Hyperprolactinemia associated with intake of neuroleptics (HAN) is a commonest endocrine disorder encountered in psychiatric practice. Approaches to the treatment of this condition remain to be developed. It is supposed that the use of dopamine receptor agonists may cause deterioration of the patients' psychic status. We have studied the influence of therapy with cabergolin on 44 patients presenting with HAN. It was shown that the long-term treatment using cabergolin is a safe and efficacious therapeutic modality for the patients suffering from psychic disorders. The frequency of exacerbation of psychic disorders in the group of patients treated with cabergolin was lower than in the control group. It is concluded that the correction of HAN by cabergolin in the patients presenting with psychic disorders leads to the significant improvement of reproductive and sexual functions.

According to foreign data somatotropinoma volume reduction was noted more than at a half of the patients receiving somatostatin analogs within 12 months as the first line of acromegaly treatment, however there is no data about tumor-supp ressive effect of Octreotid-depot. We assessed somatotropinoma volume during Octreotid-depot treatment in patients with an active acromegaly, and also tried to indentify possible predictors of tumor volume reduction during somastatin analogs treatment. Open prospective study include 18 patients with acromegaly (16 women, 2 men, age from 22 till 76 years old); after non-radical adenomectomy (n=5) and as first line of treatment (n=13). Patients received Octreotid-depot continuously within 12 months. Brain MRI was carried out before and after 12 months of Octreotid-depot therapy. Change of tumor volume for ≥20% from initial was interpreted as "significant". The GH level ≤2,5 ng/ml and the normal IGF-1 level were noted in 7 (38,9%) patients; GH ≤;2,5 ng/ml either the normal IGF-1 level, or simultaneous decrease in the GH and IGF-1 levels more than 50% from initial - in 8 (44,4%) patients, absence of effect from treatment - in other 3 cases. Significant tumor volume reduction was found in 12 (66,7%) of 18 cases, and degree of reduction varied from 23 to 97% (median 42% [38; 74%]); stabilization of the a tumor volume - in 5 (28%) patients; insignificant change of the sizes of a tumor (-7% and +12,5%) in other 2 patients. It wasn't revealed essential correlations between degree of tumor volume reduction and the GH and IGF-1 levels before and after somatostatin analog treatment, and also initial tumor volume.

Postoperative hypocalcemia is a most frequent complication following thyroidectomy in the patients presenting with non-toxic multinodular goiter. It may require long-term hospitalization, additional treatment, a large number of analyses, and frequent visits to outpatient facilities. The objective of the present study was to identify the predictors of postoperative hypoparathyroidism for the prevention of the development of hypocalcemia and its medicamental correction. The clinical data were collected prospectively during the period from October 2011 till May 2013. A total of 140 patients were available for the observation after thyroidectomy performed for the management of non-toxic multinodular goiter. Indications for the surgical intervention included cervical compression syndrome and a cosmetic defect. The patients were divided into two groups depending on the serum calcium level in the postoperative period. Group 1 (n=45) was comprised of the patients having the serum calcium level 2.00 mmol/l or lower, group 2 (n=95) included the patients showing the serum calcium level above 2.00 mmol/l. In addition, serum 25(OH) vitamin D and parathyroid hormone (PTH) levels were measured in all the patients pre- and postoperatively. The preoperative 25(OH)D level and postoperative calcium and PTH levels in the patients of group 1 were significantly lower than in group 2 (p=0.001). It was shown that the main prognostic factors of postoperative hypocalcemia are the preoperative 25(OH)D level below 15 ng/ml (p<0.001), postoperative PTH level below 10 pg/ml (p=0.01), and the age above 50 years (p=0.01). It is concluded that in the majority of the patients the age, the low serum 25(OH)D level in the preoperative period, and the low postoperative PTH level are significantly related to the development of postoperative hypocalcemia.

