The present study included a total of 22 patients (44 eyes/orbits) presenting with endocrine ophthalmopathy (EOP) and Graves' disease. All of them underwent routine ophthalmological examination. The activity and severity of EOP were verified in accordance with the EUGOGO recommendations. The MRI protocol included obtaining T1-, T2-weighted, and STIR sequence images of the orbits. quantitative measurement of signal intensity (SI) from extraocular muscles (EOM), and the signal intensity ratio of EOM to ipsilateral temporal muscle (SIR value). The study has revealed the relationship of the minimal, maximum, and average EOM SI with EOP activity and severity. Moreover, it demonstrated direct correlation between SIR and clinical activity of EOP. It is concluded that MRI of the orbits with STIR sequence in the patients suffering EOP provides the additional criteria for the verification of the activity and severity of the disease as well as for prognostication of the response to the immunosuppressive treatment.

The high prevalence of diseases associated with the disturbances in the renin-angiotensin-aldosterone system (RAAS) including those affecting the children dictates the necessity of the development and application of highly specific, accurate, and sensitive indices. One of them widely used at present is plasma renin activity (PRA). Meanwhile, foreign researchers have demonstrated significant correlation between PRA and direct renin concentration that can be determined by a technically simpler and readily available method. We are unaware of the studies with the application of this approach reported in the Russian-language publications. The present work was designed to consider the possibility of using direct rennin levels and PRA for monitoring health conditions of the children presenting with congenital adrenal cortical hyperplasia. PRA and direct rennin concentrations were determined with the use of the relevant assay kits in 72 patients admitted to the Pediatric Department of Endocrinological Research Centre. Group 1 was comprised of 44 patients presenting with congenital adrenal cortical hyperplasia (CAH), group 2 consisted of 28 patients with the presumably unaffected adrenal function. Direct rennin concentrations and PRA are known to have virtually identical diagnostic value, i.e. they can equally well be used to diagnose disorders of RAAS functions including those in the patients with CAH. However, the measurement of direct rennin permits to more precisely detect hyperaldosteronism and identify children exhibiting symptoms of mineralocorticoid overdose. The patients with the supposedly normal functioning adrenal glands were also found to show high percentage of abnormal PRA values and direct rennin levels which suggests the relationship between the functions of RAAS and other endocrine organs.

The present study included a total of 96 patients with long-lasting type 1 diabetes mellitus (DM1) and early (0-5) stages of chronic renal disease (CRD). Replacement renal therapy (RRT) consisted of programmed hemodialysis (PHD) and kidney transplantation (KT). Routine clinical examination was supplemented by the assessment of phosphorous and calcium metabolism indices, measurement of cardiac pathology markers, and studies of coronary artery calcification with the use of multispiral computed tomography (MSCT) of the heart with the calculation of the Agatston score index. It was shown that the impairment of the renal function was accompanied by a rise in the phosphorus, parathormone, and FGF-23 levels, increased vitamin D deficiency (with a slight deviation of its levels from the reference values in the patients at high risk of cardiovascular events treated with PHD). In the patients who had undergone KT and showed fairly good function of the renal transplant, the above parameters were similar to those of the patients with stage 0-4 CRD which suggested their normalization in case of adequate RRT during DM1. The progress of cardiovascular pathology with the deterioration of the renal function was manifested as an increase of NT-proBNP levels in parallel to the duration of CRD (r=0.304; p<0.05), decrease of the glomerular filtration rate (p=-0.540; p<0.05), and their significant correlation with the main characteristics of mineral homeostasis. The degree of coronary artery calcification was related to the patients' age, duration of DM1, and severity of arterial hypertension. The high Agatston score index and pronounced left ventricular hypertrophy in the patients following KT are supposed to reflect the irreversible character of certain cardiovascular lesions persisting despite optimal RRT and positive dynamics of phosphorus and calcium metabolism and NT-proBNP levels. It is concluded that the development and progression of renal dysfunction are associated with the disturbances of mineral and bone metabolism that promote further progress of cardiovascular pathology that is the main cause of mortality among this cohort of patients.

