This paper reports the results of research designed to study the possible predictors and the frequency of development of neoplasms in the thyroid gland and the gastrointestinal tract in the patients presenting with acromegaly. Special attention is given to the role of IGF-1 and IRI in the formation of tumours in the aforementioned organs and systems and the dependence of the frequency of their development on the patients’ age and (25)OH)D level. The detailed description of the features of the revealed thyroid and gastrointestinal neoplasms is presented.

The state of the blood antioxidant system in the patients presenting with acromegaly. The objective of the present study was to evaluate the total antioxidant activity (TAA) of blood plasma, the levels of non-protein thiols and 2-thyobarbituric acid-active products (TBA-AP), superoxide dismutase (SOD) and catalase (CAT) activities as well as ceruloplasmin (CP) level in the patients presenting with acromegaly. It was shown that plasma TAA and SOD activity in this patients was on the average 20 and 30% lower respectively than in the control subjects. At the same time, the TBA-AP and CP levels increased by 50 and 40% respectively. These data suggest the development of oxidative stress in the acromegalic patients.

Abdominal obesity is a major component of metabolic syndrome (MS) considered to be the key factor contributing to the development of testosterone deficiency (hypogonadism) in men. Bearing in mind the etiopathogenetic relationship between MS and urolithiasis (UL), the present study was undertaken for the purpose of elucidating the role of the main biochemical risk factors of metabolic syndrome in men, evaluating the influence of correction of hypogonadism on these factors, and optimization of the treatment and prevention of MS in these patients. The study included 90 men presenting with hypogonadism in whom the serum levels and renal excretion of the main lithogenic substances (uric acid, calcium, phosphates, magnesium) and urine pH were measured. At the first stage of the study, the patients were allocated to two groups. Group 1 was comprised of 52 patients with UL, group 2 consisted of 38 patients without UL. The patients of group 1 were found to suffer hyperuricemia (the serum uric acid levels 430 mcmol/l and higher). The patients of both groups exhibited hyperuricosuria (daily uric acid excretion over 4.13 mmol/24 hr) with the urine pH value of 5.5 and lower. The serum uric acid concentration was shown to positively correlate with the insulin and C-peptide levels. At the second stage of the study, 65 randomly selected patients were divided into two groups in one of which (n=40) they were given testosterone therapy. Compensation of hypogonadism in these patients was associated with a significant reduction of the serum uric acid levels and its daily excretion, an increase and normalization of urine pH, and a rise in the serum magnesium concentration, Similar significant changes of the same parameters were absent in the control subjects (n=25). Moreover, testosterone therapy improved characteristics of lipid and carbohydrate metabolism, caused reduction in the body weight, BMI, and the severity of insulin resistance.

The present study was focused on the assessment of electrophysiological, structural, and functional characteristics of the heart associated with ventricular rhythm disturbances in the patients with type 2 diabetes mellitus (DM2) suffering from diastolic cardiac insufficiency. The study involved a total of 128 patients with DM2 and coronary heart disease (CHD) exhibiting signs of functional class I-III chronic cardiac insufficiency and left ventricular ejection fraction over 50%. The patients were divided into three groups. Group 1 (n=55) included patients presenting with left ventricular relaxation. Group 2 (n=44) was comprised of the patients with the pseudo-normal type of diastolic dysfunction. Group 3 (n=29) consisted of the patients with restrictive diastolic dysfunction. The patients of the latter group were characterized by the high frequency of complicated forms of ventricular arrhythmia, such as Grade IV-V ventricular extrasystole (48.3%) and Grade III ventricular extrasystole (34.5%). Restrictive type of diastolic dysfunction was associated with the delayed fragmented activity in the end part of the ventricular complex in 72.4% of the patients. The close correlation between the left ventricular diastolic function and parameters of myocardial electrical remodeling was documented.

ACTH-ectopic syndrome in the patient with the primary site localized in the pancreas. A rare clinical case of ACTH-ectopic syndrome in the patient with the primary site localized in the pancreas is described.

There are presently no reliable methods for diagnostics of the early manifestations of the lesions in the peripheral nervous system. Only puncture biopsy of the skin and the nerves can be used at the preclinical stage. However, the application of these invasive methods is fraught with the risk of infectious complications. Confocal retinal microscopy is the new non-invasive morphometric technique that permits to reveal the early signs of the lesions in the peripheral nervous system and to study dynamics of the associated changes that can be used as a valid surrogate end point for the evaluation of the effectiveness of pharmacotherapy.

This paper concerns classification of obesity in the children and adolescents, one of the debatable issues in modern pediatrics and pediatric endocrinology. The historical sketch of various classifications of obesity in the children and adolescents accepted in this country and abroad is presented with special reference to the advantages and disadvantages of each variant. The authors emphasize the difficulty of developing a unified classification of the multifactor disease being considered. A new classification of obesity in the children and adolescents is proposed that takes into consideration the etiological aspects, complications, co-morbid conditions, and the degree of obesity. The possible variants of diagnosis formulation taking account of the present-day international classification of diseases are discussed.

The authors analyse the original and literature data concerning thienopyrimidine derivatives showing the activity of luteinizing hormone (LH) receptor agonists. These compounds are known to specifically interact with the allosteric site of LH receptors localized in the transmembrane channels and activate the LH-sensitive adenylate cyclase signal system. The thienopyrimidine derivatives were shown to stimulate steroidogenesis and ovulation both in vitro and in vivo by acting on the cells that have not only normal but also mutant receptors. The thienopyrimidine derivatives are believed to be efficacious inducers of ovulation in the women.

Charity program to help children with endocrine diseases «Alpha-Endo” is aiming to improve quality of medical care for children with endocrine pathology. The main directions of the Program include: molecular-genetic and immunological testing of hereditary endocrine diseases; improvement of health and social care for children; and obesity prevention. The best evidence-based Russian and international managerial strategies, and clinical practices of diagnostics, prevention and treatment of endocrine diseases are reviewed by experts and implemented within the Program. The synergistic cooperation involving the highly qualified Endocrinology Research Centre staff, significant financial resources “Alfa Group” and organizational support of CAF Foundation helps to solve difficult problems in pediatric endocrinology and improve welfare of children with endocrine diseases.

The present guidelines on diagnostics, differential diagnostics, and methods of treatment of Cushing’s disease have been developed by a group of Russian specialists.