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Vol 43, No 6 (1997)

Status and prospects of the fight against diabetes
Balabolkin M.I.
Abstract

Diabetes mellitus remains one of the important medical and social health problems of almost all countries of the world. The prevalence of diabetes in industrialized countries is 5-6% and has a tendency to increase. This is mainly due to the increase in patients suffering from non-insulin-dependent diabetes mellitus (NIDDM, type II diabetes). So, according to S. R. Kahn (1995), in the United States about 6-7% of the total population are patients with NIDDM. Calculations showed that in the case of an increase in the average life expectancy of up to 80 years, the number of patients with NIDDM will exceed 17% of the total population.

Problems of Endocrinology. 1997;43(6):3-9
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State register of diabetes mellitus: the prevalence of insulin-dependent diabetes and its complications
Dedov I.I., Suntsov Y.I., Kudryakova S.V., Ryzhkova S.G., Lisitsyn V.Y.
Abstract

The authors analyze the files of one territorial center of the State Register of Diabetes Mellitus, situated in the center of Moscow. Data on the incidence of insulin-dependent diabetes mellitus (IDDM) and its complications in adults as recorded for January 1, 1995, are discussed. In men the prevalence and incidence of IDDM is significantly higher than in women. The incidence of IDDM complications increases with the age of patients and duration of the disease. Organization of diabetes register appreciably improves medical statistical monitoring of the epidemiological situation with regard to diabetes, provides more complete information needed for planning and economic validation of diabetological service of public health, and helps define the strategy of primary and secondary prevention of the disease and the main trends of epidemiological research.

Problems of Endocrinology. 1997;43(6):10-13
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Pulmonary microangiopathy in patients with diabetes mellitus and tuberculosis
Karachunsky M.A., Panesek I.A., Stoilov L.D., Filippov V.P.
Abstract

Pulmonary biopsy was carried out in 30 patients with type I (insulin-dependent) diabetes mellitus during diagnostic bronchoscopy for pulmonary tuberculosis. Biopsy specimens collected at lung sites distant from the zone of tuberculous involvement were examined by routine histological methods and electron microscopy. Signs of microangiopathies (MAP) were detected in all the cases. These signe were moderate in 12 and extensive in 18 patients. The diabetic origin of MAP was confirmed not only by morphological, but by clinical data as well, namely, direct correlation with the duration and severity of diabetes and the severity of diabetic retinopathy and nephropathy. Pulmonary tuberculosis developing in the presence of manifest pulmonary MAP ran a more grave course and poorly responded to specific chemotherapy.

Problems of Endocrinology. 1997;43(6):13-17
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Conjunctival blood flow after endovascular laser therapy in patients with diabetic nephropathy
Grinshtein Y.I., Ivliev S.V., Osetrova N.B., Ilyenkov S.S.
Abstract

The conjunctival bloodflow was examined in patients with diabetic nephropathy with different status of renal function and changes in the microcirculatory bed assessed after endovascular laser therapy. Twenty-five donors and twenty-one patients with medium-severe and grave type I diabetes complicated by diabetic nephropathy were followed up. Microcirculatory disorders in the eyeball conjunctiva progressed as renal function deteriorated, which was evident from a reliable increase of the total conjunctival index in parallel with the progress of chronic- renal insufficiency. A course of endovascular laser therapy reliably improved the microcirculation: the arterio-venular coefficient increased and the total conjunctival index decreased in patients with latent and conservatively curable stages of chronic renal insufficiency due to normalization of vascular tone, boosting of the bloodflow, and decrease of red cell sludging.

Problems of Endocrinology. 1997;43(6):17-20
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The functional state of the thyroid system in pregnant women, women in childbirth and puerperas in Belarus
Iskritsky A.M., Sorokina S.E.
Abstract

The study was aimed at detecting the disorders and specific features in the function of the thyroid system in pregnant women, parturients, and puerperae in Byelorussia after the Chernobyl accident. Serum total thyroxin, total triiodothyronine, and thyroxin-binding globulin were radioimmunoassayed in 151 women. The concentrations of total thyroxin and total triiodothyronine were decreased during the second and at the beginning of the third gestation trimesters, these changes being most expressed in regions with radionuclide pollution, which are, in addition, intensive foci of endemic goiter. Insufficient intake of iodine under conditions of activated metabolism associated with pregnancy appears to be responsible for the functional changes in the thyroid system. Renewal of iodine prophylaxis is recommended for pregnant women living at territories contaminated with radionuclides.

