystically altered thyroid nodules.

The aim of the present study was to characterize and assess the quantitative parameters of the basic spectrum of steroid hormones and their precursors circulating in the peripheral blood of obese women and to reveal differences in the ratio of glucocorticoids, min-eralocorticoids, and adrenal androgens in obesity complicated and uncomplicated by sustained hypertension. Thirty women with obesity were examined and divided into 2 groups: 1) those with obesity and arterial hypertension (AH); 2) those with obesity without AH. A control group comprised 14 apparently healthy normotensive individuals with normal body mass index. The serum concentrations of Cortisol, dehydroeplandrosterone and its sulfate, 17alfa-hydroxyprogesterone, 17alfa-hydroxypregnenolone, 11-deoxycortosol, corticosterone, and aldosterone were measured by the standardized radioimmunoassay. There was a steady sig-nificant increase in the concentrations of circulating aldosterone and cortlcosterone and a reduction in adrenal androgens and pre-cursors (11-deoxycortosol and 17-hydroxy derivatives). The changes in steroid secretion were more marked in hypertensive patients. The authors attempted to assess the activity of enzymatic systems of the concentrations of the study steroids. They found that the activities of 11betta- and 18-hydroxylase, 3-olsteroid dehydrogenase and sulfatase were increased whereas the activity of 21-hydroxylase was decreased and that of 17,20-desmolase (P₄₅₀c17) was in the normal range.

The aim of this investigation was to study the clinical and morphological characteristics of tumors at various sites in patients with A CTH-ectopic syndrome (ACTH-ES) in order to assess surgical results, to determine the hormonal activity of tumor cells, to establish a possible association between the level of proliferation, the expression of neoangiogenesis factors, cell adhesion, the size of tumor size, with its malignancy potential on the basis of the signs of invasive tumor growth and dissemination, and to explore the receptor expression of somatostatin tumors associated with ACTH-ES. Eleven patients with ACTH-ES surgically treated at the Endocrinology Research Center, Russian Agency for Medical Technologies, and the N. I. Pirogov National Medical Surgical Center for carcinoid tumors of the lung and bronchus, kidney, and thymus, and small-cell carcinoma of the lung. The development of secondary adrenal insufficiency was considered to be a criterion for adequate ACTH-ectopic tumor removal. The expression of ACTН and/or cortico-trophin-releasing hormone was revealed in the cells of ACTH-ES-assoclated tumors at various sites. No association was found between the proliferative activity (Ki-67), the expression of a marker of angiogenesis (CD31), proangiogenic growth factor (VEGF), cell ad-hesion (galectin-3), the size of tumors, and the morphological signs of tumor progression. The expression of different subtypes of somatostatin receptors suggests that somatostatin analogues should be used in recurrence or continued growth of ACTH-ectopic tumors.

Investigation of opportunities to affect the synthesis of collagen is of current importance to surgery as the synthesis of extracellular matrix collagen is the constituent of wound healing, which determines the rate and quality of tissue restoration. Growth hormone is one of the factors influencing the synthesis of the major protein of connective tissue - collagen. We have hypothesized that after making a subcutaneous wound, by impairing the basement membrane integrity, and by causing skin defect resolution, a recombinant human growth hormone (rh GH) preparation may affect the starting synthesis of an extracellular collagen matrix. An electric dermatome was used for partial skin thickness damage. The experimental animals - Wistar rats were randomized into two groups. The experimental group received subcutaneous rhGH injections (2.0 mg/kg) every day. The control group was daily given subcutaneous placebo injections. Wound tissue histomorphometry was used to estimate the area of the dermal fibrillary collagen network, the number of fascicles and the length of their perimeter and to calculate the volume of the fibrillary collagen network. There were both a statistically significant prevalence of collagen synthesis in the matrix of a wound on days 3, 6, 9 (66.55tl2.65, 64.23±7.19, and 65.74±8.I8) versus (51.32+- 14.85; 52.77+-2.41 , and 61.53±9.35), respectively, and signs of early mature connective tissue formation in the region of partial skin thickness damage in the rats receiving rh GH injections, which manifested as fewer collagen fibrils (156.23±5.53 and 166.14±4.24 to 143.34±2.90) as compared with the controlgroup (200.13±4.6S and 193.79+-.5.35 to I54.14±5.42, respectively).