The present study included patients presenting with type 2 diabetes mellitus (DM2) of less than 10 years in duration having the HbA1c levels between 7.0% and 10.0%. They were treated with insulin detemir (once or twice daily) in combination with oral hypoglycemic agents (OHGA) and transferred thereafter to therapy with insulin glargine (Lantus, SoloSTAR) administered once daily. The patients were advised to adjust the dose of insulin glargine in order to achieve the desired fasting blood glucose level (FBGL) below 5.6 mmol/l. The HbA1c levels and FBGL, insulin doses, body weight, frequency of hypoglycemic episodes and adverse reactions were measured within 3 and 6 months after inclusion in the study; simultaneously, the patients and doctors' satisfaction with the treatment was estimated. A total of 915 patients were available for the examination (mean age 57.9±9.2 years, mean duration of DM2 5.9±2.3 years, average BMI 31.0±5.1 kg/m2). The number of the patients presenting with the HbA1c levels below 7% within 6 months after the onset of therapy amounted to 46.5% of the total. During the same period, percentage of the patients experiencing nocturnal and daytime glycemic episodes decreased. No cases of severe hypoglycemia were documented. Moreover, the body weight of the patients somewhat decreased (by 0.9±2.9 kg; p<0.001) by the 6 month. The majority of the patients and their doctors reported the effects of described therapy as "good" or "very good". It is concluded that the substitution of the treatment with insulin detemir in combination with OHGA by therapy with insulin glargine in the patients with DM2 and suboptimal glycemic control under conditions of the routine clinical practice may improve the quality of glycemic control without a substantial body weight gain and with the low frequency of hypoglycemic episodes.

Therapy with bisphosphonates (BP) is recognized to be "the golden standard" for the treatment of osteoporosis of different etiology. However, the data on the use of BP by the women during pregnancy and lactation are scarce. This paper reports a case of gestation, labour, and lactation in a patient treated with ibandronic acid (Bonviva) for severe steroid-induced osteoporosis attributable to Cushing's disease. To our knowledge, the application of ibandronic acid during pregnancy has never been described in the literature before. The present study has demonstrated that therapy with ibandronic acid does not necessarily require the interruption of pregnancy or cessation of birth feeding. Nevertheless, the treatment of the women of reproductive age with BP can be prescribed only upon strict indications.

The present review is focused on epidemiology, clinical picture, and principal methods for laboratory and topical diagnostics of insulinomas. Results of the comparative analysis of Russian-language and foreign publications concerning sensitivity and specificity of various methods of topical diagnostics, postoperative complications and lethality from insulinomas are presented.

The authors present the data on the prevalence of malignant tumours of the thyroid glands, gastrointestinal tract, mammary glands, prostate, and testicles in the patients presenting with acromegalia. The possible mechanisms of the development of neoplasms in the patients with acromegalia and immunological characteristics of the tumours in the patients with acromegalia are discussed.

In the second part of the review, devoted to treatment of azoospermia by micro-TESE in program IVF/ICSI, there were considered issues of hormonal preparation of patients with non-obstructive azoospermia (NOA) prior to the course of GnRH, chorionic and menopausal gonadotropin treatment. Sperm retrieval efficiency increases after stimulation of spermatogenesis 6 months. Identification of additional factors such as FSH, AMH, and Inhibin B in blood serum and seminal plasma can provide more accurate prognosis of the outcome of micro-TESE. High level of FSH is not a contraindication for microsurgical sperm retrieval in men with NOA. Neither level of FSH nor testicular volume is related to the effectiveness of operation. Molecular genetic markers of residual spermatogenesis (ESX1, VASA and CLU genes) can serve as predictors of successful sperm retrieval during micro-TESE in patients with NOA. In the review there were also considered advantages of microdissection technique, technique of operation performance (including embryological stage of detection of spermatozoa in testicular tissue), and efficiency of micro-TESE depending on pathological patterns and complications after surgery.

The author considers the mechanisms of development of insulin resistance during pregnancy.

The present review encompasses the data from the Russian-language and foreign publications. Diabetes mellitus (DM) is currently considered to be a global socio-medical, psychological, and economic problem due to the high frequency of vascular complications resulting in early invalidization of the patients. Encephalopathy (EP) is one of the most severe complications of DM leading to the substantial deterioration of the quality of life. Both the markers and the diagnostic criteria of EP remain to be determined. Certain neurospecific proteins are believed to be predictors of this pathology.

The incidence of hypoglycemia remains rather high among the population of patients with type 2 diabetes mellitus (DM2) especially in those treated with the traditional oral hypoglycemic agents. Hypoglycemia is one of the most frequent adverse events encountered by a physician dealing with diabetic (DM2) patients. At the same time, the novel approaches are currently available that allow this clinical condition to be avoided.