Objectives. We examined the level of persistence (remaining on therapy) and compliance (taking the medication according to directions) and its impact on the effectiveness of therapy in patients with postmenopausal osteoporosis (PMO) treating with combination medication containing 70 mg alendronic acide and 2800 IU colecalciferol - Fosavance under the supervision of medical practitioners. Material and methods. The trial was performed in the form of 2-year prospective observational multicenter study that included 373 patients with PMO aged 40-88 years, initiated therapy with Fosavance under the supervision of 20 physicians had their medical practice in Moscow (18) or Moscow region (2). Patient compliance and persistence with therapy assessed every 6 months for 2 years, the effectiveness of treatment evaluated in 2 years on the dynamics of bone mineral density (BMD) and indicators of quality of life (QOL) by the SF-36 scale. Results. 70.2% of recruited in the study PMO patients prematurely stopped therapy with Fosavance, including 41% - in the first 6 months. Among the patients who dropped out, 42.7% were lost to follow by medical practitioners, 28.6% switched to another drug therapy, 19.1% had no money to buy medication. 22.5% from 111 women who continued treatment after 2 years were non-compliant due to the high cost of therapy (52%), optionality with the purchase of the drug at the pharmacy (28%) or taking pills (16%), or lack of medication in the pharmacy (4%). There were no statistically significant differences in BMD change in compliant (CP) and non-compliant patients (NCP) in lumbar spine, trochanter and total proximal femur in 2 years. But the increase in femoral neck BMD was higher in CP vs. NCP (Δ=1.97% [-1.41; 13.3] and Δ=-2.03 [-10.4 5.20], p=0.0267). CP had greater increase in QOL by SF-36 scoring at role-physical functioning (Δ=5 points [0; 25] at CP vs. Δ=0 points [-50; 0] at NCP, p=0.0195), role-emotional functioning (Δ=50 points [0; 84] and Δ=0 points [-100; 0] respectively, p=0.0001) and social functioning (Δ=13 points [-13; 25] and Δ=-13 points [-25; 0] respectively, p=0.0048). Conclusions. Low adherence to Fosavance negative impact on the effectiveness of treatment PMO and QOL. At the initiation of therapy it's requires close interaction between the doctor and the patient, maintaining patients on regular treatment motivation and selection of the drug taking into account convenience of the reception.

Gonadotoxic side effects of antipsychotic agents are known to cause serious disturbances in both germinative and endocrine testicular functions. The hormonal activity of the testes undergo undulating changes whereas the germinative function progressively decreases from the onset of neuroleptic therapy. The morphological and functional disturbances in the testicles are especially well pronounced after 10 years of antipsychotic treatment. The morphofunctional changes in the ovaries become apparent from the very beginning of antipsychotropic therapy; they are indicative of the progressive impairment of reproductive and endocrine functions of the female gonads.

Aim. To elucidate the character of the relationship between gestational body weight gain (GBWG) and carbohydrate/lipid metabolism during pregnancy. Material and methods. This prospective cohort study enrolled 85 women with full-term sigleton pregnancy in the absence of signs of diabetes mellitus or severe somatic pathology including 15 ones with subnormal GBWG, 35 with excessive GBWG, and 36 with recommended GBWG. Detection of gestational body weight gain, carbohydrate tolerance test, measurement of baseline and stimulated insulin secreation, lipidograms obtained in the first, second, and third trimesters. Results. The biochemical profile in the patients with pathological GBWG has the following peculiarities in comparison with that of the women with recommended GBWG during pregnancy. The women with excessive GBWG in the second and third trimesters are characterized by enhanced levels of baseline and stimulated insulin secretion, high HOMO-IR index and LDLP concentration (p<0.05). The women with subnormal GBWG in the first trimester have a higher fasting blood glucose level whereas in the third trimester both fasting glycemia and insulin concentration in response to standard carbohydrate loading decrease to below the respective normal values (p<0.05). The biochemical and hormonal characteristics of carbohydrate and lipid metabolism undergo secondary changes following body mass variations. Conclusion. The results of this study show that changes in sensitivity to insulin are in all probability the consequence of pathological enhancement of body mass rather than its cause.