Problems of Endocrinology. 1997;43(6):20-22
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Antithyroid immunity in children with endemic goiter
Svinarev M.Y., Lisenkova L.A., Shub G.M.
Abstract

Thyroid immunity is assessed in 246 children aged 6 to 16 living in a region with moderate iodine deficit (the Khvalynsk region of the Saratov district). A total of 203 children with endemic goiter of the first-third degree and 43 children with normal-sized thyroid were examined using the ultrasonic method, measurements of the blood levels of T3, T4, and TTH, estimation of the [(T3+T4)/TTH] index, and assessment of the urinary excretion of inorganic iodine. Serum autoantibodies to the microsomal antigen (MAg) and thyroglobulin (TG) were assayed by ELISA. Autoantibodies to MAg and/or TG were detected in 10.8%) of children with endemic goiter and 2.3%o of those without enlargement of the thyroid. The rate of detection of autoantibodies increases with age (p<0.05) and is parallel with increase in the size of the thyroid (up to 21.1%o in third- degree goiter, p<0.02). Autoantibodies were detected much more often in children with various echographically detected dijfuse changes in the thyroid structure (from 17.8 to 42.9%o vs. 8.6% in cases with the intact structure of the organ). Serum TTH level was reliably increased and the thyroid index decreased in “seropositive” children (p<0.01). The findings confirm the relationship between inadequate consumption of iodine and immunological reactivity of children and demonstrate certain regularities in the development of autoimmune disorders in children with endemic goiter.

Problems of Endocrinology. 1997;43(6):22-25
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Clinical and morphological features of “inactive” pituitary adenomas: a retrospective analysis of 95 cases
Kasumova S.Y., Vaks V.V., Kadashev B.A., Marova E.I.
Abstract

Ninety-five case histories of patients with “inactive ” pituitary adenoma are analyzed. These patients were operated on from 1977 to 1983, and the diagnosis was verified in them by histological, electron-microscopic, and immunohistochemical studies of the operation material. Clinical manifestations of the disease included a) neuroophthalmological symptoms; b) sexual disorders in men and women; c) pituitary insufficiency (hypogonadism, hypothyrosis, or hypocorticoidism); d) neurological and psychopathological symptoms. By the moment of the first manifestation of the symptoms the majority of patients were middle-aged. In older patients the disease starts with ocular and/or neurological disorders, in women under 50 and men under 55 years of age as a rule with sex disorders. Moderate hyperprolactinemia was detected in half of the patients, which in 30% of cases was associated with oligo-amenorrhea-galactorrhea often leading to hyperdiagnosis of prolactotrophic adenoma. In general, all types of inactive pituitary adenoma are chromophobic by their tinctorial properties, except oncocytoma, which is poorly eosinophilic in half the cases; electron microscopy showed zero-cell adenoma to be the most incident (40%) in the examined patient population.

Problems of Endocrinology. 1997;43(6):26-30
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Hyperuricemia as a component of metabolic syndrome X
Madyanov I.V., Balabolkin M.I., Grigorev A.A., Markov D.S., Oreshnikov E.V., Markova T.N.
Abstract

The authors analyze the results of epidemiological survey of a random sampling of population (n=594, aged 16 to 65, mean age 39.4±0.5 years). The study was aimed at elucidating the relationship between hyperuricemia and the principal symptoms of the metabolic X syndrome: obesity, arterial hypertension, hyperlipoproteinemia, hyperinsulinemia, and carbohydrate disorders of diabetic nature (impaired glucose tolerance and type II diabetes mellitus). Calculation of the association coefficient (Ka) showed that at the population level, hyperuricemia was definitely associated with arterial hypertension (Ka=0.46), type IV hyperlipoproteinemia (Ka=0.5), obesity with body weight index more than 30 kg/m2 (Ka—0.51), hyperinsulinemia (Ka=0.57), and carbohydrate disorders of diabetic origin (Ka=0.62).

 

Problems of Endocrinology. 1997;43(6):30-32
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Thyroid cancer
Bronstein M.E.
Abstract

The problem of thyroid cancer (thyroid cancer) is far from new, but until recently it was a general biological problem, part of its purely oncological aspect, in recent years it is one of the most urgent problems of both oncology and endocrinology, especially the practical sections of these industries medicine.