We have undertaken a cohort study of 659 mother-child pairs for the determination of the prevalence and main risk factors of excessive body mass in the children of an Azerbaidjan population aged from 2 to 5 years. The anthropometric calculations were carried out as recommended by the relevant WHO program (Antro). The results of the study give reason to estimate the prevalence and risk factors of excessive body mass in the population of interest at 16.1%. The frequency of excessive body mass in the children delivered via Cesarean section was thrice that in the naturally born children; it was associated with the body weight at birth over 4000 grams and the start on solid foods before the age of 4 months. No relationship was documented between the mode of feeding and excessive body weight after the age above 2 years.

Acromegaly is frequently associated with the development of colon and thyroid cancer. Stomach cancer concomitant with this pathology is a rare form of tumorigenic complications of acromegaly. The present paper reports a 33 year-old woman with verified diagnosis of acromegaly characterized by enhanced serum IGF-1 and GH levels and the presence of pituitary microadenoma confirmed by the MRT study (2006). The patient was many times advised to undergo neurosurgical treatment that she flatly refused. The patient was regularly treated with sandostatin and dopamine agonists. In 2008, the patient began to complain of uncomfortable feeling in the epigastric region and was examined in the ultrasound study of the abdominal cavity and small pelvis organs. She was found to develop ascites and bilateral ovarian tumour. By way of preparing for the surgical treatment of ovarian cancer, the patient underwent gastroscopy that revealed infiltrative ulcers in the stomach. The histological study of gastric biopsies gave evidence of gastric signet ring cell carcinoma while the bilateral ovarian tumour turned out to be Krukenberg's metastases.

The overwhelming majority of the pituitary tumours are benign adenomas that remain a serious challenge to endocrinologists and neurosurgeons by virtue of great variety of their early manifestations, the impossibility to predict the neoplastic growth, and the influence exerted on the patients' quality of life. Most pituitary adenomas are sporadic tumours and only few of them develop in the framework of hereditary syndromes. The present review is focused on the variants of hereditary syndromes with special reference to various pituitary neoplasms. The molecular and genetic studies revealed several genetic defects that are believed to contribute to the formation of pituitary adenomas. Moreover, a few genes were identified responsible for the development of hereditary forms of pituitary tumours. Identification of such genes and pathogenetic mechanisms underlying the development of pituitary microadenomas is of paramount importance for the improvement of their diagnostics and treatment that in its turn may promote the understanding of pathogenesis of sporadic adenomas and improve their prognosis.

Insulin is traditionally the main application point on which all methods for the management of type 2 diabetes mellitus are targeted. One of the new strategies for the treatment of this pathology utilizes sodium-dependent glucose transporter-2 (SGLT-2) inhibitors transforms this approach making kidneys the new point of application of antidiabetic therapy. SGLT-2 functions as a tunnel built into the epithelial wall of the initial segment of the proximal tubules in the nephron. When the channel is open, glucose is filtered into primary urine and can be reabsorbed in the proximal tubule. Based on this observation, the pharmaceutical companies began to search for the chemical substances that could be used to close the SGLT-2 tunnels and thereby interfere with the reverse flow of glucose from urine to blood, i.e. stimulate glycosuria. During the last decade, a few alternative molecules have been synthesized capable of selective inhibition of SGLT-2. At present, two of them, dapagliflozin and canagliflozin, are approved for the clinical application.

Shereshevsky-Turner syndrome is a chromosomal pathology related to partial or complete monosomia. Characteristic manifestations of this condition include growth retardation, sexual infantilism, and various inborn anomalies of the physical development. The present recommendations present information on etiology of this disease, its pre- and postnatal diagnostics, protocols of relevant studies and treatment of the patients belonging to different age groups.