Problems of Endocrinology. 1997;43(6):33-37
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The effect of estrogen deficiency on rat ganglioside metabolism
Saatov T.S., Isaev E.I., Ergashova M.Z., Kukina O.Y., An A.P.
Abstract

The effect of estrogen insufficiency on the formation of gangliosides from precursors is studied. Oophorectomy changes the production of gangliosides in the heart, skeletal muscles, fatty tissue, and pancreas. Estrogen insufficiency is paralleled by decrease of cardiac monosialogangliosides G^j and GM3> skeletal muscle disialogangliosides GDlb and GDla and monosialogangliosides Gmi end Gmj, fatty tissue disialoganglioside GDlb and monosialogangliosides G^] and GM3> and pancreatic monosialoganglioside GMI. The findings indicate that estrogens can contribute to regulation of ganglioside metabolism.

Problems of Endocrinology. 1997;43(6):37-39
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The effect of chorionic gonadotropin on the functional activity of some populations of splenocytes
Shirshev S.V.
Abstract

Selective immunomodulating effects of high (50 IU/ml) and low (10 IU/ml) doses of chorionic gonadotropin (CG) on the functional activity of A cells and intact splenic T and В lymphocytes were revealed for the syngeneic transfer system. One- hour incubation of nonfractionated splenocytes with CG suppressed the formation of antibody-producing cells (APC) in le- thally irradiated syngeneic recipients. Removal of macrophages from the suspension of intact splenocytes arrested CG-induced immunosuppression and, in case of a low dose, activated the formation of APC. Addition of CG in a low dose to cell culture rich in В lymphocytes activated APC formation. A high dose of the hormone exerted no immunostimulating effect of this kind but selectively suppressed the function of T lymphocytes fractionated by fdtration through nylon fiber filters. Study of the functional activity of A cells by luminol-dependent chemiluminescence showed CG in the studied doses to suppress the generation of active oxygen forms, thus determining the key role of A cells as inducers of CG-dependent immunosuppression in a heterogeneous suspension of splenocytes.

Problems of Endocrinology. 1997;43(6):40-42
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Comparative evaluation of the inotropic effect of lipophilic and hydrophilic forms of 17P-estradiol and progesterone
Matyushin A.I., Karachentsev A.N., Isaev S.A., Mambetova A.Z.
Abstract

Changes in the contractility under the effect of lipophilic and hydrophilic 17^-estradiol and progesterone were studied on an isolated atrial auricula. The hydrophilic forms of female sex steroids possessed a higher cardiotropic activity than their lipophilic analogs. Lipophilic 17^-estradiol suppressed, whereas the hydrophilic form boosted the contractile function of the isolated rat atrium. Progesterone depressed cardiac contractility, no matter which forms were used.

Problems of Endocrinology. 1997;43(6):43-45
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Reviews
Pathogenesis, diagnosis and treatment of endocrine ophthalmopathy
Rodionova T.I.
Abstract

Endocrine ophthalmopathy (EO), or orbitopathy, is currently considered as a genetically determined independent autoimmune disease [38, 39]. At the same time, there is a close relationship between EO and autoimmune diseases of the thyroid gland (thyroid gland). In approximately 90% of cases, EO develops in patients with diffuse toxic goiter (DTZ), in 5% in patients with Hashimoto's autoimmune thyroiditis; in 5-10% of patients with EO, thyroid diseases are not detected [66]. The average age of patients with EA at the 1st visit to the doctor is 45-50 years and corresponds to the age of patients with DTZ; in children, EO develops rarely and proceeds, as a rule, in a mild form [51]. Smoking is considered a risk factor for the development of EO: among 85 EO patients, 53 (62%) smokers were found, and only 23% of the patients with DTZ without EO smoked [61, 66].

Problems of Endocrinology. 1997;43(6):46-51
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Autoimmune thyroiditis. - Bishkek, 1996 .-- 158 p. D. S. Rafibekov, A. P. Kalinin
Levit I.D.
Abstract

The monograph is dedicated to autoimmune thyroiditis (AIT), a “young” disease described 85 years ago. The problem is little developed, despite the wide spread of the disease throughout the world. Scientists and practitioners are generally new to her. Hence, on the one hand, the low detection rate of the disease, on the other hand, its overdiagnosis.

Problems of Endocrinology. 1997;43(6):51-52
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